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World Journal of Surgery
Published in: World Journal of Surgery 12/2012

01-12-2012

Low Perioperative Serum Prealbumin Predicts Early Recurrence after Curative Pulmonary Resection for Non-Small-Cell Lung Cancer

Authors: Hideki Kawai, Hideki Ota

Published in: World Journal of Surgery | Issue 12/2012

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Abstract

Background

Early recurrence after surgery for non-small-cell lung cancer (NSCLC) is often observed in spite of pathologically proven early-stage disease. The aim of this study was to identify biomarkers that might be useful in predicting postoperative early recurrence of lung cancer. In this study we evaluated the perioperative nutritional status of the patients by measuring the serum level of prealbumin and analyzed the correlation between this factor and early recurrence.

Methods

Forty-four patients with NSCLC were enrolled in the study. Serum level of prealbumin was measured 5 days before and 7 days after surgery, respectively.

Results

For the patients who developed early recurrence, the perioperative serum prealbumin level was statistically significantly lower than those of the patients who did not develop recurrence (p < 0.05). Furthermore, the patients with low prealbumin level showed statistically significantly poorer outcomes compared with the patients with higher prealbumin level (p < 0.001). On the other hand, there was no correlation between the pathological stage and the serum prealbumin level. Multivariate analysis revealed that low perioperative serum prealbumin level could be an independent prognostic factor of poor outcome (hazard ratio, 10.1; 95 % confidence interval, 2.8–35.5; p = 0.0003).

