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Modified Albumin–Bilirubin Grade optimized for risk stratification of patients with stage II–III gastric cancer

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Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusion

The mALBI grade accurately predicted the long-term postoperative prognosis of locally advanced GC.

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Data availability

All the data obtained and/or analyzed during the current study were available from the corresponding authors on reasonable request.

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Acknowledgements

We thank Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan

    Michita Shoka, Mitsuro Kanda, Dai Shimizu, Chie Tanaka, Michitaka Fujiwara & Yasuhiro Kodera

  2. Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan

    Seiji Ito

  3. Department of Surgery, Komaki Municipal Hospital, Komaki, Japan

    Yoshinari Mochizuki

  4. Department of Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan

    Hitoshi Teramoto

  5. Department of Surgery, Konan Kosei Hospital, Konan, Japan

    Kiyoshi Ishigure

  6. Department of Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan

    Toshifumi Murai

  7. Department of Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Japan

    Takahiro Asada

  8. Department of Surgery, Okazaki City Hospital, Okazaki, Japan

    Akiharu Ishiyama

  9. Department of Surgery, Tosei General Hospital, Seto, Japan

    Hidenobu Matsushita

  10. Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Japan

    Kenta Murotani

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  1. Michita Shoka
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  2. Mitsuro Kanda
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Correspondence to Mitsuro Kanda.

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595_2023_2669_MOESM1_ESM.tif

The Kaplan–Meier analysis of overall survival according to mALBI grade. (a) In the learning cohort. (b) In the validation cohort. mALBI, modified albumin–bilirubin (TIF 6662 KB)

Supplementary file2 (DOCX 29 KB)

Supplementary file3 (DOCX 29 KB)

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Shoka, M., Kanda, M., Ito, S. et al. Modified Albumin–Bilirubin Grade optimized for risk stratification of patients with stage II–III gastric cancer. Surg Today 53, 1149–1159 (2023). https://doi.org/10.1007/s00595-023-02669-x

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  • DOI: https://doi.org/10.1007/s00595-023-02669-x

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