Albumin-Bilirubin Score as a Novel Prognostic Prediction Tool for Surgically Treated Head and Neck Squamous Cell Carcinoma

Ming Hsien Tsai; Chao Hui Yang; Yu Tsai Lin; Hui Ching Chuang; Tai Lin Huang; Hui Lu; Wen Ling Tsai; Chih Yen Chien; Fu Min Fang

doi:10.1002/kjm2.70115

Albumin-Bilirubin Score as a Novel Prognostic Prediction Tool for Surgically Treated Head and Neck Squamous Cell Carcinoma

Ming Hsien Tsai
, Chao Hui Yang
, Yu Tsai Lin
, Hui Ching Chuang
, Tai Lin Huang
, Hui Lu
, Wen Ling Tsai
, Chih Yen Chien^*
, Fu Min Fang^*

^*Corresponding author for this work

Chang Gung University
National Sun Yat-sen University
Cheng Shiu University Taiwan

Research output: Contribution to journal › Journal Article › peer-review

Abstract

We investigated the prognostic significance of the preoperative albumin-bilirubin (ALBI) score in surgically treated head and neck squamous cell carcinoma (HNSCC). This retrospective study included 663 patients who underwent radical surgery between 2007 and 2017. The ALBI score, calculated using preoperative bilirubin and albumin levels, was assessed for its impact on overall survival (OS) through univariate and multivariate Cox regression analyses. Patients were randomly assigned to training and validation cohorts in a 3:1 ratio, and using a cutoff of −2.871, patients were stratified into low- and high-ALBI groups, revealing significant prognostic differences in both cohorts. A high preoperative ALBI score was an independent predictor of worse OS in both cohorts, with an ALBI-based nomogram being developed to predict OS with strong concordance indices (0.759 and 0.749 in the training and validation cohorts, respectively). Accordingly, the ALBI score is a simple and effective prognostic marker for improving risk stratification and survival prediction in HNSCC patients.

Original language	English
Article number	e70115
Pages (from-to)	e70115
Journal	Kaohsiung Journal of Medical Sciences
Volume	42
Issue number	4
Early online date	25 09 2025
DOIs	https://doi.org/10.1002/kjm2.70115
State	E-pub ahead of print - 25 09 2025

Bibliographical note

Publisher Copyright:
© 2025 The Author(s). The Kaohsiung Journal of Medical Sciences published by John Wiley & Sons Australia, Ltd on behalf of Kaohsiung Medical University.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

ALBI
head and neck cancer
prognosis
serum albumin
serum bilirubin

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10.1002/kjm2.70115

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Tsai, M. H., Yang, C. H., Lin, Y. T., Chuang, H. C., Huang, T. L., Lu, H., Tsai, W. L., Chien, C. Y., & Fang, F. M. (2025). Albumin-Bilirubin Score as a Novel Prognostic Prediction Tool for Surgically Treated Head and Neck Squamous Cell Carcinoma. Kaohsiung Journal of Medical Sciences, 42(4), e70115. Article e70115. Advance online publication. https://doi.org/10.1002/kjm2.70115

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title = "Albumin-Bilirubin Score as a Novel Prognostic Prediction Tool for Surgically Treated Head and Neck Squamous Cell Carcinoma",

abstract = "We investigated the prognostic significance of the preoperative albumin-bilirubin (ALBI) score in surgically treated head and neck squamous cell carcinoma (HNSCC). This retrospective study included 663 patients who underwent radical surgery between 2007 and 2017. The ALBI score, calculated using preoperative bilirubin and albumin levels, was assessed for its impact on overall survival (OS) through univariate and multivariate Cox regression analyses. Patients were randomly assigned to training and validation cohorts in a 3:1 ratio, and using a cutoff of −2.871, patients were stratified into low- and high-ALBI groups, revealing significant prognostic differences in both cohorts. A high preoperative ALBI score was an independent predictor of worse OS in both cohorts, with an ALBI-based nomogram being developed to predict OS with strong concordance indices (0.759 and 0.749 in the training and validation cohorts, respectively). Accordingly, the ALBI score is a simple and effective prognostic marker for improving risk stratification and survival prediction in HNSCC patients.",

