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Publications

Journal Article Systematic Review Meta-Analysis Review Epublish

PubMed: 41533275 DOI: 10.1007/s12029-025-01370-1

Prognostic Value of albumin-bilirubin (ALBI) Grade in Patients with Gastric Cancer: A Systematic Review and meta-analysis.

J Gastrointest Cancer 57(1):13

Authors: Mahyaar Omouri-Kharashtomi, Hamed Ghoshouni, Ariyan Ayati Firoozabadi, Faraz Mahdizadeh, Amir Anushiravani

Affiliations

  • Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  • Cardiovascular Epidemiology Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
  • Student Research Committee, Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Student Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
  • Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

BACKGROUND

Gastric cancer (GC) is considered a leading cause of cancer-related deaths. Identifying patients with poor survival outcomes and factors related to prognosis are crucial measures in patient care. In addition to the existing prognostic markers, new markers need to be introduced to overcome their limitations and improve risk stratification. In this systematic review and meta-analysis, we aim to assess the albumin-bilirubin (ALBI) grade as a novel prognostic marker in patients with GC.

METHOD

The PubMed, Web of Science, Embase, and Scopus databases were searched from inception to April 4, 2025. Studies investigating the prognostic value of the ALBI grade in GC were included. The prognostic efficacy was evaluated using hazard ratio (HR) with 95% confidence interval (95% CI). The meta-analysis was performed using R version 4.5.1.

RESULT

The meta-analysis included 3,459 patients in the univariate analysis for overall survival (OS) and 2,503 in the multivariate analysis. A higher ALBI grade was associated with worse OS in both univariate (HR = 3.05; 95%CI, 1.74-5.33; P ˂ 0.0001) and multivariate analyses (HR = 1.89; 95%CI, 1.30-2.76; P = 0.0010). A meta-analysis of 888 patients also showed that a higher ALBI grade was associated with worse recurrence-free survival/disease-free survival (RFS/DFS) in both univariate (HR = 2.23; 95%CI, 1.74-2.85; P ˂ 0.0001) and multivariate analyses (HR = 1.86; 95%CI, 1.42-2.43; P ˂ 0.0001).

CONCLUSION

A higher ALBI grade is associated with worse OS and RFS/DFS. This novel marker could be used to complement the existing prognostic markers and enhance survival prediction in patients with GC.

MeSH

Disease-Free Survival, Neoplasms, Multivariate Analysis, Stomach Neoplasms, Bilirubin