title: Serum albumin as a significant prognostic factor for patients with gastric carcinoma.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Clínica de Neoplasias Gástricas, Gastroenterology Department, Instituto Nacional de Cancerología, San Fernando 22, México D.F., 14080, México. lfonate@gmail.com
authors.forename: Luis F
authors.initials: LF
authors.lastname: Oñate-Ocaña
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Aiello-Crocifoglio
authors.forename: Dolores
authors.initials: D
authors.lastname: Gallardo-Rincón
authors.forename: Roberto
authors.initials: R
authors.lastname: Herrera-Goepfert
authors.forename: Rocío
authors.initials: R
authors.lastname: Brom-Valladares
authors.forename: José F
authors.initials: JF
authors.lastname: Carrillo
authors.forename: Eduardo
authors.initials: E
authors.lastname: Cervera
authors.forename: Alejandro
authors.initials: A
authors.lastname: Mohar-Betancourt
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D012709:Serum Albumin / Q000032:analysis*; D013274:Stomach Neoplasms / Q000097:blood* / Q000628:therapy; D016019:Survival Analysis
chemical_list: D012709:Serum Albumin