Postoperative Serum Albumin is a Potential Prognostic Factor for Older Patients with Gastric Cancer

Yonago Acta Med. 2018 Mar 28;61(1):72-78. doi: 10.33160/yam.2018.03.010. eCollection 2018 Mar.

Abstract

Background: The incidence of gastric cancer (GC) among older adults is increasing. Therefore, determining postoperative age-associated prognostic factors is clinically important. This study retrospectively investigated the prognostic significance of serum albumin level in older GC patients.

Methods: We enrolled 135 patients aged ≥ 75 years, who underwent gastrectomies with histopathological diagnoses of gastric adenocarcinoma.

Results: Preoperative albumin (pre-Alb) levels in patients with advanced GC and stage III/IV GC were significantly lower than those in patients with early GC (P = 0.0032) and stage I/II GC (P = 0.006), respectively. Postoperative albumin (post-Alb) levels (measured 1 month after surgery) in male patients and in patients with advanced GC were significantly lower than those in female patients (P = 0.024) and those with early GC (P = 0.044), respectively. Post-Alb levels of patients who died of other diseases were significantly lower than those who were still living (P = 0.0004). Prognosis of patients with high post-Alb levels (≥ 4g/dL) was significantly better than that of patients with low post-Alb levels (< 4g/dL; P = 0.045); and in multivariate analysis, post-Alb level was an independent prognostic indicator.

Conclusion: Post-Alb level is a useful predictive factor for the prognosis of older GC patients. Postoperative nutritional support might help improve the prognosis of older GC patients.

Keywords: age; albumin; gastric cancer; malnutrition; prognosis.