title: Hypoalbuminemia in colorectal cancer prognosis: Nutritional marker or inflammatory surrogate?
abstract: Albumin is the single most abundant protein in the human serum. Its roles in physiology and pathology are diverse. Serum albumin levels have been classically thought to reflect the nutritional status of patients. This concept has been challenged in the last two decades as multiple factors, such as inflammation, appeared to affect albumin levels independent of nutrition. In general, cancer patients have a high prevalence of hypoalbuminemia. As such, the role of hypoalbuminemia in patients with colorectal cancer has received significant interest. We reviewed the English literature on the prognostic value of pretreatment albumin levels in colorectal cancer. We also consolidated the evidence that led to the current understanding of hypoalbuminemia as an inflammatory marker rather than as a nutritional one among patients with colorectal cancer.
authors.affiliation: Bassel Nazha, Elias Moussaly, Mazen Zaarour, Chanudi Weerasinghe, Department of Medicine, North Shore-LIJ Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Bassel
authors.initials: B
authors.lastname: Nazha
authors.affiliation: Bassel Nazha, Elias Moussaly, Mazen Zaarour, Chanudi Weerasinghe, Department of Medicine, North Shore-LIJ Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Elias
authors.initials: E
authors.lastname: Moussaly
authors.affiliation: Bassel Nazha, Elias Moussaly, Mazen Zaarour, Chanudi Weerasinghe, Department of Medicine, North Shore-LIJ Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Mazen
authors.initials: M
authors.lastname: Zaarour
authors.affiliation: Bassel Nazha, Elias Moussaly, Mazen Zaarour, Chanudi Weerasinghe, Department of Medicine, North Shore-LIJ Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Chanudi
authors.initials: C
authors.lastname: Weerasinghe
authors.affiliation: Bassel Nazha, Elias Moussaly, Mazen Zaarour, Chanudi Weerasinghe, Department of Medicine, North Shore-LIJ Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Basem
authors.initials: B
authors.lastname: Azab
keywords: Albumin; Albumin-to-globulin ratio; Cancer survival; Colorectal cancer; Glasgow prognostic score; Hypoalbuminemia; Systemic inflammatory response