Conclusions

Low serum prealbumin level in the perioperative period is associated with a poorer prognosis in NSCLC patients and could serve as a marker for identifying patients at high risk, even at an early clinical stage.
Literature
1.
Mountain CF (1997) Revisions in the international system for staging lung cancer. Chest 111:1710–1717PubMedCrossRef
2.
Suzuki K, Nagai K, Yoshida J et al (1999) Conventional clinicopathologic prognostic factors in surgically resected nonsmall cell lung carcinoma. A comparison of prognostic factors for each pathologic TNM stage based on multivariate analyses. Cancer 86:1976–1984PubMedCrossRef
3.
Gu CD, Osaki T, Oyama T et al (2002) Detection of micrometastatic tumor cells in pN0 lymph nodes of patients with completely resected nonsmall cell lung cancer. Impact on recurrence and survival. Ann Surg 235:133–139PubMedCrossRef
4.
Coello MC, Luketich JD, Litle VR et al (2004) Prognostic significance of micrometastasis in non-small-cell lung cancer. Clin Lung Cancer 5:214–225PubMedCrossRef
5.
Ben-Eliyahu S (2003) The promotion of tumor metastasis by surgery and stress: immunological basis and implications for psychoneuroimmunology. Brain Behav Immun 17:S27–S36PubMedCrossRef
6.
Bistrian BR, Blackburn GL, Heddle R (1974) Protein status of general surgical patients. JAMA 230:858–860PubMedCrossRef
7.
Nixon DW, Heymsfield SB, Cohen AE et al (1980) Protein-caloric undernutrition in hospitalized cancer patients. Am J Med 68:683–690PubMedCrossRef
8.
Meakins JL (1989) Host defense mechanisms in surgical patients: effect of surgery and trauma. Acta Chir Scand Suppl 550:43–53PubMed
9.
Decker D, Schondorf M, Bidlingmaier F et al (1996) Surgical stress induces a shift in the type-1/type-2 T-helper cell balance, suggesting down-regulation of cell-mediated and up-regulation of antibody-mediated immunity commensurate to the trauma. Surgery 119:316–325PubMedCrossRef
10.
Chandra RK, Kumari S (1994) Nutrition and immunity: an overview. J Nutr 124:1433S–1435SPubMed
11.
Chandra RK (1990) Nutrition is an important determinant of immunity in old age. Proc Clin Biol Res 326:321–334
12.
Lesourd B (1995) Protein undernutrition as the major cause of decreased immune function in the elderly: clinical and functional implications. Nutr Rev 53:S86–S94PubMedCrossRef
13.
Walrand S, Moreau K, Caldefie F et al (2001) Specific and nonspecific immune responses to fasting and refeeding differ in healthy young adult and elderly persons. Am J Clin Nutr 74:670–678PubMed
14.
Marcos A, Nova E, Montero A (2003) Changes in the immune system are conditioned by nutrition. Eur J Clin Nutr 57:S66–S69PubMedCrossRef
15.
Dempsey DT, Mullen JL, Buzby GP (1988) The link between nutritional status and clinical outcome: can nutritional intervention modify it? Am J Clin Nutr 47:352–356PubMed
16.
Vallejo R, Hord ED, Barna SA et al (2003) Perioperative immunosuppression in cancer patients. J Environ Pathol Toxicol Oncol 22:139–146PubMedCrossRef
17.
Ondrey FG, Hom DB (1994) Effects of nutrition on wound healing. Otolaryngol Head Neck Surg 110:557–559PubMed
18.
Daly JM, Redmond HP, Gallagher H (1992) Perioperative nutrition in cancer patients. JPEN J Parenter Enteral Nutr 16:100S–105SPubMedCrossRef
19.
Nishi M, Hiramatsu Y, Hioki K et al (1988) Risk factors in relation to postoperative complications in patients undergoing esophagectomy or gastrectomy for cancer. Ann Surg 207:148–154PubMedCrossRef
20.
Campos AC, Meguid MM (1992) A critical appraisal of the usefulness of perioperative nutritional support. Am J Clin Nutr 55:117–130PubMed
21.
Braga M, Gianotti L, Radaelli G et al (1999) Perioperative immunonutrition in patients undergoing cancer surgery. Arch Surg 134:428–433PubMedCrossRef
22.
Fearon KC, Luff R (2003) The nutritional management of surgical patients: enhanced recovery after surgery. Proc Nutr Soc 62:807–811PubMedCrossRef
23.
Bozzetti F, Gianotti L, Braga M et al (2007) Postoperative complications in gastrointestinal cancer patients: the joint role of the nutritional status and the nutritional support. Clin Nutr 26:698–709PubMedCrossRef
24.
Chandra RK (1997) Nutrition and the immune system: an introduction. Am J Clin Nutr 66:460S–463SPubMed
25.
Bashir Y, Graham TR, Torrance A et al (1990) Nutritional state of patients with lung cancer undergoing thoracotomy. Thorax 45:183–186PubMedCrossRef
26.
Fredrix EW, Staal-van den Brekel AJ, Wouters EF (1997) Energy balance in nonsmall cell lung carcinoma patients before and after surgical resection of their tumors. Cancer 79:717–723PubMedCrossRef
27.
Bianchi RC, de Souza JN, Giaciani Cde A et al (2006) Prognostic factors for complications following pulmonary resection: pre-albumin analysis, time on mechanical ventilation, and other factors. J Bras Pneumol 32:489–494PubMedCrossRef
28.
Tewari N, Martin-Ucar AE, Black E et al (2007) Nutritional status affects long term survival after lobectomy for lung cancer. Lung Cancer 57:389–394PubMedCrossRef
29.
Jagoe RT, Goodship TH, Gibson GJ (2001) Nutritional status of patients undergoing lung cancer operations. Ann Thorac Surg 71:929–935PubMedCrossRef
30.
Beck FK, Rosenthal TC (2002) Prealbumin: a marker for nutritional evaluation. Am Fam Physician 65:1575–1578PubMed
31.
Devoto G, Gallo F, Marchello C et al (2006) Prealbumin serum concentrations as a useful tool in the assessment of malnutrition in hospitalized patients. Clin Chem 52:2281–2285PubMedCrossRef
32.
33.
Ishizuka M, Nagata H, Takagi K et al (2007) Inflammation-based prognostic score is a novel predictor of postoperative outcome in patients with colorectal cancer. Ann Surg 246:1047–1051PubMedCrossRef
34.
Ramsey S, Lamb GWA, Aitchison M et al (2007) Evaluation of an inflammation-based prognostic score in patients with metastatic renal cancer. Cancer 109:205–212PubMedCrossRef
35.
Braga M, Gianotti L, Vignali A et al (2002) Preoperative oral arginine and n-3 fatty acid supplementation improves the immunometabolic host response and outcome after colorectal resection for cancer. Surgery 132:805–814PubMedCrossRef
36.
Giger U, Büchler M, Farhadi J et al (2007) Preoperative immunonutrition suppresses perioperative inflammatory response in patients with major abdominal surgery—a randomized controlled pilot study. Ann Surg Oncol 14:2798–2806PubMedCrossRef
37.
38.
Plank LD, McCall JL, Gane EJ et al (2005) Pre- and postoperative immunonutrition in patients undergoing liver transplantation: a pilot study of safety and efficacy. Clin Nutr 24:288–296PubMedCrossRef
39.
Gunerhan Y, Koksal N, Sahin UY et al (2009) Effect of preoperative immunonutrition and other nutrition models on cellular immune parameters. World J Gastroenterol 15:467–472PubMedCrossRef
40.
Buijs N, van Bokhorst-de van der Schueren MA, Langius JA et al (2010) Perioperative arginine-supplemented nutrition in malnourished patients with head and neck cancer improves long-term survival. Am J Clin Nutr 92:1151–1156
Metadata
Title
Low Perioperative Serum Prealbumin Predicts Early Recurrence after Curative Pulmonary Resection for Non-Small-Cell Lung Cancer
Authors
Hideki Kawai
Hideki Ota
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 12/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-012-1766-y

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