Is Albumin-Bilirubin Grade an Effective Factor in Terms of Recurrence Following Resection in HCC Patients?

Abstract

Introduction: Recent studies have revealed the fact that albumin-bilirubin (ALBI) grade can be an independent prognostic factor in terms of liver failure, long-term survival and recurrence. Material-Method: Patients who had undergone resection with pathologic diagnosis of HCC were examined retrospectively. Age, gender, etiologic factor, preoperative and postoperative 5th day ALBI grade, type of hepatic resection, length of hospital stay, tumor size, lymph node involvement and resection margin of tumor were examined. Recurrence and survival therefore in the long-term results were investigated. Patients who underwent non-HCC liver resection, those who died in early postoperative period, patients who went out of follow-up and patients who underwent R1-R2 resection were excluded from the study. Results: Thirty-one patients were included in the study. The mean age was 65.52±10.87 years. The median tumor size was 5 cm (2-17). The median hospital stay was 4 (1-25) days. Kaplan-Meier mean recurrence time was 32.17 (standard error = 4.67) months. In the univariate analysis, surgical margin of < 1 mm was the only factor affecting recurrence (p = 0.001). Resection margin (p = 0.002) and lymph node involvement (p = 0.019) were found to be significant for overall survival. Preoperative ALBI grade was found to be significant in terms of recurrence (p = 0.026) (HR = 3.414 (95% confidence interval: 1.154-10.097)). Conclusion: Preoperative ALBI grade is more significant compared to postoperative ALBI grade in postoperative recurrence. At the same time, surgical margin's being < 1 mm is the only negative prognostic factor in terms of recurrence and overall survival.Table 1Characteristics of patientsCharacteristicsNGender (M / F)27 / 4Tumor Size < 5 cm ≥ 5 cm14 / 17Etiology HBV / HCV / Other15 /4 /12Surgery Major resection / minor resection11/ 20Preoperative ALBI grade Grade 1/Grade 2 /Grade 318/12 /1Postoperative ALBI grade Grade 1/Grade 2 /Grade 32/ 21 / 7Resection margin < 1 mm, ≥ 1- 5 mm, > 5- 10mm, > 10 mm8/ 15/ 5 /3 Open table in a new tab