Albumin-bilirubin (ALBI) and Platelet-ALBI (PALBI) Grades: Novel Prognostic Factors for Cholangiocellular Carcinoma.

[BACKGROUND/AIM] Cholangiocarcinoma (CCA) is the second most frequently occurring primary malignant tumor of the liver, characterized by poor survival due to late diagnosis and limited treatment options. The albumin-bilirubin (ALBI) and platelet-ALBI (PALBI) scores, which reflect liver function and inflammation, have emerged as potential prognostic markers in hepatocellular carcinoma (HCC). Their prognostic significance in CCA, however, remains less established.

[PATIENTS AND METHODS] A retrospective analysis was conducted on 184 patients diagnosed with CCA between 2007 and 2024. The study evaluated the relationship between tumor location, ALBI/PALBI grades, and overall survival (OS). Patients were categorized into three groups based on their ALBI and PALBI scores, and survival outcomes were analyzed.

[RESULTS] Tumor location significantly impacted OS. The median OS (mOS) was 18 months for distal CCA, 13 months for perihilar CCA, and 7 months for intrahepatic CCA (<0.001). When stratified by ALBI grade, mOS was 17 months for Grade 1, 8 months for Grade 2, and 2 months for Grade 3 (=0.001). Similarly, for PALBI grade, mOS was 13 months for Grade A1, 11 months for Grade A2, and 8 months for Grade A3 (=0.037). Among the variables included in the multivariate analysis, only the ALBI grade retained its significance as an independent prognostic factor for overall survival.

[CONCLUSION] ALBI and PALBI grades serve as effective prognostic indicators in CCA, with lower grades associated with enhanced survival rates. Notably, ALBI grade was found to be an independent predictor of OS, presenting a cost-efficient biomarker that may support clinical decision-making by providing crucial prognostic information insights.