Prognostic significance of preoperative serum albumin level in patients with gastric cancer.]

Liu N, Liang H, Zhang RP, Pan Y, Ke B, Zhao JZ, Liu XY, Han T.

Department of Gastrointestinal Cancer, Tianjin Cancer Hospital, Key Laboratory of Cancer Prevention and Treatment of Tianjin City, Tianjin Medical University, Tianjin 300060, China.

OBJECTIVE: To evaluate the prognostic significance of preoperative serum albumin in patients with gastric cancer undergoing radical resection.

METHODS: A total of 146 patients with gastric cancer underwent radical resection from January 2001 to December 2003. Clinicopathological data were analyzed retrospectively. Patients were divided into two groups, including patients with a normal preoperative serum albumin level(>35 g/L, n=115) and patients with hypoalbuminemia (≤35 g/L, n=31).

RESULTS: Patients with a low albumin level were associated with a higher postoperative recurrence rate(90.3% vs. 43.5%, P<0.01). The overall 5-year survival rate in patients with a normal serum albumin level was significantly higher than that in patients with a low serum level(57.4% vs. 9.7%, P<0.01). On multivariate analysis, preoperative serum albumin level was an independent factor associated with survival(P<0.01). When stratified by nodal metastasis, normal serum albumin level was still associated with higher survival rate(P<0.05). Prognostic significance was found in patients with lower stomach cancer(P<0.01), but not in patients with cancer in the upper and middle stomach(P>0.05).

CONCLUSION: Hypoalbuminemia is associated with worse survival in patients with cancer in the lower stomach and adjuvant therapy should be considered.