title: Impacts of Preoperative Serum Albumin Level on Outcomes of Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy.
abstract: Only few small studies in the literature have explored the impacts of preoperative serum albumin level and clinical outcomes of patients with peritoneal surface malignancy (PSM) who underwent cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy (PIC). This study aimed to evaluate the value of preoperative serum albumin as a prognostic factor for long-term survival outcomes after CRS and PIC in a large patient cohort and to determine whether preoperative serum albumin is correlated with perioperative complications.
  
  
  
  This retrospective study examined prospectively collected data for patients with PSM who underwent CRS and PIC by one surgical team at St George Hospital in Sydney, Australia. The study used 35 g/L as the cuffoff for normal serum albumin level.
  
  
  
  The study enrolled 591 patients. Hypoalbuminemia was found to be associated with a significantly higher rate of major morbidity (p < 0.001), a longer ICU stay (p = 0.003), a longer HDU stay (p < 0.001), a longer total hospital stay (p < 0.001), and a shorter overall survival (OS) (p = 0.016). Factor analysis showed preoperative serum hypoalbuminemia to be a prognostic factor for a poor perioperative outcome (p = 0.018) and a poor OS (p = 0.026).
  
  
  
  Preoperative hypoalbuminemia is associated with poor perioperative outcomes. More importantly, it is a predictor of poorer OS for patients with PSM independent of the PCI, age, and completeness of cytoreduction. In the future, strategies should be undertaken to improve preoperative nutrition of malnourished patients as a means of improving clinical outcomes for patients with PSM.
authors.affiliation: St George Clinical School, University of New South Wales, Sydney, NSW, Australia.|Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Yeqian
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, University of New South Wales, Sydney, NSW, Australia.|College of Medicine, Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia.
authors.forename: Nayef A
authors.initials: NA
authors.lastname: Alzahrani
authors.affiliation: Department of Surgery, Ryde Hospital, North Shore Ryde Health Service, St Leonards, Sydney, NSW, Australia.
authors.forename: Terence C
authors.initials: TC
authors.lastname: Chua
authors.affiliation: St George Clinical School, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Ya Ruth
authors.initials: YR
authors.lastname: Huo
authors.affiliation: Department of Medical Oncology, St George Hospital, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Winston
authors.initials: W
authors.lastname: Liauw
authors.affiliation: Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, University of New South Wales, Sydney, NSW, Australia. david.morris@unsw.edu.au.
authors.forename: David L
authors.initials: DL
authors.lastname: Morris
mesh_terms: D001315:Australia; D017024:Chemotherapy, Adjuvant; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D034141:Hypoalbuminemia / Q000150:complications*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000601:surgery*; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome