Prognosis of intrahepatic cholangiocarcinoma stratified by albumin-bilirubin (ALBI) grade.

Kaneko, Shun; Kurosaki, Masayuki; Tsuchiya, Kaoru; Yasui, Yutaka; Inada, Kento; Kirino, Sakura; Yamashita, Koji; Osawa, Leona; Hayakawa, Yuka; Sekiguchi, Shuhei; Higuchi, Mayu; Takaura, Kenta; Maeyashiki, Chiaki; Tamaki, Nobuharu; Itakura, Jun; Takahashi, Yuka; Nakanishi, Hiroyuki; Asano, Daisuke; Irie, Takumi; Kawachi, Yasuyuki; Izumi, Namiki

BACKGROUND Intrahepatic cholangiocarcinoma (ICC) is a highly aggressive malignancy. However, the characteristics and prognosis of ICC is not well-known. This study aims to reveal the relationship between liver function and prognosis of ICC. METHODS A total of 83 ICC patients were recruited retrospectively from March 2009 to August 2020. Child-Pugh (CP) and albumin-bilirubin (ALBI) scores were used to assess liver function. The extent of portal vein tumor thrombosis (PVTT) was classified from Vp0 to Vp4. The endpoint for this analysis was overall survival (OS). RESULTS The median age was 72 (44-88) years old, 48 patients were male (57.8%), and 70 patients were classified as CP grade A (84.3%). At baseline, chronic liver disease (hepatitis B: 9.6%, hepatitis C: 15.7%, alcoholic liver disease: 9.6%, and non-alcoholic fatty liver: disease 4.8%) were diagnosed. The median OS of all ICC patients was 21.2 months. A total of 27 patients underwent surgical resection; these patients demonstrated a longer median OS compared to those who did not (50.8 months vs 5.5 months, P < 0.001). The prognosis of patients with ICC can be stratified by ALBI grade (grade 1: 54.3 months, grade 2a: 8.4 months, grade 2b: 3.9 months, and grade 3: 1.4 months; P < 0.001) and the extent of PVTT (Vp0: 54.3 months, Vp1/2: 8.4 months, Vp3/4: 3.9 months; P = 0.0039). CONCLUSION Viral hepatitis (25.3%) was found as the background liver disease of ICC. Assessing liver function via ALBI grade is useful for stratifying prognosis of patients with ICC. This article is protected by copyright. All rights reserved.