Preoperative albumin–bilirubin score as a prognostic indicator in patients with stage III colon cancer
Hyun Gu Lee, Seok‐Byung Lim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Jin Cheon Kim
Abstract
Abstract The albumin–bilirubin (ALBI) score was created to assess the severity of liver dysfunction and to predict prognosis of hepatocellular carcinoma. Purpose of this study was to investigate the prognostic value of the ALBI score in patients with stage III colon cancer using propensity score matching (PSM) analysis. This study analyzed 510 patients with stage III colon cancer who had surgery between 2014 and 2015. The ALBI score was calculated as follows: (log 10 bilirubin (μmol/L) $$\times$$ <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mo>×</mml:mo> </mml:math> 0.66) + (albumin (g/L) $$\times$$ <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mo>×</mml:mo> </mml:math> −0.0852), and the optimal cut-off value was determined using a receiver operating characteristic analysis and the Youden Index. According to the calculated cut-off value, patients were divided into two groups: Group A (ALBI ≤ − 2.54) and Group B (ALBI > − 2.54). The average ALBI score was − 2.68 (from − 3.39 to − 0.69). Group A had a significantly higher 5-year disease-free survival rate (85.5% vs 75.7%, p = 0.02), 5-year cancer-specific survival rate (93.7% vs 84.4%, p = 0.02), and 5-year overall survival rate (90.6% vs 77.4%, p = 0.01) than Group B. High ALBI scores were found to be an independent risk factor for both disease-free survival (HR 1.68, p = 0.048) and cancer-specific survival (HR 2.24, p = 0.028). The preoperative ALBI score was found to be a promising prognostic indicator for predicting recurrence and survival in patients with stage III colon cancer in this study. Because the ALBI score is simple and inexpensive to obtain, it has the potential to be a useful clinical marker for colon cancer patients.