J Cancer 2019; 10(20):4836-4845. doi:10.7150/jca.33877

Research Paper

Combined preoperative albumin-bilirubin (ALBI) and serum γ-glutamyl transpeptidase (GGT) predicts the outcome of hepatocellular carcinoma patients following hepatic resection

Chi-Hao Zhang1,#, Xiao-Chun Ni1,#, Bi-Yin Chen2,#, Shuang-Jian Qiu3, Yi-Ming Zhu1,✉, Meng Luo1,✉

1. Department of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
2. Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
3. Department of General Surgery, Zhongshan Hospital, School of Medicine, Fudan University, Shanghai, China
#Chi-Hao Zhang, Xiao-Chun Ni and Bi-Yin Chen contributed equally to this work

Abstract

Background: Liver function is an important prognostic factor for patients with hepatocellular carcinoma. The purpose of this study was to develop and validate a nomogram integrating the albumin-bilirubin (ALBI) and serum γ-glutamyl transpeptidase (GGT) level to predict postoperative overall survival (OS) and disease-free survival (DFS) of hepatocellular carcinoma (HCC).

Methods: The effect of combined of ALBI and GGT on HCC prognosis was investigated using univariate and multivariate Cox analyses. The nomogram for OS and DFS were developed, respectively, and their predictive ability was compared with other conventional staging systems, including the American Joint Commission on Cancer (AJCC), Barcelona Clinic Liver Cancer (BCLC) and the Cancer of the Liver Italian Program (CLIP).

Results: Combined ALBI and GGT was highly associated with OS (P<0.001) and DFS (P<0.001) of HCC patients treated with hepatic resection. In addition, the C-index of the OS (0.706±0.034) or DFS (0.674±0.032) nomogram in the training cohort was larger than AJCC, BCLC and CLIP. The Akaike information criterion (AICs) of the OS (2178.405) or DFS (2961.018) nomogram in the training cohort was smaller than above staging systems. The results suggested that the OS or DFS nomogram was the most powerful model to predict HCC prognosis. The similar trend was observed in the validation cohort.

Conclusion: The novel nomogram integrating ALBI and GGT was highly associated with OS and DFS of postoperative HCC patients.

Keywords: Hepatocellular carcinoma, ALBI, GGT, Cox analysis, nomogram

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How to cite this article:
Zhang CH, Ni XC, Chen BY, Qiu SJ, Zhu YM, Luo M. Combined preoperative albumin-bilirubin (ALBI) and serum γ-glutamyl transpeptidase (GGT) predicts the outcome of hepatocellular carcinoma patients following hepatic resection. J Cancer 2019; 10(20):4836-4845. doi:10.7150/jca.33877. Available from http://www.jcancer.org/v10p4836.htm