Clinical Impact of Preoperative Albumin-Bilirubin Status in Esophageal Cancer Patients Who Receive Curative Treatment

Abstract

Background/Aim: The albumin-bilirubin (ALBI) score, which evaluates the perioperative liver function, was developed, and had a clinical impact on both the short-and long-term oncological outcomes in some malignancies. We evaluated the clinical impact of preoperative albuminbilirubin status in patients with resectable esophageal cancer who received curative treatment. Patients and Methods: The study included 121 patients who underwent curative surgery followed by adjuvant chemotherapy for esophageal cancer between 2005 and 2018. The risk factors for overall survival (OS) and recurrence-free survival (RFS) were identified. Results: Based on the 3-and 5-year OS rates, we set the cutoff value for the ALBI score at -2.7. Eighty patients were classified into the ALBI-low group (ALBI score <-2.7), 41 patients were categorized into the ALBI-high group (ALBI score >-2.7). The 3-and 5-year OS rates were 62.2% and 53.2%, respectively, in the ALBI-low group, and 42.2% and 35.2% in the ALBI-high group. There was a significant difference in OS (p=0.0113). The 3-and 5-year RFS rates were 43.1% and 40.3%, respectively, in the ALBI-low group and 37.7% and 26.1% in the ALBI-high group. There was a significant difference in RFS (p=0.048). When comparing the perioperative clinical course between the ALBI-high and ALBI-low groups, the incidence of postoperative anastomotic leakage was 46.3% (19/41) in the ALBI-high group, and 27.5% (22/80) in the ALBI-low group (p=0.038). Conclusion: The ALBI status had a clinical impact on both OS and RFS in esophageal cancer patients. Therefore, ALBI may have potential application as a prognostic factor for esophageal cancer patients.

Analysis of the albumin‐bilirubin score as an indicator of improved liver function among hepatitis C virus patients with sustained viral response after direct‐acting antiviral therapy

“…This ability of ALBI to discriminate liver function in patients without cirrhosis could be useful in clinical practice (and should be assessed prospectively) in several scenarios such as the baseline evaluation and later monitoring of liver function in noncirrhotic patients submitted to liver resection, under therapies with potential impact on liver function (for instance, oxaliplatin or irinotecan chemotherapy for cancer patients), with liver metastasis from any cancer, and others. [24][25][26] Moreover, our results also support the possibility that ALBI could be used to estimate noninvasively the degree of fibrosis and differentiate cirrhosis from non-cirrhotic stages, as recently suggested. 23 This study has some limitations.…”

Novel prognostic score based on the preoperative total bilirubin-albumin ratio and fibrinogen-albumin ratio in ampullary adenocarcinoma

“…However, Feng et al [ 19 ] demonstrated that baseline bilirubin and serum proteins were not associated with the prognosis of advanced pancreatic cancer. Instead, a Japanese study indicated that a low albumin-bilirubin (ALBI) grade is related to better OS and RFS in esophageal cancer patients[ 20 ]. AC will directly affect the biliary tract, and the presence of jaundice can predict malignant ampullary strictures[ 21 ]; thus, their disease may be diagnosed at an earlier stage.…”

The Association of Albumin-Bilirubin (ALBI) Grade with Mortality Risk in Trauma Patients with Liver Injuries

“…Patients who died had a significantly lower ALBI score than those who survived (2.8±0.4 vs 3.4±0.7, p < 0.001). Patients who died had a significantly lower GCS score (median [Q 1 -Q 3 ]; 8 [3][4][5][6][7][8][9][10][11][12][13] vs 15 [14][15], p < 0.001) but higher ISS (median [Q 1 -Q 3 ]; 33 [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] vs 20 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], p < 0.001) than the surviving patients.…”

“…[21][22][23][24][25][26][27] Patients with cholangiocarcinoma, 28 intrahepatic cholangiocarcinoma, 29 pancreatic cancer with liver metastases, 30 colorectal cancer with liver metastases, 31 and primary biliary cholangitis 32 can all benefit from knowing their ALBI grade as a prognostic indicator. Additionally, other non-hepatological disorders, including aortic dissection, 33 heart failure, 34,35 acute pancreatitis, 36 lung cancer, 24,37,38 esophageal cancer, 39 gastric cancer, 40 lung cancer, 41 and medulloblastoma, 42 have shown a high correlation between ALBI and death.…”