JOURNAL of
ONCOLOGICAL
SCIENCES

ORIGINAL RESEARCH ARTICLE

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
Doi: 10.37047/jos.2020-77649 - Article's Language: EN
J Oncol Sci. 2020;6(3):133-40
This is an open access article under the CC BY-NC-ND license
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.
KAYNAKLAR
  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. [Crossref]  [PubMed] 
  2. Smyth EC, Verheij M, Allum W, Cunningham D, Cervantes A, Arnold D; ESMO Guidelines Committee. Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27(suppl 5):v38-v49. [Crossref]  [PubMed] 
  3. Sitarz R, Skierucha M, Mielko J, Offerhaus GJA, Maciejewski R, Polkowski WP. Gastric cancer: epidemiology, prevention, classification, and treatment. Cancer Manag Res. February 2018;10:239-248. [Crossref]  [PubMed]  [PMC] 
  4. Gravalos C, Jimeno A. HER2 in gastric cancer: a new prognostic factor and a novel therapeutic target. Ann Oncol. 2008;19(9):1523-1529. [Crossref]  [PubMed] 
  5. Johnson PJ, Berhane S, Kagebayashi C, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade. J Clin Oncol. 2015;33(6):550-558. [Crossref]  [PubMed]  [PMC] 
  6. Hiraoka A, Michitaka K, Kumada T, et al. Validation and potential of albumin-bilirubin grade and prognostication in a nationwide survey of 46,681 hepatocellular carcinoma patients in Japan: the need for a more detailed evaluation of hepatic function. Liver Cancer. 2017;6(4):325-336. [Crossref]  [PubMed]  [PMC] 
  7. Lee PC, Chen YT, Chao Y, et al. Validation of the albumin-bilirubin grade-based integrated model as a predictor for sorafenib-failed hepatocellular carcinoma. Liver Int. 2018;38(2):321-330. [Crossref]  [PubMed] 
  8. Hiraoka A, Kumada T, Kudo M, et al; Real-Life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics). Albumin-bilirubin (ALBI) grade as part of the evidence-based clinical practice guideline for HCC of the Japan Society of Hepatology: a comparison with the liver damage and child-pugh classifications. Liver Cancer. 2017;6(3):204-215. [Crossref]  [PubMed]  [PMC] 
  9. Abdel-Rahman O. Prognostic value of baseline ALBI score among patients with colorectal liver metastases: a pooled analysis of two randomized trials. Clin Colorectal Cancer. 2019;18(1):e61-e68. [Crossref]  [PubMed] 
  10. Demircan NC, Köstek O, Gökyer A, et al. The albumin-bilirubin (ALBI) grade as a significant prognostic factor in colorectal cancer patients with liver metastases. J Surg Med. 2019;3(12):841-844. [Crossref] 
  11. Kanda M, Tanaka C, Kobayashi D, et al. Preoperative albumin-bilirubin grade predicts recurrences after radical gastrectomy in patients with pT2-4 gastric cancer. World J Surg. 2018;42(3):773-781. [Crossref]  [PubMed] 
  12. Miwa T, Kanda M, Tanaka C, et al. Albumin-bilirubin score predicts tolerability to adjuvant S-1 monotherapy after curative gastrectomy. J Gastric Cancer. 2019;19(2):183-192. [Crossref]  [PubMed]  [PMC] 
  13. Liu BZ, Tao L, Chen YZ, et al. Preoperative body mass index, blood albumin and triglycerides predict survival for patients with gastric cancer. PLoS One. 2016;11(6):e0157401. [Crossref]  [PubMed]  [PMC] 
  14. Chen J, Zhou Y, Xu Y, Zhu HY, Shi YQ. Low pretreatment serum globulin may predict favorable prognosis for gastric cancer patients. Tumour Biol. 2016;37(3):3905-3911. [Crossref]  [PubMed] 
  15. Xue F, Lin F, Yin M, et al. Preoperative albumin/globulin ratio is a potential prognosis predicting biomarker in patients with resectable gastric cancer. Turk J Gastroenterol. 2017;28(6):439-445. [Crossref]  [PubMed] 
  16. Sun J, Chen X, Gao P, et al. Can the neutrophil to lymphocyte ratio be used to determine gastric cancer treatment outcomes? A systematic review and meta-analysis. Dis Markers. 2016;2016:7862469. [Crossref]  [PubMed]  [PMC] 
  17. Szor DJ, Dias AR, Pereira MA, et al. Prognostic role of neutrophil/lymphocyte ratio in resected gastric cancer: a systematic review and meta-analysis. Clinics (Sao Paulo). 2018;73:e360. [Crossref]  [PubMed]  [PMC] 
  18. Li S, Xu X, Liang D, Tian G, Song S, He Y. [Prognostic value of blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with gastric cancer]. Zhonghua Zhong Liu Za Zhi. 2014;36(12):910-915. [PubMed] 
  19. Sun K, Chen S, Xu J, Li G, He Y. The prognostic significance of the prognostic nutritional index in cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol. 2014;140(9):1537-1549. [Crossref]  [PubMed] 
  20. Hirashima K, Watanabe M, Shigaki H, et al. Prognostic significance of the modified Glasgow prognostic score in elderly patients with gastric cancer. J Gastroenterol. 2014;49(6):1040-1046. [Crossref]  [PubMed] 
  21. Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. December 2010;9:69. [Crossref]  [PubMed]  [PMC] 
  22. Crumley AB, Stuart RC, McKernan M, McMillan DC. Is hypoalbuminemia an independent prognostic factor in patients with gastric cancer? World J Surg. 2010;34(10):2393-2398. [Crossref]  [PubMed] 
  23. Sun H, He B, Nie Z, et al. A nomogram based on serum bilirubin and albumin levels predicts survival in gastric cancer patients. Oncotarget. 2017;8(25):41305-41318. [Crossref]  [PubMed]  [PMC] 
  24. Kogevinas M, Porta M. Socioeconomic differences in cancer survival: a review of the evidence. In: Kogevinas M, Pearce N, Susser M, Boffetta P, eds. Social Inequalities and Cancer. IARC Scientific Publications No: 138. Lyon: International Agency for Research on Cancer; 1997:177-206.
  25. Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ. Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. Br J Cancer. 2004;90(9):1704-1706. [Crossref]  [PubMed]  [PMC] 
  26. Digklia A, Wagner AD. Advanced gastric cancer: Current treatment landscape and future perspectives. World J Gastroenterol. 2016;22(8):2403-2414. [Crossref]  [PubMed]  [PMC] 
  27. Van Cutsem E, Kang Y, Chung H, Shen L, Sawaki A, Lordick F. Efficacy results from the ToGA trial: a phase III study of trastuzumab added to standard chemotherapy (CT) in first-line human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer (GC). J Clin Oncol. 2009;27(18_Suppl). [Crossref]