Preoperative Albumin-Bilirubin Grade as a Useful Prognostic Indicator in Patients With Pancreatic Cancer

Abstract

Background: The albumin-bilirubin (ALBI) grade assesses the severity of liver dysfunction in patients with hepatocellular carcinoma. Herein we investigated the prognostic significance of the combination of the ALBI grade with serum carbohydrate antigen 19-9 (CA 19-9) concentration, the most frequently used tumor marker in pancreatic cancer (PC) in resected patients with PC.

Materials and methods: Included patients (n=100) had a histopathological diagnosis of pancreatic cancer and underwent pancreatectomy. Serum concentrations of albumin, bilirubin, and CA19-9 were measured within 5 days before surgery. Patients were divided into groups with high and low CA19-9 (cut-off ≥35 U/ml) and ALBI grade (2 and 3 vs. 1).

Results: The 5-year overall survival (OS) rates of the ALBI^High and ALBI^Low groups were 21.6% and 35.3%, respectively (p=0.015). The 5-year OS rates of the CA19-9^High and CA19-9^Low groups were 22.2% and 41.5%, respectively (p=0.017). Patients were divided into groups A (ALBI^High and CA19-9^High), B (ALBI^High and CA19-9^Low or ALBI^Low and CA19-9^High), and C (ALBI^Low and CA19-9^Low). The 5-year OS rates of groups A, B, and C were 13.8%, 31.0%, and 43.3%, respectively (p=0.0006). Multivariate analysis revealed that the ALBI grade combined with the CA19-9 concentration, served as an independent prognostic indicator.

Conclusion: The combination of ALBI grade and CA19-9 concentration predicted the prognosis of patients with PC.

Keywords: Albumin; albumin–bilirubin grade; bilirubin; pancreatic cancer; prognosis.