title: Clinical significance of postoperative recovery of serum albumin levels in patients with esophageal cancer who underwent transthoracic esophagectomy.
abstract: OBJECTIVE
  We evaluated postoperative recovery after transthoracic esophagectomy using postoperative serum albumin (Alb) levels and investigated the correlation between postoperative Alb recovery and the survival of patients with esophageal cancer.
  
  
  METHODS
  Esophageal cancer patients who underwent transthoracic esophagectomy were retrospectively reviewed. To evaluate postoperative Alb recovery, the recovery rate of Alb was used. We investigated the correlation between Alb recovery, clinicopathological factors, and the survival. Furthermore, the postoperative systemic inflammatory response was evaluated using serum C-reactive levels, and its impact on the Alb recovery was examined.
  
  
  RESULTS
  Ninety-seven (51 %) of 191 patients were classified as having insufficient Alb recovery. In the multivariate survival analysis, pStage and insufficient Alb recovery (hazard ratio 1.863; P = 0.021) were significantly independent predictive factors for the overall survival. Patients with pStage IB-IV with insufficient Alb recovery had a significantly shorter recurrence-free survival (5-year recurrence-free survival rate, 59.5 vs. 41.5 %; P = 0.035) and significantly higher serum CRP levels at POM 3 compared with patients with sufficient Alb recovery.
  
  
  CONCLUSIONS
  Insufficient Alb recovery correlates with the systemic postoperative inflammatory response and a poor prognosis. Further studies are warranted to investigate the survival benefit of intervention to enhance postoperative Alb recovery.
authors.affiliation: Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Matsuda
authors.affiliation: Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan. niihara.m@gmail.com.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Niihara
authors.affiliation: Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsubosa
authors.affiliation: Department of Surgery, Division of Upper Gastrointestinal Tract, International Medical Center, Saitama University, 1397-1, Yamane, Hidaka-Shi, Saitama, 350-1298, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.affiliation: Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Takebayashi
authors.affiliation: Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kawamorita
authors.affiliation: Clinical Trial Coordination Office, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Mori
authors.affiliation: Division of Gastrointestinal Oncology, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsushima
authors.affiliation: Division of Gastrointestinal Oncology, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasui
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Takeuchi
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis*; D015996:Survival Rate; D019616:Thoracic Surgical Procedures / Q000379:methods*
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; D002097:C-Reactive Protein
keywords: Esophageal cancer; Esophagectomy; Postoperative albumin
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