胃癌患者接受根治性治疗时前白蛋白水平的临床意义。
Clinical Significance of the Prealbumin Level in Gastric Cancer Patients Who Receive Curative Treatment.
机构信息
Department of Surgery, Yokohama City University, Yokohama, Japan.
Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
出版信息
J Gastrointest Cancer. 2023 Mar;54(1):27-34. doi: 10.1007/s12029-021-00777-w. Epub 2021 Dec 18.
BACKGROUND
We investigated the clinical influence of the prealbumin level on the gastric cancer survival and recurrence after curative treatment.
METHODS
This study included 447 patients who underwent curative treatment for gastric cancer between 2013 and 2017. The risk factors for the overall survival (OS) and recurrence-free survival (RFS) were identified.
RESULTS
A prealbumin level of 20 mg/dl was regarded as the optimal point of classification, considering the 3- and 5-year survival rates. The OS rates at 3 and 5 years after surgery were 80.7% and 65.0% in the low-prealbumin group, respectively, and 93.1% and 87.9% in the high-prealbumin group, respectively, a statistically significant difference (p < 0.001). The RFS rates at 3 and 5 years after surgery were 71.7% and 68.0% in the low-prealbumin group, respectively, and 90.1% and 84.7% in the high-prealbumin group, respectively, a statistically significant difference (p = 0.031). A multivariate analysis demonstrated that the prealbumin level was a significant independent risk factor for the OS and RFS. In addition, the rate of introduction of adjuvant chemotherapy was significantly lower and the frequency of peritoneal recurrence and lymph node recurrence significantly higher in the low-prealbumin group than in the high-prealbumin group.
CONCLUSION
Prealbumin is a risk factor for the survival in patients who undergo curative treatment for gastric cancer. It is necessary to develop an effective plan of perioperative care and surgical strategy according to the prealbumin level.
背景
我们研究了白蛋白水平对根治性治疗后胃癌生存和复发的临床影响。
方法
本研究纳入了 2013 年至 2017 年间接受根治性胃癌治疗的 447 例患者。确定了总生存(OS)和无复发生存(RFS)的危险因素。
结果
考虑到 3 年和 5 年的生存率,白蛋白水平为 20mg/dl 被认为是分类的最佳点。术后 3 年和 5 年的 OS 率分别为低白蛋白组的 80.7%和 65.0%,高白蛋白组的 93.1%和 87.9%,差异有统计学意义(p<0.001)。术后 3 年和 5 年的 RFS 率分别为低白蛋白组的 71.7%和 68.0%,高白蛋白组的 90.1%和 84.7%,差异有统计学意义(p=0.031)。多变量分析表明,白蛋白水平是 OS 和 RFS 的显著独立危险因素。此外,低白蛋白组辅助化疗的引入率明显低于高白蛋白组,腹膜复发和淋巴结复发的频率明显高于高白蛋白组。
结论
白蛋白是接受根治性胃癌治疗的患者生存的危险因素。根据白蛋白水平制定有效的围手术期护理和手术策略是必要的。