keywords = "ALBI, head and neck cancer, prognosis, serum albumin, serum bilirubin",

author = "Tsai, \{Ming Hsien\} and Yang, \{Chao Hui\} and Lin, \{Yu Tsai\} and Chuang, \{Hui Ching\} and Huang, \{Tai Lin\} and Hui Lu and Tsai, \{Wen Ling\} and Chien, \{Chih Yen\} and Fang, \{Fu Min\}",

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T1 - Albumin-Bilirubin Score as a Novel Prognostic Prediction Tool for Surgically Treated Head and Neck Squamous Cell Carcinoma

AU - Tsai, Ming Hsien

AU - Yang, Chao Hui

AU - Lin, Yu Tsai

AU - Chuang, Hui Ching

AU - Huang, Tai Lin

AU - Lu, Hui

AU - Tsai, Wen Ling

AU - Chien, Chih Yen

AU - Fang, Fu Min

PY - 2025/9/25

Y1 - 2025/9/25

N2 - We investigated the prognostic significance of the preoperative albumin-bilirubin (ALBI) score in surgically treated head and neck squamous cell carcinoma (HNSCC). This retrospective study included 663 patients who underwent radical surgery between 2007 and 2017. The ALBI score, calculated using preoperative bilirubin and albumin levels, was assessed for its impact on overall survival (OS) through univariate and multivariate Cox regression analyses. Patients were randomly assigned to training and validation cohorts in a 3:1 ratio, and using a cutoff of −2.871, patients were stratified into low- and high-ALBI groups, revealing significant prognostic differences in both cohorts. A high preoperative ALBI score was an independent predictor of worse OS in both cohorts, with an ALBI-based nomogram being developed to predict OS with strong concordance indices (0.759 and 0.749 in the training and validation cohorts, respectively). Accordingly, the ALBI score is a simple and effective prognostic marker for improving risk stratification and survival prediction in HNSCC patients.

AB - We investigated the prognostic significance of the preoperative albumin-bilirubin (ALBI) score in surgically treated head and neck squamous cell carcinoma (HNSCC). This retrospective study included 663 patients who underwent radical surgery between 2007 and 2017. The ALBI score, calculated using preoperative bilirubin and albumin levels, was assessed for its impact on overall survival (OS) through univariate and multivariate Cox regression analyses. Patients were randomly assigned to training and validation cohorts in a 3:1 ratio, and using a cutoff of −2.871, patients were stratified into low- and high-ALBI groups, revealing significant prognostic differences in both cohorts. A high preoperative ALBI score was an independent predictor of worse OS in both cohorts, with an ALBI-based nomogram being developed to predict OS with strong concordance indices (0.759 and 0.749 in the training and validation cohorts, respectively). Accordingly, the ALBI score is a simple and effective prognostic marker for improving risk stratification and survival prediction in HNSCC patients.

KW - ALBI

KW - head and neck cancer

KW - prognosis

KW - serum albumin

KW - serum bilirubin

UR - https://www.scopus.com/pages/publications/105017859558

U2 - 10.1002/kjm2.70115

DO - 10.1002/kjm2.70115

M3 - 文章

C2 - 40999594

AN - SCOPUS:105017859558

SN - 1607-551X

VL - 42

SP - e70115

JO - Kaohsiung Journal of Medical Sciences

JF - Kaohsiung Journal of Medical Sciences

IS - 4

M1 - e70115

ER -

Albumin-Bilirubin Score as a Novel Prognostic Prediction Tool for Surgically Treated Head and Neck Squamous Cell Carcinoma

Abstract

Bibliographical note

UN SDGs

Keywords

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