Prognostic value of ALBI score in lung cancer patients with liver metastases and hepatic failure: a single-center experience

Abstract

Aims: Lung cancer remains the leading cause of cancer-related mortality worldwide, with especially poor outcomes in the metastatic stage. Liver metastases and subsequent liver failure significantly worsen prognosis. Accurate risk stratification is therefore essential in this setting. The albumin-bilirubin (ALBI) score, a simple and objective indicator of liver function, may aid in prognostic evaluation. Unlike previous studies, this study specifically focuses on lung cancer patients with liver failure, a clinically distinct and high-risk subgroup. Methods: Clinicopathological data and laboratory parameters were retrospectively retrieved from the hospital information system for patients with histologically confirmed lung cancer and concurrent liver metastases complicated by liver failure. ALBI score was calculated based on peripheral blood test results using the formula: (0.66×log10[bilirubin, μmol/L])−(0.085×albumin, g/L). Results: The median overall survival (mOS) was 0.19 months in ALBI grade 3 (95% CI: 0.10–0.28) and 1.54 months in ALBI grade 2 (95% CI: 0.19–2.89), with a statistically significant difference (p<0.01). Univariate analysis identified NSCLC histology, ALBI grade 3, and chemotherapy during hepatic failure as significant predictors of overall survival. In multivariate analysis, chemotherapy (HR: 0.11, p<0.001) and ALBI grade 3 (HR: 2.31, p=0.008) remained independent prognostic factors. Conclusion: ALBI score is a useful prognostic marker for survival after liver failure, with ALBI grade 3 indicating worse outcomes. It may aid in risk stratification and clinical decision-making in this high-risk group.

Keywords

• ALBI
• albumin
• bilirubin
• lung cancer

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