Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia

Yung Chang Lien, Chih Cheng Hsieh, Yu Chung Wu, Han Shui Hsu, Wen Hu Hsu, Liang Shun Wang, Min Hsiung Huang, Biing Shiun Huang

Research output: Contribution to journalArticle

111 Citations (Scopus)

Abstract

Among patients with adenocarcinoma of the gastric cardia, we noted that patients with higher preoperative serum albumin levels appeared to survive longer than patients with lower levels. Thus, we evaluated serum albumin as a prognostic factor for patient survival. From 1987 to 1997, 314 patients with adenocarcinoma of the gastric cardia underwent curative resection. Patient serum albumin levels were evaluated on the second day after admission, before any nutritional support. Patients were divided into two groups: those with normal serum albumin levels (>3.5 g/dl) and those with abnormal serum albumin levels. The perioperative mortality and morbidity were 5.7% (18 of 314) and 22.3% (70 of 314), respectively. The surgical resectability rate was significantly better among patients with normal serum albumin levels (P <0.001). The 5-year overall survival rate of patients with normal serum albumin levels was also better than those with abnormally low serum albumin levels (38.4% versus 19.1%, P = 0.0003). In each cancer stage, the 5-year survival rate of patients with normal serum albumin levels was better than that among those with hypoalbuminemia. By multivariate analysis, serum albumin level and the pathologic T, N statuses were independent factors correlated with prognosis. Preoperative serum albumin level correlated highly with resectability and survival. Patients with abnormal serum albumin levels had worse survival than did those with normal serum albumin levels. We recommend that postoperative adjuvant therapy be given to all patients with hypoalbuminemia preoperatively.

Original languageEnglish
Pages (from-to)1041-1048
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume8
Issue number8
DOIs
Publication statusPublished - Dec 1 2004
Externally publishedYes

Keywords

  • adenocarcinoma
  • gastric cardia
  • Serum albumin

ASJC Scopus subject areas

  • Surgery

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