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. 2023 Oct 30;9(11):e21772.
doi: 10.1016/j.heliyon.2023.e21772. eCollection 2023 Nov.

Assessment of the albumin-bilirubin score in breast cancer patients with liver metastasis after surgery

Li Chen  1   2 , Chunlei Tan  3 , Qingwen Li  4 , Zhibo Ma  4 , Meng Wu  4 , Xiaosheng Tan  4 , Tiangen Wu  5 , Jinwen Liu  1 , Jing Wang  2
Affiliations

Assessment of the albumin-bilirubin score in breast cancer patients with liver metastasis after surgery

Li Chen et al. Heliyon. .

Abstract

Objective: This study aims to investigate the potential prognostic value of albumin-bilirubin (ALBI) score in breast cancer patients with liver metastasis after surgery.

Methods: This was a retrospective study of 178 breast cancer patients with liver metastasis after surgery. ALBI score was calculated by the following formula: (log10 bilirubin × 0.66) - (albumin × 0.085). The optimal cutoff value of ALBI score was assessed by X-tile. The clinical influence of ALBI score on survival outcomes using Kaplan-Meier method, Log-rank test, Cox proportional hazards regression model. The calibration curves, decision curve analysis and time-dependent ROC curve were used to assess the predictive performance of the nomogram's models.

Results: The classifications of 178 breast cancer patients with liver metastasis after surgery were as follows: low ALBI score group (＜-3.36) vs. high ALBI score group (≥-3.36). The Cox proportional hazards regression model indicated that ALBI score was a potential predictor. Kaplan-Meier survival curve performed that the median disease free survival (p = 0.0029) and overall survival (p＜0.0001) in low ALBI score group were longer than in high ALBI score group. The ALBI-based nomograms had good predictive performance.

Conclusions: The ALBI score has high prognostic ability for survival time in breast cancer with liver metastasis after surgery. These models will be valuable in discriminating patients at high risks of liver metastasis.

Keywords: Albumin; Albumin-bilirubin grade; Bilirubin; Breast cancer; Liver metastasis.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival plots comparing disease free survival (DFS) and overall survival (OS) in breast cancer patients with liver metastasis after surgery (A for DFS, B for OS).
Fig. 2
Fig. 2
The established of ALBI-based nomograms in breast cancer patients with liver metastasis after surgery (A, nomogram of disease free survival; B, nomogram of overall survival).
Fig. 3
Fig. 3
The calibration curves for ALBI-nomogram model in predicting different survival time. A) 1-year DFS, B) 3-year DFS, C) 5-year DFS, D) 1-year OS, E) 3-year OS, F) 5-year OS, G) 10-year OS.
Fig. 4
Fig. 4
The decision curve analysis for the ALBI-nomogram and ALBI score model in evaluating the benefits for different survival time. A) 1-year DFS, B) 3-year DFS, C) 5-year DFS, D) 10-year DFS, E) 3-year OS, F) 5-year OS, G) 10-year OS, H) 15-year OS.
Fig. 5
Fig. 5
Time-dependent receiver operating characteristic (TDROC) analyzed the plots of area under the receiver operating characteristic curves (AUROCs) for ALBI score in breast cancer patients with liver metastasis after surgery of followup. A) Time-dependent AUROCs for DFS, B) 95%CI changes of AUROCs for DFS, C) Time-dependent AUROCs for OS, D) 95%CI changes of AUROCs for OS.
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