ORIGINAL RESEARCH ARTICLE
Initial Albumin-Bilirubin Grade as a Prognostic Indicator of Pancreatic Cancer with Liver Metastasis
Received Date : 26 Nov 2021
Accepted Date : 05 Jan 2023
Available Online : 24 Jan 2023
Seval AYa, Muhammed Mustafa ATCIb, Rukiye ARIKANc, Özgecan DÜLGARa,Deniz TATAROĞLU ÖZYÜKSELERd, Mahmut GÜMÜŞa
aDivision of Medical Oncology, İstanbul Medeniyet University Faculty of Medicine, İstanbul, Türkiye
bClinic of Medical Oncology, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, Türkiye
cDivision of Medical Oncology, Marmara University Faculty of Medicine, İstanbul, Türkiye
dClinic of Medical Oncology, İstanbul Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, Türkiye
Doi: 10.37047/jos.2021-87242 - Article's Language: EN
J Oncol Sci.
ABSTRACT
Objective: Pancreatic cancer (PCa) is the fourth leading cause of cancer-related deaths. Thus, there is a need for prognostic indicators
that can aid in disease classification and subsequent selection of appropriate treatment options. Albumin-bilirubin (ALBI) grade,
which is calculated using a logarithmic formula, is indicative of liver function. The present study evaluated the prognostic performance of the
initial ALBI grade for metastatic PCa in patients receiving first-line chemotherapy. Material and Methods: In this retrospective study, the
medical records of 114 patients with de novo liver metastatic PCa and unresectable liver metastasis were evaluated. The ALBI grade was calculated
using the formula (log10 bilirubin × 0.66) + (albumin × -0.085), and based on the grade, patients were divided into 3 groups, namely,
ALBI Grade 1, ≤-2.60; ALBI Grade 2, between −2.60 and -1.39; and ALBI Grade 3, ≥-1.39. Results: Median progression-free survival (PFS)
was 13 months [95% confidence interval (CI), 7.3-18.6]. The estimated PFS was 16 months for ALBI Grade 1 (95% CI, 13.0-20.4), 8 months
for ALBI Grade 2 (95% CI, 7.5-9.9), and 5 months for ALBI Grade 3 (95% CI, 4.3-5.6). Median overall survival (OS) was 11 months (95%
CI, 9.0-12.9). The estimated OS was 18 months for ALBI Grade 1 (95% CI, 14.4-21.5), 9 months for ALBI Grade 2 (95% CI, 7.8-10.1), and
6 months for ALBI Grade 3 (95% CI, 4.1-7.8; p<0.001). Conclusion: The initial ALBI grade demonstrated outstanding performance as an
independent prognostic factor in PCa patients with liver metastasis.
Keywords: Pancreatic cancer; liver metastasis; albumin-bilirubin grade; prognostic indicator; progression-free survival; overall survival
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