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Published in: International Journal of Colorectal Disease 4/2011

01-04-2011 | Original Article

Low preoperative serum albumin in colon cancer: a risk factor for poor outcome

Authors: Cheng-Chou Lai, Jeng-Fu You, Chien-Yuh Yeh, Jinn-Shiun Chen, Reiping Tang, Jeng-Yi Wang, Chih-Chien Chin

Published in: International Journal of Colorectal Disease | Issue 4/2011

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Abstract

Objective

The number of colon cancer patients is increasing worldwide. Malnutrition and comorbidities are frequently associated with these patients. The relationships between the preoperative malnutrition and the outcomes of colon cancer patients are unclear; this study aimed to clarify these issues.

Methods

A total of 3,849 consecutive colon cancer patients were enrolled in an analysis of short-term outcomes and 2,529 patients were included in an analysis of the long-term outcomes. These patients were divided into the hypoalbuminemic and normal groups according to the definition of hypoalbuminemia (serum albumin < 35 g/L).

Results

Advanced age, female gender, abnormal CEA levels, right colon or large tumors, mucinous adenocarcinoma, poor differentiation, stage II cancer, TNM advancing T stage, old cardiovascular accident, diabetes, and liver cirrhosis were more likely to be associated with hypoalbuminemia. Hypoalbuminemic patients had a higher rate of postoperative mortality and morbidity, including complications related to wounds, lungs, the urinary system, and anastomosis. The 5-year overall survival rates of patients with normal albumin and hypoalbuminemia were 78.0% and 60.0%, respectively (P < 0.0001), and the 5-year relapse-free survival rates were 78.9% and 73.5%, respectively (P = 0.0042). In a multivariate analysis, the albumin level was also significantly correlated with 5-year overall survival (<35 vs. ≥35, HR 1.75; 95% CI 1.49–2.08) and 5-year relapse-free survival (<35 vs. ≥35, HR 1.28; 95% CI 1.04–1.56).

Conclusions

Hypoalbuminemia is a predictor of poor surgical outcomes of colon cancer and is a poor prognosis factor for long-term survival of colon cancer after curative operation.
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Metadata
Title
Low preoperative serum albumin in colon cancer: a risk factor for poor outcome
Authors
Cheng-Chou Lai
Jeng-Fu You
Chien-Yuh Yeh
Jinn-Shiun Chen
Reiping Tang
Jeng-Yi Wang
Chih-Chien Chin
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 4/2011
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-010-1113-4

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