Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-Ku, Tokyo, 135-8550, Japan.
Gastric Cancer. 2024 May;27(3):611-621. doi: 10.1007/s10120-024-01472-y. Epub 2024 Feb 24.
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.
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.
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.
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.
术前前白蛋白水平与胃癌患者胃切除术后长期预后之间的关系尚未完全研究清楚。本研究旨在阐明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。
本回顾性队列研究纳入了 2006 年 5 月至 2017 年 3 月期间接受根治性胃切除术治疗原发性 pStage I-III 期胃癌且术前前白蛋白水平可测量的连续患者。根据术前前白蛋白水平将患者分为高（≥22mg/dL）、中（15-22mg/dL）和低（<15mg/dL）组。使用对数秩检验比较三组的总生存率（OS），并使用 Cox 比例风险回归分析确定预后因素。
中位随访时间为 66 个月。在 4732 例患者中，3649 例（77.2%）为高组，925 例（19.6%）为中组，158 例（3.3%）为低组。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 15-22mg/dL[风险比（HR）：1.576，95%置信区间（CI）：1.353-1.835，P<0.001]和<15mg/dL（HR：1.769，95% CI：1.376-2.276，P<0.001）是 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。
术前前白蛋白水平与胃癌患者胃切除术后的 OS 相关；前白蛋白水平越低，预后越差。前白蛋白水平可能与其他原因的生存率相关。
