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Serum Albumin as a Significant Prognostic Factor for Patients with Gastric Carcinoma

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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The definition of prognostic factors in gastric carcinoma (GC) remains controversial. The potential of serum albumin as a prognostic factor for GC is emphasized because the technique to measure it is simple as well as being cheap and widely available. Our aim was to define the prognostic role of serum albumin in GC.

Methods

A cohort treated from January 1987 to December 2002 was studied. Relevant clinical, pathological and therapeutic variables were recorded. Kaplan–Meier and Cox’s methods were used to define prognostic factors associated with cancer-related survival.

Results

One thousand and twenty-three patients were included. Serum albumin did impact survival, showing a dose-response effect. This effect was present after adjustment for other prognostic factors, including Tumor-Node-Metastasis (TNM) stage, surgical resection and type of lymphadenectomy. In multivariate analysis, TNM stage [Stage Ia and Ib Hazard Ratio [HR] 1, Stage II HR 1.6 (95% confidence interval [CI], 0.56–4.7), Stage IIIa HR 4.4 (95% CI 1.7–11.3), Stage IIIb HR 5.6 (95% CI 2.6–17.2), Stage IV HR 6.8 (95% CI 2.7–17.5), high albumin HR 1, medium albumin HR 1.2 (95% CI 0.8–1.7), low albumin HR 1.2 (95% CI 0.8–1.8), very low albumin HR 1.8 (95% CI 1.3–2.6), D2 dissection HR 1, D1 dissection HR 1.9 (95% CI 1.3–2.97), and no resection HR 3.7 (95% CI 2.4–5.7)] were the most significant prognostic factors associated to survival (model P = 0.00001).

Conclusion

Pretherapeutic serum albumin level is a significant prognostic factor, which should be evaluated along with other well-defined prognostic factors in decisions concerning therapy for GC.

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Acknowledgments

Many thanks to Maria Esther Briones Trejo and to Blanca Rosas Rosas for their kind help with logistics as well as to Isabel Sierra Colindres and all fellows in the Clinical Archive and personnel in the Clinical Laboratory, particularly from the Clinical Chemistry Laboratory. Many thanks to Alejandra García Hubard for her support in the writing of the manuscript and to Maggie Brunner, M.A. for her English-language editorial review.

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Authors and Affiliations

  1. Clínica de Neoplasias Gástricas, Gastroenterology Department, Instituto Nacional de Cancerología, San Fernando 22, México D.F., 14080, México

    Luis F. Oñate-Ocaña M.D. & Vincenzo Aiello-Crocifoglio M.D.

  2. Medical Oncology Department, Instituto Nacional de Cancerología, Mexico City, México

    Dolores Gallardo-Rincón M.D.

  3. Pathology Department, Instituto Nacional de Cancerología, Mexico City, México

    Roberto Herrera-Goepfert M.D.

  4. Computed Tomography, Ultrasound and Magnetic Resonance Department, Instituto Nacional de Cancerología, Mexico City, México

    Rocío Brom-Valladares M.D., M.P.H.

  5. Surgery Division, Instituto Nacional de Cancerología, Mexico City, México

    José F. Carrillo M.D.

  6. Hematology Department, Instituto Nacional de Cancerología, Mexico City, México

    Eduardo Cervera M.D.

  7. Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología/Instituto de Biomédicas. Universidad Nacional Autónoma de México, Mexico City, México

    Alejandro Mohar-Betancourt M.D. PhD.

Authors
  1. Luis F. Oñate-Ocaña M.D.
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  2. Vincenzo Aiello-Crocifoglio M.D.
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  3. Dolores Gallardo-Rincón M.D.
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  7. Eduardo Cervera M.D.
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  8. Alejandro Mohar-Betancourt M.D. PhD.
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Corresponding author

Correspondence to Luis F. Oñate-Ocaña M.D..

Additional information

This work wins the “National Oncology Award 2005 Dr. Guillermo Montaño Islas” issued by the Mexican Society of Oncology.

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Oñate-Ocaña, L.F., Aiello-Crocifoglio, V., Gallardo-Rincón, D. et al. Serum Albumin as a Significant Prognostic Factor for Patients with Gastric Carcinoma. Ann Surg Oncol 14, 381–389 (2007). https://doi.org/10.1245/s10434-006-9093-x

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  • DOI: https://doi.org/10.1245/s10434-006-9093-x

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