ArticleFrontiers in oncology2026
ALBI-SII grade: a novel prognostic indicator superior to Child-Pugh score for long-term survival in hepatocellular carcinoma and its nomogram construction and validation.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Prognostic heterogeneity is common in patients with hepatocellular carcinoma (HCC) within the same clinical stage. While the albumin-bilirubin (ALBI) score and systemic immune-inflammation index (SII) have individual prognostic value, their combined significance remains unclear. We aimed to develop a novel ALBI-SII grade and a prognostic nomogram to refine risk stratification. Methods: This retrospective study included 210 patients with HCC diagnosed between 2013 and 2021. A novel ALBI-SII grade was constructed by integrating ALBI and SII. Overall survival (OS) was analyzed using Kaplan-Meier methods and Cox regression based on a multiple imputation dataset. A nomogram incorporating ALBI-SII grade and China Liver Cancer (CNLC) staging was developed and validated using time-dependent ROC curves, DeLong's test, and decision curve analysis (DCA). Results: The ALBI-SII grade stratified patients into three distinct risk groups (Median OS: Grade 0, 639 days; Grade 1, 310 days; Grade 2, 148 days; P < 0.001). In multivariate analysis, ALBI-SII grade remained an independent prognostic factor (Grade 2 vs. 0: HR = 2.576, 95% CI: 1.654-4.012, P < 0.001). The 5-year AUC of ALBI-SII was 0.735, which was statistically comparable to that of CNLC staging (AUC = 0.724; DeLong's P > 0.05). The nomogram demonstrated robust discrimination (C-index: 0.695) and favorable clinical net benefit. Conclusion: The ALBI-SII grade is an objective and practical prognostic indicator for HCC. A nomogram integrating ALBI-SII and CNLC staging provides reliable survival prediction, particularly for long-term outcomes.
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