Impact of preoperative prealbumin levels on long-term prognosis in patients with gastric cancer after gastrectomy: a retrospective cohort study,Gastric Cancer

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Impact of preoperative prealbumin levels on long-term prognosis in patients with gastric cancer after gastrectomy: a retrospective cohort study
Gastric Cancer ( IF 6.0 ) Pub Date : 2024-02-24 , DOI: 10.1007/s10120-024-01472-y
Ryota Matsui ₁ , Satoshi Ida ₁ , Motonari Ri ₁ , Rie Makuuchi ₁ , Masaru Hayami ₁ , Koshi Kumagai ₁ , Manabu Ohashi ₁ , Takeshi Sano ₁ , Souya Nunobe ₁

Affiliation

Background

The relationship between preoperative prealbumin levels and long-term prognoses in patients with gastric cancer after gastrectomy has not been fully investigated. This study clarified the effect of preoperative prealbumin levels on the long-term prognosis of patients with gastric cancer after gastrectomy.

Methods

This retrospective cohort study included consecutive patients who underwent radical gastrectomy for primary pStage I–III gastric cancer and whose preoperative prealbumin levels were measured between May 2006 and March 2017. Participants were categorized according to their preoperative prealbumin levels into high (≥22 mg/dL), moderate (15–22 mg/dL), and low (<15 mg/dL) groups. The overall survival (OS) in the three groups was compared using the log-rank test, and prognostic factors were identified using Cox proportional hazards regression analysis.

Results

The median follow-up duration was 66 months. Of 4732 patients, 3649 (77.2%) were classified as high, 925 (19.6%) as moderate, and 158 (3.3%) as low. Lower prealbumin levels were associated with poorer prognoses (P < 0.001). Multivariate analysis showed that prealbumin levels of 15–22 mg/dL [hazard ratio (HR): 1.576, 95% confidence interval (CI): 1.353–1.835, P < 0.001] and <15 mg/dL (HR: 1.769, 95% CI: 1.376–2.276, P < 0.001) were independent poor prognostic factors for OS. When analyzed according to the cause of death, prealbumin levels were associated with other-cause survival, but not cancer-specific survival.

Conclusions

Preoperative prealbumin levels correlated with OS in patients with gastric cancer after gastrectomy; the lower the prealbumin level, the worse is the prognosis. Prealbumin levels may be associated with other-cause survival.

中文翻译：

术前前白蛋白水平对胃癌患者胃切除术后长期预后的影响：一项回顾性队列研究

背景

胃癌患者胃切除术后术前前白蛋白水平与长期预后之间的关系尚未得到充分研究。本研究阐明了术前前白蛋白水平对胃癌患者胃切除术后长期预后的影响。

方法

这项回顾性队列研究纳入了因原发性 I-III 期胃癌接受根治性胃切除术的连续患者，并在 2006 年 5 月至 2017 年 3 月期间测量了其术前前白蛋白水平。根据术前前白蛋白水平将参与者分为高（≥22 mg/dL））、中度（15-22 mg/dL）和低度（<15 mg/dL）组。使用对数秩检验比较三组的总生存期（OS），并使用Cox比例风险回归分析确定预后因素。

结果

中位随访时间为 66 个月。在 4732 名患者中，3649 名 (77.2%) 被归类为高，925 名 (19.6%) 被归类为中度，158 名 (3.3%) 被归类为低。较低的前白蛋白水平与较差的预后相关（ P < 0.001）。多变量分析显示，前白蛋白水平为 15–22 mg/dL [风险比 (HR)：1.576，95% 置信区间 (CI)：1.353–1.835， P < 0.001] 和 <15 id=75>P < 0.001） OS 的独立不良预后因素。根据死因进行分析时，前白蛋白水平与其他原因的生存率相关，但与癌症特异性生存率无关。