Assessment of the albumin-bilirubin score in breast cancer patients with liver metastasis after surgery

Li Chen; Chunlei Tan; Qingwen Li; Zhibo Ma; Meng Wu; Xiaosheng Tan; Tiangen Wu; Jinwen Liu; Jing Wang

doi:10.1016/j.heliyon.2023.e21772

Assessment of the albumin-bilirubin score in breast cancer patients with liver metastasis after surgery

Heliyon. 2023 Oct 30;9(11):e21772. doi: 10.1016/j.heliyon.2023.e21772. eCollection 2023 Nov.

Authors

Li Chen^{1

2}, Chunlei Tan³, Qingwen Li⁴, Zhibo Ma⁴, Meng Wu⁴, Xiaosheng Tan⁴, Tiangen Wu⁵, Jinwen Liu¹, Jing Wang²

Affiliations

¹ Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, PR China.
² Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, PR China.
³ Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, PR China.
⁴ Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Key Laboratory of Organ Transplantation, Ministry of Education, NHC Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, Hubei 430030, PR China.
⁵ Department of Hepatobiliary&Pancreatic Surgery, Zhongnan Hospital of Wuhan University,Wuhan, Hubei, 430071, PR China.

Abstract

Objective: This study aims to investigate the potential prognostic value of albumin-bilirubin (ALBI) score in breast cancer patients with liver metastasis after surgery.

Methods: This was a retrospective study of 178 breast cancer patients with liver metastasis after surgery. ALBI score was calculated by the following formula: (log10 bilirubin × 0.66) - (albumin × 0.085). The optimal cutoff value of ALBI score was assessed by X-tile. The clinical influence of ALBI score on survival outcomes using Kaplan-Meier method, Log-rank test, Cox proportional hazards regression model. The calibration curves, decision curve analysis and time-dependent ROC curve were used to assess the predictive performance of the nomogram's models.

Results: The classifications of 178 breast cancer patients with liver metastasis after surgery were as follows: low ALBI score group (＜-3.36) vs. high ALBI score group (≥-3.36). The Cox proportional hazards regression model indicated that ALBI score was a potential predictor. Kaplan-Meier survival curve performed that the median disease free survival (p = 0.0029) and overall survival (p＜0.0001) in low ALBI score group were longer than in high ALBI score group. The ALBI-based nomograms had good predictive performance.

Conclusions: The ALBI score has high prognostic ability for survival time in breast cancer with liver metastasis after surgery. These models will be valuable in discriminating patients at high risks of liver metastasis.

Keywords: Albumin; Albumin-bilirubin grade; Bilirubin; Breast cancer; Liver metastasis.