Abstract
To investigate whether albumin-bilirubin score can be used as a prognostic marker in pancreatic cancer patients post-surgery. The retrospective study was conducted at the Medical Oncology Clinic, Karadeniz Technical University, Trabzon, Turkey, and comprised data from 2010 to 2018 of pancreatic cancer patients who had undergone distal pancreatectomy or pancreaticoduodenectomy and were followed up for 3 years. Preoperative and postoperative serum albumin, carcinoembryonic antigen, carbohydrate antigen 19-9, bilirubin, neutrophil:lymphocyte ratio and platelet:lymphocyte ratio were compared as inflammation markers, while albumin-bilirubin scores were calculated using the equation linear predictor. Data was analysed using SPSS 17. Of the 39 patients, 23(59%) were men and 16(41%) were women. The mean age of the sample was 62.4±10.2 years. No statistically significant changes were observed between preoperative and postoperative albumin-bilirubin scores, carcinoembryonic antigen, neutrophil:lymphocyte ratio and platelet:lymphocyte ratio (p>0.05). Significant decreases were observed in postoperative carbohydrate antigen 19-9, aspartate transaminase and alanine transaminas levels (respectively<0.05). No significant change was determined in postoperative albumin-bilirubin grade distributions compared to preoperative values (p=0.180). Although the rate of recurrence increased in line with preoperative albumin-bilirubin scores, the finding was not statistically significant (p=0.055). Mortality rate increased significantly in line with preoperative albumin-bilirubin scores (p=0.013). The albumin-bilirubin score affected survival in patients with pancreatic cancer, and can be employed as a prognostic factor in this patient group.
Highlights
Pancreatic cancer is a disease with high mortality, and is the fourth most important cause of all cancer-related deaths[1]
The rate of recurrence increased in line with preoperative albumin-bilirubin scores, the finding was not statistically significant (p=0.055)
It entered into clinical use as an alternative to the Child-Pugh score used in patients with cirrhosis, and studies have been performed with hepatocellular carcinoma (HCC) patients[4]
Summary
Pancreatic cancer is a disease with high mortality, and is the fourth most important cause of all cancer-related deaths[1]. Albuminbilirubin (ALBI) grading is a scoring system developed to estimate the degree of liver function in patients with hepatocellular carcinoma (HCC)[3]. It entered into clinical use as an alternative to the Child-Pugh score used in patients with cirrhosis, and studies have been performed with HCC patients[4]. It is important to identify a prognostic marker in pancreatic cancer patients post-surgery because this patient group generally presents with recurrence and metastasis, especially if the patients were not suitable for neoadjuvant or adjuvant treatment and could not take additional treatment except surgery. There is no standard prognostic marker other than carbohydrate antigen
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