Abstract
PURPOSE: The liver function index can predict the prognosis of hepatocellular carcinoma and many other non-neoplastic diseases. We aimed to determine whether the preoperative albumin-bilirubin (ALBI) grade could predict the prognosis of patients with gastric cancer (GC). PATIENTS AND METHODS: Data of 243 patients with GC who underwent radical resection were collected retrospectively. Patients were divided into the high ALBI (>-2.34) and low ALBI (≤-2.34) grade groups. Overall survival was analyzed between the two groups using the Kaplan-Meier curves. Univariate and multivariate analyses identified the independent factors associated with postoperative complications and overall survival. RESULTS: The postoperative complication rates were higher in the high ALBI grade group than in the low ALBI grade group (P=0.005). The high ALBI grade group also had worse overall survival (P<0.001), especially TNM stage II-III patients (stage II, P=0.043; stage III, P<0.001). In the high ALBI grade group, patients with TNM stage III not undergoing chemotherapy had significantly worse survival times (P=0.001). High ALBI grade (P=0.032), Charlson score of 1-2 (P=0.007), and laparotomy surgery (P=0.045) were independent risk factors for postoperative complications. High ALBI grade (P=0.005), age ≥70 years (P=0.002), nutritional risk screening score 2002 score of 5-6 (P=0.019), tumor located in the cardia (P=0.020), diffuse tumor (P<0.001), and TNM stage III (P<0.001) were independent risk factors for overall survival. CONCLUSION: Preoperative ALBI grade could predict postoperative complications and overall survival of patients with GC, especially those with TNM stages II-III. This grading method has the advantages of preoperative availability, simplicity, and objectivity and aids in improving preoperative prognosis prediction and in achieving better outcomes of postoperative chemotherapy.