Prognostic significance of pretreatment albumin-bilirubin (ALBI) grade and platelet-albumin-bilirubin (PALBI) grade in patients with small cell lung cancer

Abstract

Small cell lung cancer (SCLC) is one of the most common cancers worldwide. Despite advances in diagnosis and treatment, the prognosis is still poor. There is no effective biomarker other than stage in daily practice. However, in daily practice, patients may have different features and survival times even though they have the same stage. Previously, albumin-bilirubin (ALBI) grade, platelet-albumin-bilirubin (PALBI) grade were used to determine the prognosis of acute-chronic liver failure and acute upper gastrointestinal bleeding in liver cirrhosis. In subsequent studies, they were found to be associated with prognosis in hepatocellular carcinoma (HCC) and other solid cancers.However, the prognostic relationship between ALBI grade, PALBI grade, and SCLC is unknown. Therefore, we conducted this study to examine the relationship between ALBI grade and PALBI grade and prognosis in SCLC patients. Data of 138 patients with advanced SCLC at diagnosis between 2009 and 2020 were analyzed retrospectively. The results of the multivariate analysis were as follows: ALBI grade 1 vs 2, hazard ratio (HR) = 2.905, p < 0.001 for overall survival (OS) and HR = 1.800, p < 0.001 for progression-free survival (PFS); ALBI grade 1 vs 3, HR = 4.340, p < 0.001 for OS and HR = 3.105, p < 0.001 for PFS; PALBI grade1 vs 2, HR = 2.031, p = 0.002 for OS and HR = 1.674, p < 0.001 for PFS; and PALBI grade 1 vs 3 (HR = 4.045, p < 0.001 for OS and HR = 2.972, p < 0.001 for PFS). In conclusion, the ALBI and PALBI grades were determined to be associated with the prognosis of SCLC, and they can be used as easy, inexpensive, and practical markers in determining the follow-up treatment and prognosis of SCLC patients.