Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 5/2017

01-11-2017 | Gynecologic Oncology

The preoperative albumin level is an independent prognostic factor for optimally debulked epithelial ovarian cancer

Authors: Ali Ayhan, Emre Günakan, İrem Alyazıcı, Nihan Haberal, Özden Altundağ, Polat Dursun

Published in: Archives of Gynecology and Obstetrics | Issue 5/2017

Login to get access

Abstract

Purpose

A low albumin level has been reported to be a prognostic factor for various cancers. The aim of this study was to determine the association between preoperative serum albumin level and survival in patients with epithelial ovarian cancer (EOC).

Methods

Records of 337 patients with EOC that underwent optimal cytoreductive surgery were retrospectively reviewed. Threshold albumin level was planned as 32.5 g L−1 due to the statistical analyses.

Results

Mean overall survival was 51.5 months. Area under the ROC curve was found statistically significant for the discriminative role of albumin for survival outcome (AUC = 0.857, 95% CI 0.813–0.90, P < 0.001). The best cut-off point for albumin was determined as 32.5 g L−1. The sensitivity rate, specificity rate, positive and negative predictive values, and accuracy rate for this cut-off level were found 67.2, 91.2, 81.2, 83.1, and 82.5%, respectively. Preoperative hypoalbuminemia was noted in 101 (30.0%) of the patients, of which 6.2% had an albumin level <25 g L−1. The albumin level was independently and significantly associated with overall survival (HR 2.6; 95% CI 2.1–3.1; P < 0.001). Subgroup analysis showed that patients with an albumin level <32.5 and ≥32.5 g L−1 had mean estimated overall survival of 40.6 and 96.0 months, respectively. Age, stage, and presence of ascites were the other independent significant factors.

