Skip to main content

Advertisement

SpringerLink
Log in

Prognostic Value of a Modified Albumin–Bilirubin Score Designed for Patients with Esophageal Squamous Cell Carcinoma After Radical Resection

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The albumin–bilirubin (ALBI) score was originally developed to assess the severity of liver dysfunction in patients with hepatocellular carcinoma and has subsequently been used as a prognostic marker for that disease. Here, we examined the value of the preoperative ALBI score as a prognostic marker for patients with esophageal squamous cell carcinoma (ESCC) after radical esophagectomy.

Methods

We retrospectively analyzed data from 449 patients who underwent curative resection for ESCC. The ALBI score was calculated as (log10 serum bilirubin [μmol/l] × 0.66) + (serum albumin [g/l] × − 0.0852). Receiver operating characteristic curve analysis was used to define a preoperative modified ALBI (mALBI) score for patient stratification.

Results

Of the 449 ESCC patients, 232 and 217 were assigned to mALBI Grade 1 or Grade 2 groups based on preoperative ALBI scores of ≤ − 3.33 or > − 3.33, respectively. Preoperative mALBI grade was significantly associated with age, excessive alcohol consumption, squamous cell carcinoma antigen level, and clinical disease stage. The mALBI Grade 2 group had significantly shorter disease-specific and recurrence-free survival than the mALBI Grade 1 group. Multivariate analysis demonstrated that mALBI Grade 2 was an independent prognostic factor for disease-specific survival (hazard ratio 1.86, 95% confidence interval 1.18–2.93, P = 0.0074). In most subgroup analyses, mALBI Grade 2 was associated with a greater risk of disease-specific death.

Conclusions

mALBI grade serves as a simple and useful prognostic marker for disease-specific survival in patients with ESCC after radical esophagectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7–34.

    Article  Google Scholar 

  2. Huang FL, Yu SJ. Esophageal cancer: risk factors, genetic association, and treatment. Asian J Surg. 2018;41(3):210–5.

    Article  Google Scholar 

  3. Lagergren J, Smyth E, Cunningham D, et al. Oesophageal cancer. Lancet. 2017;390(10110):2383–96.

    Article  Google Scholar 

  4. 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):550–8.

    Article  Google Scholar 

  5. Chan AW, Chan RC, Wong GL, et al. New simple prognostic score for primary biliary cirrhosis: albumin-bilirubin score. J Gastroenterol Hepatol. 2015;30(9):1391–6.

    Article  CAS  Google Scholar 

  6. Chen RC, Cai YJ, Wu JM, et al. Usefulness of albumin-bilirubin grade for evaluation of long-term prognosis for hepatitis B-related cirrhosis. J Viral Hepat. 2017;24(3):238–45.

    Article  CAS  Google Scholar 

  7. 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):773–81.

    Article  Google Scholar 

  8. Ando N, Kato H, Igaki H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19(1):68–74.

    Article  Google Scholar 

  9. Kanda M, Koike M, Tanaka C, et al. Modified systemic inflammation score is useful for risk stratification after radical resection of squamous cell carcinoma of the esophagus. Ann Surg Oncol. 2019;26(13):4773–81.

    Article  Google Scholar 

  10. Lerut T, Moons J, Coosemans W, et al. Postoperative complications after transthoracic esophagectomy for cancer of the esophagus and gastroesophageal junction are correlated with early cancer recurrence: role of systematic grading of complications using the modified Clavien classification. Ann Surg. 2009;250(5):798–807.

    Article  Google Scholar 

  11. Zhang D, Zheng Y, Wang Z, et al. Comparison of the 7th and proposed 8th editions of the AJCC/UICC TNM staging system for esophageal squamous cell carcinoma underwent radical surgery. Eur J Surg Oncol. 2017;43(10):1949–55.

    Article  CAS  Google Scholar 

  12. Inaoka K, Kanda M, Uda H, et al. Clinical utility of the platelet-lymphocyte ratio as a predictor of postoperative complications after radical gastrectomy for clinical T2–4 gastric cancer. World J Gastroenterol. 2017;23(14):2519–26.

    Article  Google Scholar 

  13. Sasahara M, Kanda M, Ito S, et al. The preoperative prognostic nutritional index predicts short-term and long-term outcomes of patients with stage II/III gastric cancer: analysis of a multi-institution dataset. Dig Surg. 2020;37(2):135–44.

    Article  Google Scholar 

  14. Kanda M, Koike M, Tanaka C, et al. Risk prediction of postoperative pneumonia after subtotal esophagectomy based on preoperative serum cholinesterase concentrations. Ann Surg Oncol. 2019;26(11):3718–26.

    Article  Google Scholar 

  15. Kanda M, Shimizu D, Sawaki K, et al. Therapeutic monoclonal antibody targeting of neuronal pentraxin receptor to control metastasis in gastric cancer. Mol Cancer. 2020;19(1):131.

    Article  CAS  Google Scholar 

  16. Thurnham DI. Interactions between nutrition and immune function: using inflammation biomarkers to interpret micronutrient status. Proc Nutr Soc. 2014;73(1):1–8.

    Article  CAS  Google Scholar 

  17. Li J, Mei X, Sun D, et al. A Nutrition and Inflammation-Related Nomogram to Predict Overall Survival in Surgically Resected Esophageal Squamous Cell Carcinoma (ESCC) Patients. Nutr Cancer. 2021. https://doi.org/10.1080/01635581.2021.1957131.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Wang P, Li Y, Sun H, et al. Predictive value of body mass index for short-term outcomes of patients with esophageal cancer after esophagectomy: a meta-analysis. Ann Surg Oncol. 2019;26(7):2090–103.

    Article  Google Scholar 

  19. Mengardo V, Pucetti F, Mc Cormack O, et al. The impact of obesity on esophagectomy: a meta-analysis. Dis Esophagus. 2017;31(6):1–9.

    Google Scholar 

  20. Okamura A, Watanabe M, Yamashita K, et al. Implication of visceral obesity in patients with esophageal squamous cell carcinoma. Langenbecks Arch Surg. 2018;403(2):245–53.

    PubMed  Google Scholar 

  21. Liu B, Cheng B, Wang C, et al. The prognostic significance of metabolic syndrome and weight loss in esophageal squamous cell carcinoma. Sci Rep. 2018;8(1):10101.

    Article  Google Scholar 

Download references

Acknowledgements

We thank Anne M. O’Rourke, PhD, from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan

    Takahiro Shinozuka MD, Mitsuro Kanda MD, FACS, Dai Shimizu MD, Chie Tanaka MD, Yoshikuni Inokawa MD, Norifumi Hattori MD, Masamichi Hayashi MD, FACS, Masahiko Koike MD & Yasuhiro Kodera MD, FACS

Authors
  1. Takahiro Shinozuka MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mitsuro Kanda MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dai Shimizu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chie Tanaka MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshikuni Inokawa MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Norifumi Hattori MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masamichi Hayashi MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masahiko Koike MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yasuhiro Kodera MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mitsuro Kanda MD, FACS.

Ethics declarations

Disclosure

All authors have no conflicts of interest to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shinozuka, T., Kanda, M., Shimizu, D. et al. Prognostic Value of a Modified Albumin–Bilirubin Score Designed for Patients with Esophageal Squamous Cell Carcinoma After Radical Resection. Ann Surg Oncol 29, 4889–4896 (2022). https://doi.org/10.1245/s10434-022-11654-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-022-11654-6

Search

Navigation