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Purpose <p>Perihilar cholangiocarcinoma (PHCC) accounts for 50–60% of cholangiocarcinoma and it has a poor prognosis, with low survival rates after surgery. The albumin–bilirubin (ALBI) score, based on serum albumin and bilirubin levels, has been reported to predict survival more accurately than the Child–Pugh score. This study aimed to evaluate the prognostic value of the modified ALBI score (mALBI) in patients with PHCC following radical resection.</p> Methods <p>We retrospectively analyzed the medical records of patients with PHCC who underwent major hepatectomy with extrahepatic bile duct resection between January 2001 and December 2023 at Kobe University.</p> Results <p>We included 100 patients with PHCC in the analysis. Patients in the low mALBI group (grades 1 and 2a; <i>n</i> = 44) had a significantly better overall and recurrence-free survival than those in the high mALBI group (grades 2b and 3; <i>n</i> = 56). The high mALBI group was associated with higher preoperative CA19-9 levels, a higher incidence of preoperative cholangitis, and recurrent venous and perineural invasion. Postoperatively, the patients in the high mALBI group showed a delayed recovery of serum albumin levels and persistently elevated bilirubin levels. Furthermore, liver regeneration after right hepatectomy was significantly greater in the low mALBI group, whereas no significant difference was observed after left hepatectomy.</p> Conclusions <p>The mALBI grade is a promising prognostic biomarker for both overall and recurrence-free survival in patients with PHCC following curative resection.</p>

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Preoperative albumin–bilirubin grade predicts the prognosis in patients with perihilar cholangiocarcinoma

  • 期刊论文

  • 发表日期：

    2026年4月1日

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  • Michihiko Yoshida,
  • Hiroaki Yanagimoto,
  • Daisuke Tsugawa,
  • Masayuki Akita,
  • Yuki Okazoe,
  • Ryunosuke Konaka,
  • Toru Takahashi,
  • Jun Ishida,
  • Takeshi Urade,
  • Yoshihide Nanno,
  • Kenji Fukushima,
  • Shohei Komatsu,
  • Sadaki Asari,
  • Masahiro Kido,
  • Takumi Fukumoto

摘要

Purpose

Perihilar cholangiocarcinoma (PHCC) accounts for 50–60% of cholangiocarcinoma and it has a poor prognosis, with low survival rates after surgery. The albumin–bilirubin (ALBI) score, based on serum albumin and bilirubin levels, has been reported to predict survival more accurately than the Child–Pugh score. This study aimed to evaluate the prognostic value of the modified ALBI score (mALBI) in patients with PHCC following radical resection.

Methods

We retrospectively analyzed the medical records of patients with PHCC who underwent major hepatectomy with extrahepatic bile duct resection between January 2001 and December 2023 at Kobe University.

Results

We included 100 patients with PHCC in the analysis. Patients in the low mALBI group (grades 1 and 2a; n = 44) had a significantly better overall and recurrence-free survival than those in the high mALBI group (grades 2b and 3; n = 56). The high mALBI group was associated with higher preoperative CA19-9 levels, a higher incidence of preoperative cholangitis, and recurrent venous and perineural invasion. Postoperatively, the patients in the high mALBI group showed a delayed recovery of serum albumin levels and persistently elevated bilirubin levels. Furthermore, liver regeneration after right hepatectomy was significantly greater in the low mALBI group, whereas no significant difference was observed after left hepatectomy.

Conclusions

The mALBI grade is a promising prognostic biomarker for both overall and recurrence-free survival in patients with PHCC following curative resection.