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Surgery Today
Published in: Surgery Today 10/2023

24-03-2023 | Gastrectomy | Original Article

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

Authors: Michita Shoka, Mitsuro Kanda, Seiji Ito, Yoshinari Mochizuki, Hitoshi Teramoto, Kiyoshi Ishigure, Toshifumi Murai, Takahiro Asada, Akiharu Ishiyama, Hidenobu Matsushita, Dai Shimizu, Chie Tanaka, Michitaka Fujiwara, Kenta Murotani, Yasuhiro Kodera

Published in: Surgery Today | Issue 10/2023

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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.
Appendix
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Metadata
Title
Modified Albumin–Bilirubin Grade optimized for risk stratification of patients with stage II–III gastric cancer
Authors
Michita Shoka
Mitsuro Kanda
Seiji Ito
Yoshinari Mochizuki
Hitoshi Teramoto
Kiyoshi Ishigure
Toshifumi Murai
Takahiro Asada
Akiharu Ishiyama
Hidenobu Matsushita
Dai Shimizu
Chie Tanaka
Michitaka Fujiwara
Kenta Murotani
Yasuhiro Kodera
Publication date
24-03-2023
Publisher
Springer Nature Singapore
Published in
Surgery Today / Issue 10/2023
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-023-02669-x

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