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Albumin-Bilirubin Grade and Tumor Burden Score Predict Outcomes Among Patients with Intrahepatic Cholangiocarcinoma After Hepatic Resection: a Multi-Institutional Analysis.

2023-03Text Open access
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dc.contributor.authorMunir, Muhammad Musaab
dc.contributor.authorEndo, Yutaka
dc.contributor.authorLima, Henrique A
dc.contributor.authorAlaimo, Laura
dc.contributor.authorMoazzam, Zorays
dc.contributor.authorShaikh, Chanza
dc.contributor.authorPoultsides, George A
dc.contributor.authorGuglielmi, Alfredo
dc.contributor.authorAldrighetti, Luca
dc.contributor.authorWeiss, Matthew
dc.contributor.authorBauer, Todd W
dc.contributor.authorAlexandrescu, Sorin
dc.contributor.authorKitago, Minoru
dc.contributor.authorMaithel, Shishir K
dc.contributor.authorPinto Marques, Hugo
dc.contributor.authorMartel, Guillaume
dc.contributor.authorPulitano, Carlo
dc.contributor.authorShen, Feng
dc.contributor.authorCauchy, François
dc.contributor.authorKoerkamp, Bas Groot
dc.contributor.authorEndo, Itaru
dc.contributor.authorPawlik, Timothy M
dc.contributor.editorSpringer
dc.date.accessioned2025-03-14T12:14:17Z
dc.date.available2025-03-14T12:14:17Z
dc.date.issued2023-03
dc.description.abstractBackground: The prognostic role of tumor burden score (TBS) relative to albumin-bilirubin (ALBI) grade among patients undergoing curative-intent resection of ICC has not been examined. Methods: We identified patients who underwent curative-intent resection for ICC between 1990 and 2017 from a multi-institutional database. Multivariable analysis was performed to assess the effect of TBS relative to ALBI grade on both short- and long-term outcomes. Results: Among 724 patients, 360 (49.7%) patients had low TBS and low ALBI grade, 142 (19.6%) patients had low TBS and high ALBI grade, 138 (19.1%) patients had high TBS and low ALBI grade, and 84 patients (11.6%) had high TBS and high ALBI grade. Decreased tumor burden was associated with better long-term outcomes among patients with both low (5-year OS; low TBS vs. high TBS: 52.4% vs 21.4%; p < 0.001) and high ALBI grade (5-year OS; low TBS vs. high TBS: 40.7% vs 12.0%; p < 0.001). On multivariable analysis, higher ALBI grade was associated with greater odds of an extended hospital LOS (> 10 days) (OR 2.80, 95%CI 1.62-4.82; p < 0.001), perioperative transfusion (OR 2.04, 95%CI 1.25-3.36; p = 0.005), 90-day mortality (OR 2.56, 95%CI 1.12-5.81; p = 0.025), as well as a major complication (OR 1.99, 95%CI 1.13-3.49; p = 0.016) among patients with similar tumor burden. Of note, patients with high TBS and high ALBI grade had markedly worse overall survival compared with patients who had low TBS and low ALBI grade disease (HR 2.27; 95%CI 1.44-3.59; p < 0.001). Importantly, high TBS and high ALBI grade were strongly associated with both early recurrence (88.1%%) and 5-year risk of death (96.4%). Conclusion: Both TBS (i.e., tumor morphology) and ALBI grade (i.e., hepatic function reserve) were strong predictors of outcomes among patients undergoing ICC resection. There was an interplay between TBS and ALBI grade relative to patient prognosis after hepatic resection of ICC with high ALBI grade predicting worse outcomes among ICC patients with different TBS.eng
dc.identifier.citationJ Gastrointest Surg . 2023 Mar;27(3):544-554.
dc.identifier.doi10.1007/s11605-023-05578-z
dc.identifier.pmid36652178
dc.identifier.urihttp://hdl.handle.net/10400.17/5066
dc.language.isoen
dc.peerreviewedyes
dc.publisherSpringer
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectBile Duct Neoplasms* / surgery
dc.subjectBile Ducts
dc.subjectIntrahepatic
dc.subjectBilirubin
dc.subjectCarcinoma
dc.subjectHepatocellular* / surgery
dc.subjectCholangiocarcinoma* / surgery
dc.subjectHumans
dc.subjectPrognosis
dc.subjectLiver Neoplasms* / surgery
dc.subjectRetrospective Studies
dc.subjectSerum Albumin
dc.subjectTumor Burden
dc.titleAlbumin-Bilirubin Grade and Tumor Burden Score Predict Outcomes Among Patients with Intrahepatic Cholangiocarcinoma After Hepatic Resection: a Multi-Institutional Analysis.eng
dc.typetext
dspace.entity.typePublication
oaire.citation.endPage554
oaire.citation.issue3
oaire.citation.startPage544
oaire.citation.titleJournal of Gastrointestinal Surgery
oaire.citation.volume27
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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