Prognostic Effect of Albumin-Bilirubin Grade on Survival in Advance Gastric Cancer Patients with de-novo Liver Metastasis
Received Date : 24 Jun 2020
Accepted Date : 01 Sep 2020
Available Online : 29 Sep 2020
Ahmet KÜÇÜKARDAa, Ali GÖKYERa, İvo GÖKMENa, Osman KÖSTEKb,Muhammet Bekir HACIOĞLUa, Sernaz UZUNOĞLUa, Bülent ERDOĞANa, İrfan ÇİÇİNa
aDepartment of Internal Medicine, Division of Medical Oncology, Trakya University Faculty of Medicine, Edirne, TURKEY
bClinic of Medical Oncology, Edirne State Hospital, Edirne, TURKEY
Doi: 10.37047/jos.2020-77649 - Article's Language: EN
J Oncol Sci. 2020;6(3):133-40
ABSTRACT
Objective: We aimed to explore the prognostic effect of albumin-bilirubin scores on survival prior to the treatment of patients
with gastric cancer with de-novo liver metastasis. Material and Methods: Retrospective screening was conducted on 203 patients who were
followed up in our clinic. Two different models have been developed to compare the effect of albumin and bilirubin alone based on the albumin-
bilirubin score. Albumin and bilirubin values in Model 1 and albumin-bilirubin grade in Model 2 were included in multivariate analysis.
Results: Median age of the patients was 63, and 78.8% of the study population was male. There were 57 (28.1%) patients in the
albumin-bilirubin grade 1 group, 95 (46.8%) patients inthe albumin-bilirubin grade 2 group, whereas, 51 (25.1%) patients in the albumin-bilirubin
grade 3 group. Median progression-free survival accordingto albumin-bilirubin grades 1-2-3 was8.9 (6.1-11.6) months, 4.2 (2.8-5.5)
months, and 0.9 (0.7-1.2) months, respectively (p<0.01). In univariate analysis, poor prognostic effects of high albumin-bilirubin grade were
reflected in bothprogression-free survival and overall survival. Multivariate analyzes revealed that in model 1; albumin <3.5 gr/dL and bilirubin
>1.2 gr/dL values were prognostic for both progression-free survival and overall survival. In model 2, albumin-bilirubin grade was an independent
prognostic factor for progression-free survival and overall survival. {[H 3.45 (1.98-6.02)] in progression-free survival and [H 4.41
(2.45-7.93)] in overall survival for albumin-bilirubin grade 3}. Conclusion: High albumin-bilirubin score (grade) is much more sensitive as
compared to low albumin and high bilirubin values alone in showing poor prognosis on progression-free survival and overall survival in patients
with gastric cancer with liver metastasis.
Keywords: ALB protein; bilirubin; gastric cancer; prognosis