Prognostic value of albumin-bilirubin grade in lung cancer: a meta-analysis

Abstract

Purpose: To clarify the prognostic role of pretreatment albumin-bilirubin (ALBI) grade in lung cancer patients. Methods: The PubMed, EMBASE, Web of Science and CNKI databases were searched up to April 20, 2024. Primary outcomes included the overall survival (OS), progression-free survival (PFS) and cancer-specific survival (CSS). Hazard ratios (HRs) with 95% confidence intervals (CIs) were combined and subgroup analysis based on the type of lung cancer [non-small cell lung cancer (NSCLC) vs. small cell lung cancer (SCLC)] and treatment [surgery vs. immune checkpoint inhibitors (ICIs) vs. chemotherapy] was conducted. Results: Eight studies with 2,057 patients were included. Pooled results indicated that elevated pretreatment ALBI grade was significantly related to poor OS (HR = 2.50, 95% CI: 2.03–3.09, P<0.001), PFS (HR = 1.91, 95% CI: 1.56–2.33, P<0.001) and CSS (HR = 1.90, 95% CI: 1.11–3.11, P = 0.018). Subgroup analysis for OS based on the pathological type and primary treatment manifested similar results. Conclusion: Pretreatment ALBI grade is associated with prognosis in lung cancer and patients with elevated ALBI grade are more likely to experience worse survival.