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

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.