title: Prognostic value of albumin in patients with head and neck cancer.
abstract: Albumin is an indicator of nutritional status and has been investigated as a predictor of cancer survival and perioperative outcomes. This study investigated the prognostic value of preoperative serum albumin in surgical patients with head and neck cancer (HNC).
  
  
  
  Retrospective cohort study.
  
  
  
  A chart review was performed of patients who underwent HNC resection over a 6-year period at a single institution. Statistical analyses including Cox proportional hazards models, Pearson's correlation, and logistic regression were used to identify relationships between preoperative serum albumin and postoperative outcomes. Albumin was analyzed as a continuous variable.
  
  
  
  A total of 604 patients were studied representing all cancer types. There was no association between albumin and pneumonia, flap complications, or length of stay. Albumin was found to have statistically significant inverse associations with overall survival (OS) (hazard ratio [HR] = 0.685, P < .001) and postoperative wound infection (HR = 0.455, P = .001). In multivariate analysis of OS, albumin did not achieve significance as an independent predictor (HR = 0.78, P = .064), whereas hemoglobin, age, and cancer stage remained significant. In a subgroup of 280 patients with upper aerodigestive squamous cell carcinoma (SCCA), albumin maintained significance in multivariate analysis of OS (HR = 0.74, P = .046). When controlling for preoperative radiotherapy, salvage surgery, and cancer stage in multivariate analysis, albumin was a significant predictor of wound infection (OR = 0.55, P = .018).
  
  
  
  In patients with HNC, lower preoperative serum albumin is associated with an increased rate of wound infection and poorer OS. The effect on OS is most pronounced in patients with upper aerodigestive SCCA.
  
  
  
  2b Laryngoscope, 126:1567-1571, 2016.
authors: Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors: Deepa
authors: D
authors: Danan
authors: Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors: David C
authors: DC
authors: Shonka
authors: Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors: Yamil
authors: Y
authors: Selman
authors: Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors: Zenia
authors: Z
authors: Chow
authors: Department of Public Health Sciences, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors: Mark E
authors: ME
authors: Smolkin
authors: Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors: Mark J
authors: MJ
authors: Jameson
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000401:mortality / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011184:Postoperative Period; D011237:Predictive Value of Tests; D057234:Preoperative Period; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D000077195:Squamous Cell Carcinoma of Head and Neck; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000209:etiology; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D012709:Serum Albumin
keywords: Albumin; head and neck cancer