Karaciğere metastatik kolorektal kanserde önemli bir prognostik faktör olarak albumin-bilirubin (ALBI) gradı

Öz

Amaç: Kolorektal kanser en sık görülen kanserlerden biridir ve hastalık sürecinde karaciğer metastazı sık olarak gelişmektedir. Albumin-bilirubin (ALBI) skoru/gradının hepatoselüler kanserde sağkalımı predikte ettiği gösterilmiştir. Bu çalışmada ALBI skoru/gradının karaciğer metastatik kolon kanserindeki prognostik değerinin araştırılması amaçlanmıştır.

Yöntemler: Kolorektal kanser tanılı ve senkron ya da metakron karaciğer metastazı olan hastaların tıbbi kayıtları incelenmiştir. Karaciğer metastazının saptandığı andaki serum albumin, total bilirubin, laktat dehidrojenaz, karsinoembryonik antijen and nötrofil-lenfosit oranı belirlenmiştir. Albumin ve bilirubin kullanılarak ALBI skoru hesaplanmış ve derecelendirilmiştir. Prognostik faktörler çok değişkenli regresyon modelleri ile değerlendirilmiştir.

Bulgular: Çalışmaya 223 hasta dahil edildi. Medyan genel sağkalım ALBI grad 1, 2 ve 3 için sırasıyla 23.9, 16.0 ve 4.0 ay olarak saptandı (P<0.001). İlk çok değişkenli modelde serum albumin bağımsız bir prognostik faktörken (Tehlike oranı=1.97, P=0.001) total bilirubin değildi (Tehlike oranı=1.43, P=0.17). İkinci çok değişkenli analizde ALBI gradın genel sağkalımı bağımsız olarak predikte edebildiği görüldü (ALBI grad 2 için tehlike oranı=1.54, P=0.02 ve grad 3 için tehlike oranı=3.85, P<0.001).

Sonuç: ALBI gradı karaciğer metastazı olan kolorektal kanser hastalarında mortaliteyi tahmin etmek için değerli bir prognostik metod olabilir.

Anahtar Kelimeler

• Albumin-bilirubin gradı,Karaciğer metastazı,Kolorektal kanser,Prognostik faktör

The albumin-bilirubin (ALBI) grade as a significant prognostic factor in colorectal cancer patients with liver metastases

Öz

Aim: Colorectal cancer is one of the most common cancers and liver metastases are frequent during its course. Albumin-bilirubin (ALBI) score/grade was shown to predict survival in hepatocellular carcinoma. We aimed to assess the prognostic value of the ALBI score/grade in colorectal cancer patients with liver metastases.

Methods: Medical records of patients with colorectal cancer and synchronous or metachronous liver metastases were reviewed. Serum albumin, total bilirubin, lactate dehydrogenase, carcinoembryogenic antigen and neutrophile-to-lymphocyte ratio at the time of first liver metastasis were determined. ALBI score was calculated from serum albumin and bilirubin and was graded. Multivariate regression models were used to evaluate prognostic factors.

Results: The study included 223 patients. Median overall survival was 23.9, 16.0 and 4.0 months for ALBI grades 1, 2 and 3, respectively (P<0.001). In the first multivariate model, serum albumin was an independent prognostic factor (Hazard ratio=1.97, P=0.001) but total bilirubin was not (Hazard ratio=1.43, P=0.17). In the second multivariate analysis, ALBI grade was a significant predictor of overall survival (Hazard ratio=1.54, P=0.02 for ALBI grade 2 and Hazard ratio=3.85, P<0.001 for ALBI grade 3).

Conclusion: ALBI grade may be a valuable prognostic method to estimate the mortality of patients with colorectal cancer and liver metastases.

Anahtar Kelimeler

• Albumin-bilirubin grade,Colorectal cancer,Liver metastasis,Prognostic factor

Kaynakça

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