Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia.
Among patients with adenocarcinoma of the gastric cardia, we noted that patients with higher preoperative serum albumin levels appeared to survive longer than patients with lower levels. Thus, we evaluated serum albumin as a prognostic factor for patient survival. From 1987 to 1997, 314 patients with adenocarcinoma of the gastric cardia underwent curative resection. Patient serum albumin levels were evaluated on the second day after admission, before any nutritional support. Patients were divided into two groups: those with normal serum albumin levels (>3.5 g/dl) and those with abnormal serum albumin levels. The perioperative mortality and morbidity were 5.7% (18 of 314) and 22.3% (70 of 314), respectively. The surgical resectability rate was significantly better among patients with normal serum albumin levels (P < 0.001). The 5-year overall survival rate of patients with normal serum albumin levels was also better than those with abnormally low serum albumin levels (38.4% versus 19.1%, P=0.0003). In each cancer stage, the 5-year survival rate of patients with normal serum albumin levels was better than that among those with hypoalbuminemia. By multivariate analysis, serum albumin level and the pathologic T, N statuses were independent factors correlated with prognosis. Preoperative serum albumin level correlated highly with resectability and survival. Patients with abnormal serum albumin levels had worse survival than did those with normal serum albumin levels. We recommend that postoperative adjuvant therapy be given to all patients with hypoalbuminemia preoperatively.
Lien
Yung-Chang
YC
Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan.
Hsieh
Chih-Cheng
CC
Wu
Yu-Chung
YC
Hsu
Han-Shui
HS
Hsu
Wen-Hu
WH
Wang
Liang-Shun
LS
Huang
Min-Hsiung
MH
Huang
Biing-Shiun
BS
D000230:Adenocarcinoma / Q000097:blood* / Q000401:mortality / Q000601:surgery; D000368:Aged; D002299:Cardia; D016022:Case-Control Studies; D003680:Deglutition Disorders / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011300:Preoperative Care; D011379:Prognosis; D012709:Serum Albumin / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000097:blood* / Q000401:mortality / Q000601:surgery; D015996:Survival Rate; D013997:Time Factors
D012709:Serum Albumin