Is hypoalbuminemia an independent prognostic factor in patients with gastric cancer?

Crumley, A.B.C., Stuart, R., McKernan, M. and McMillan, D.C. (2010) Is hypoalbuminemia an independent prognostic factor in patients with gastric cancer? World Journal of Surgery, 34(10), pp. 2393-2398. (doi:10.1007/s00268-010-0641-y)

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Publisher's URL: http://dx.doi.org/10.1007/s00268-010-0641-y

Abstract

Background

Studies have indicated that hypoalbuminemia is associated with decreased survival of patients with gastric cancer. However, the prognostic value of albumin may be secondary to an ongoing systemic inflammatory response. The aim of the study was to assess the relation between hypoalbuminemia, the systemic inflammatory response, and survival in patients with gastric cancer.

Methods

Patients diagnosed with gastric carcinoma attending the upper gastrointestinal surgical unit in the Royal Infirmary, Glasgow between April 1997 and December 2005 and who had a pretreatment measurement of albumin and C-reactive protein (CRP) were studied.

Results

Most of the patients had stage III/IV disease and received palliative treatment. The minimum follow-up was 15 months. During follow-up, 157 (72%) patients died of their cancer. On univariate analysis, stage (p < 0.001), treatment (p < 0.001), albumin level (p < 0.001), and CRP level (p < 0.001) were significant predictors of survival. On multivariate analysis, stage (p < 0.001), treatment (p < 0.001), and CRP level (p < 0.001) remained significant predictors of survival. Albumin was no longer an independent predictor of survival.

Conclusions

Low albumin concentrations are associated with poorer survival in patients with gastric cancer. However, the strength of this relation with survival is dependent on the presence of a systemic inflammatory response, as evidenced by an elevated CRP level. Therefore, it appears that the relation between hypoalbuminemia and poor survival is secondary to that of the systemic inflammatory response.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McMillan, Professor Donald
Authors: Crumley, A.B.C., Stuart, R., McKernan, M., and McMillan, D.C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:World Journal of Surgery
Publisher:Springer
ISSN:0364-2313
Published Online:03 July 2010

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