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10.1245/s10434-006-9093-x
Annals of Surgical Oncology 14:381-389 (2007)
© 2007 Society of Surgical Oncology
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Original Article

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

Luis F. Oñate-Ocaña, M.D.1, Vincenzo Aiello-Crocifoglio, M.D.1, Dolores Gallardo-Rincón, M.D.2, Roberto Herrera-Goepfert, M.D.3, Rocío Brom-Valladares, M.D., M.P.H.4, José F. Carrillo, M.D.5, Eduardo Cervera, M.D.6 and Alejandro Mohar-Betancourt, M.D., PhD.7

1 Clínica de Neoplasias Gástricas, Gastroenterology Department, Instituto Nacional de Cancerología, San Fernando 22, México D.F. 14080, México
2 Medical Oncology Department, Instituto Nacional de Cancerología, Mexico City, México
3 Pathology Department, Instituto Nacional de Cancerología, Mexico City, México
4 Computed Tomography, Ultrasound and Magnetic Resonance Department, Instituto Nacional de Cancerología, Mexico City, México
5 Surgery Division, Instituto Nacional de Cancerología, Mexico City, México
6 Hematology Department, Instituto Nacional de Cancerología, Mexico City, México
7 Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología/Instituto de Biomédicas. Universidad Nacional Autónoma de México, Mexico City, México

Correspondence: Address correspondence and reprint requests to: Luis F. Oñate-Ocaña, M.D.; E-mail: lfonate{at}gmail.com

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.

Key Words: Stomach neoplasm • Adenocarcinoma • Prognostic factor • Serum albumin






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