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Association of Albumin-Bilirubin Grade and Myosteatosis with its Prognostic Significance for Patients with Colorectal Cancer

 Hwa-Hee Koh  ;  Eun-Suk Cho  ;  Jae-Hoon Lee  ;  Su-Jin Shin  ;  Hye Sun Lee  ;  Eun Jung Park  ;  Seung Hyuk Baik  ;  Kang Young Lee  ;  Jeonghyun Kang 
 ANNALS OF SURGICAL ONCOLOGY, Vol.29(6) : 3868-3876, 2022-06 
Journal Title
Issue Date
Bilirubin ; Carcinoma, Hepatocellular* ; Colorectal Neoplasms* / complications ; Colorectal Neoplasms* / diagnostic imaging ; Colorectal Neoplasms* / surgery ; Humans ; Liver Neoplasms* / diagnostic imaging ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Serum Albumin
Background: The albumin-bilirubin (ALBI) grade is a useful prognostic and predictive marker for patients with liver disease. Its clinical significance has been limited to patients with colorectal cancer (CRC). Furthermore, the association between the ALBI grade and skeletal muscle-related indices is unclear.

Methods: This study enrolled 1015 patients who underwent computed tomography (CT) scans within 31 days before surgery. The prognostic value of the ALBI grade in predicting overall survival (OS) was assessed using the Cox proportional hazards model. The correlation between the ALBI grade and the skeletal muscle index or radiodensity (myosteatosis) was evaluated. The predictive accuracy of ALBI alone and in combination with myosteatosis was compared using Harrell's concordance index (C-index).

Results: The significant prognostic factors for OS identified in the multivariable analysis were the ALBI group (low vs high: hazard ratio [HR], 1.566; 95 % confidence interval [CI], 1.174-2.089; p = 0.002) and myosteatosis (low vs. high: HR, 0.648; 95 % CI, 0.486-0.865; p = 0.003). The rate of low-grade myosteatosis increased as the ALBI grade increased. The C-index of combined ALBI and myosteatosis (0.650; 95 % CI, 0.618-0.683) was superior to that of ALBI alone (0.603; 95 % CI, 0.575-0.631; bootstrap incremental area under the curve [iAUC] mean difference, 0.047; 95 % CI, 0.012-0.070) and myosteatosis alone (0.608; 95 % CI, 0.577-0.640; bootstrap iAUC mean difference, 0.042; 95 % CI, 0.023-0.064).

Conclusion: The ALBI grade is significantly associated with myosteatosis. The ALBI grade is a significant prognostic factor, and the combination of ALBI and myosteatosis show an additive value in discriminating survival of patients with CRC.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kang, Jeonghyun(강정현) ORCID logo https://orcid.org/0000-0001-7311-6053
Park, Eun Jung(박은정) ORCID logo https://orcid.org/0000-0002-4559-2690
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Shin, Su Jin(신수진) ORCID logo https://orcid.org/0000-0001-9114-8438
Lee, Kang Young(이강영)
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0002-9898-9886
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Cho, Eun Suk(조은석)
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