Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan.
Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan.
Surg Today. 2023 Oct;53(10):1149-1159. doi: 10.1007/s00595-023-02669-x. Epub 2023 Mar 24.
The albumin-bilirubin (ALBI) grade is calculated using albumin and bilirubin values. We determined the optimal cutoff value of the ALBI grade for predicting the postoperative prognosis of gastric cancer (GC).
We retrospectively reviewed a multicenter database of 3571 patients who underwent gastrectomy for GC between January 2010 and December 2014. The modified ALBI (mALBI) grade was determined using cutoff values: grade 1 (mALBI ≤ - 2.70), 2 (mALBI - 2.70 to - 2.10), and 3 (mALBI > - 2.10). We used a validation cohort to evaluate reproducibility.
The entire cohort (n = 956) was randomly assigned to the learning or validation cohorts (n = 478 each). The former was categorized into the following groups by the preoperative mALBI grade: grade 1 (n = 235), grade 2 (n = 162), and grade 3 (n = 81). The disease-specific survival (DSS) rates of the learning and validation cohorts were significantly shortened in association with higher mALBI grade (learning, p = 0.0068; validation, p = 0.0100). A multivariate analysis revealed that mALBI grade 3 served as an independent prognostic factor for DSS. Furthermore, mALBI grade 2 or 3 was associated with a greater risk of disease-specific death in most subgroups.
The mALBI grade accurately predicted the long-term postoperative prognosis of locally advanced GC.
ALBI 分级是通过白蛋白和胆红素值计算得出的。我们确定了 ALBI 分级预测胃癌（GC）术后预后的最佳截断值。
我们回顾性分析了 2010 年 1 月至 2014 年 12 月期间接受 GC 胃切除术的 3571 例患者的多中心数据库。使用以下截断值确定改良 ALBI（mALBI）分级：1 级（mALBI ≤-2.70）、2 级（mALBI-2.70 至-2.10）和 3 级（mALBI＞-2.10）。我们使用验证队列来评估可重复性。
整个队列（n=956）被随机分配到学习或验证队列（n=478 例）。前者根据术前 mALBI 分级分为以下几组：1 级（n=235）、2 级（n=162）和 3 级（n=81）。学习和验证队列的疾病特异性生存率（DSS）与 mALBI 分级升高显著缩短（学习队列，p=0.0068；验证队列，p=0.0100）。多变量分析显示，mALBI 分级 3 是 DSS 的独立预后因素。此外，mALBI 分级 2 或 3 与大多数亚组中疾病特异性死亡的风险增加相关。
mALBI 分级准确预测了局部晚期 GC 的长期术后预后。
