Albumin-based Liver Reserve Models as Prognostic Markers for Patients With Extensive-stage Small-cell Lung Cancer

Background/Aim: Albumin-based liver reserve models, such as the albumin-bilirubin (ALBI) score/grade, are simple and useful indices of hepatic functional reserve that can be calculated using routine blood tests. Recently, the ALBI score has been reported to be useful for predicting the prognosis of several cancers, but its relationship with extensive-stage small-cell lung cancer (ES-SCLC) prognosis has not been fully investigated. The aim of this study was to evaluate the prognostic value of albumin-based liver reserve models in patients with ES-SCLC treated using platinum-doublet chemotherapy. Patients and Methods: We retrospectively analyzed the pretreatment ALBI, easy (EZ)-ALBI, platelet-albumin-bilirubin (PALBI), and platelet-albumin (PAL) grades of patients with ES-SCLC who were treated using first-line platinum-doublet chemotherapy at the Kainan Hospital. Results: Data from 104 patients were analyzed. Patients with low ALBI and PAL grades (≤−2.60 and ≤−3.77, respectively) had significantly longer overall survival (OS) than patients with high ALBI and PAL grades [ALBI: median OS=351.5 days vs. 214.5 days, respectively (p=0.018); PAL: median OS=360.5 days vs. 193.5 days, respectively (p=0.018)]. On multivariate analysis, ALBI and PAL grades were also independent prognostic factors for OS [ALBI: Hazard ratio (HR)=1.798 (95% confidence interval (CI)=1.184-2.731, p=0.006); PAL: HR=1.711 (95%CI=1.132-2.584, p=0.011)]. Conclusion: Albumin-based liver reserve models, especially ALBI and PAL grades, may be prognostic markers for patients with ES-SCLC treated with platinum-doublet chemotherapy.