Clinical Impact of Albumin-Bilirubin (ALBI) Score in Patients With Recurrent Esophageal Cancer After Curative Treatment

Background/Aim: The albumin-bilirubin (ALBI) score, which evaluates pretreatment liver function, has been reported as a prognostic factor in several malignancies. We conducted a retrospective study to clarify the prognostic impact of the ALBI score in patients with recurrent esophageal cancer. Patients and Methods: We retrospectively reviewed the medical records and data of consecutive patients with recurrent esophageal cancer who received treatment, including best supportive care, at Yokohama City University from 2005 to 2022. The primary endpoint of the present study was overall survival (OS) after recurrence. The secondary endpoint was the association between the ALBI score and the treatment course after recurrence. Results: Ninety patients were eligible for the present study. The median overall survival was 10.4 months (95% confidence interval=4.9-15.8 months). Based on previous studies and exploratory analyses of 1- and 3-year OS, the ALBI score cut-off was set at −2.80. The 90 patients were divided into the ALBI-low (ALBI score <−2.80, n=29) and ALBI-high (ALBI score ≥−2.80, n=61) groups. The 1- and 3-year OS rates were 70.9% and 40.8% in the ALBI-low group and 35.5% and 13.7% in the ALBI-high group, respectively (p=0.007). In the multivariate analysis, the ALBI score was an independent prognostic factor for OS (hazard ratio=2.046, 95% confidence interval=1.164-3.594, p=0.013). The first-line treatment rate tended to be higher in the ALBI-low group than in the ALBI-high group [89.7% (26/29) vs. 73.8% (45/61), p=0.084]. Conclusion: The ALBI score may be a promising prognostic factor for patients with recurrent esophageal cancer.