Conclusions

The preoperative albumin level is an independent prognostic factor for overall survival in optimally debulked EOC patients. Further investigations about preoperative albumin level in prognostic models will contribute to the literature.
Literature
1.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386. doi:10.​1002/​ijc.​29210 (Epub 2014 Oct 9) CrossRefPubMed
2.
Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ (2002) Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol Off J Am Soc Clin Oncol 20:1248–1259CrossRef
3.
du Bois A, Reuss A, Pujade-Lauraine E, Harter P, Ray-Coquard I, Pfisterer J (2009) Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische OnkologieStudiengruppeOvarialkarzinom (AGO-OVAR) and the Grouped’InvestigateursNationaux Pour les Etudes des Cancers de l’Ovaire (GINECO). Cancer 115:1234–1244CrossRefPubMed
4.
5.
Bian C, Yao K, Li L, Yi T, Zhao X (2016) Primary debulking surgery vs. neoadjuvant chemotherapy followed by interval debulking surgery for patients with advanced ovarian cancer. Arch Gynecol Obstet 293(1):163–168. doi:10.​1007/​s00404-015-3813-z (Epub 2015 Jul 22) CrossRefPubMed
6.
Laky B, Janda M, Bauer J, Vavra C, Cleghorn G, Obermair A (2007) Malnutrition among gynaecological cancer patients. Eur J Clin Nutr 61(5):642–646 (Epub 2006 Oct 4) PubMed
7.
Nicholson JP, Wolmarans MR, Park GR (2000) The role of albumin in critical illness. Br J Anaesth 85(4):599–610CrossRefPubMed
8.
Uppal S, Al-Niaimi A, Rice LW, Rose SL, Kushner DM, Spencer RJ et al (2013) Preoperative hypoalbuminemia is an independent predictor of poor perioperative outcomes in women undergoing open surgery for gynecologic malignancies. Gynecol Oncol 131(2):416–422. doi:10.​1016/​j.​ygyno.​2013.​08.​011 (Epub 2013 Aug 17) CrossRefPubMed
9.
Ataseven B, du Bois A, Reinthaller A, Traut A, Heitz F, Aust S, Prader S et al (2015) Pre-operative serum albumin is associated with post-operative complication rate and overall survival in patients with epithelial ovarian cancer undergoing cytoreductive surgery. Gynecol Oncol 138(3):560–565. doi:10.​1016/​j.​ygyno.​2015.​07.​005 (Epub 2015 Jul 8) CrossRefPubMed
10.
Kumar A, Janco JM, Mariani A, Bakkum-Gamez JN, Langstraat CL, Weaver AL, McGree ME et al (2016) Risk-prediction model of severe postoperative complications after primary debulking surgery for advanced ovarian cancer. Gynecol Oncol 140(1):15–21. doi:10.​1016/​j.​ygyno.​2015.​10.​025 (Epub 2015 Nov 2) CrossRefPubMed
11.
Schwartzbaum JA, Lal P, Evanoff W, Mamrak S, Yates A, Barnett GH et al (1999) Presurgical serum albumin levels predict survival time from glioblastoma multiforme. J Neurooncol 43(1):35–41CrossRefPubMed
12.
Lien YC, Hsieh CC, Wu YC, Hsu HS, Hsu WH, Wang LS et al (2004) Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia. J Gastrointest Surg 8(8):1041–1048CrossRefPubMed
13.
Al Murri AM, Bartlett JM, Canney PA, Doughty JC, Wilson C, McMillan DC (2006) Evaluation of an inflammation-based prognostic score (GPS) in patients with metastatic breast cancer. Br J Cancer 94(2):227–230CrossRefPubMed
14.
15.
Seebacher V, Grimm C, Reinthaller A, Heinze G, Tempfer C, Hefler L et al (2013) The value of serum albumin as a novel independent marker for prognosis in patients with endometrial cancer. Eur J Obstet Gynecol Reprod Biol 171(1):101–106. doi:10.​1016/​j.​ejogrb.​2013.​07.​044 (Epub 2013 Aug 11) CrossRefPubMed
16.
Danan D, Shonka DC Jr, Selman Y, Chow Z, Smolkin ME, Jameson MJ (2016) Prognostic value of albumin in patients with head and neck cancer. Laryngoscope 126(7):1567–1571. doi:10.​1002/​lary.​25877 (Epub 2016 Feb 10) CrossRefPubMed
17.
Fiala O, Pesek M, Finek J, Racek J, Minarik M, Benesova L et al (2016) Serum albumin is a strong predictor of survival in patients with advanced-stage non-small cell lung cancer treated with erlotinib. Neoplasma 63(3):471–476. doi:10.​4149/​318_​151001N512 CrossRefPubMed
18.
Ren Y, Jiang R, Yin S, You C, Liu D, Cheng X, Tang J, Zang R (2015) Radical surgery versus standard surgery for primary cytoreduction of bulky stage IIIC and IV ovarian cancer: an observational study. BMC Cancer 13(15):583. doi:10.​1186/​s12885-015-1525-1 CrossRef
19.
Bookman MA, Greer BE, Ozols RF (2003) Optimal therapy of advanced ovarian cancer: carboplatin and paclitaxel vs. cisplatin and paclitaxel (GOG 158) and an update on GOG0 182-ICON5. Int J Gynecol Cancer 13(6):735–740CrossRefPubMed
20.
Aletti GD, Dowdy SC, Podratz KC et al (2007) Relationship among surgical complexity, short-term morbidity, and overall survival in primary surgery for advanced ovarian cancer. Am J Obstet Gynecol 197:676.e1–676.e7CrossRef
21.
Laky B, Janda M, Cleghorn G, Obermair A (2008) Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients. Am J Clin Nutr 87:1678–1685PubMed
22.
McIntosh EN, Laurent LL (1983) Nutritional assessment of the hospitalized patient. Am Fam Physician 27:169–175PubMed
23.
Ishizuka M, Nagata H, Takagi K, Horie T, Kubota K (2007) Inflammation-based prognostic score is a novel predictor of postoperative outcome in patients with colorectal cancer. Ann Surg 246:1047–1051CrossRefPubMed
24.
25.
Ballmer PE, Ochsenbein AF, Schutz-Hofmann S (1994) Transcapillary escape rate of albumin positively correlates with plasma albumin concentration in acute but not in chronic inflammatory disease. Metabolism 43:697–705CrossRefPubMed
26.
Simons JP, Schols AM, Buurman WA, Wouters EF (1999) Weight loss and low body cell mass in males with lung cancer: relationship with systemic inflammation, acute-phase response, resting energy expenditure, and catabolic and anabolic hormones. Clin Sci (Lond) 97:215–223CrossRef
27.
O’Gorman P, McMillan DC, McArdle CS (1998) Impact of weight loss, appetite, and the inflammatory response on quality of life in gastrointestinal cancer patients. Nutr Cancer 32:76–80CrossRefPubMed
28.
Barber MD, Ross JA, Fearon KC (1999) Changes in nutritional, functional, and inflammatory markers in advanced pancreatic cancer. Nutr Cancer 35:106–110CrossRefPubMed
29.
Langstraat C, Aletti GD, Cliby WA (2011) Morbidity, mortality and overall survival in elderly women undergoing primary surgical debulking for ovarian cancer: a delicate balance requiring individualization. Gynecol Oncol 123(2):187–191. doi:10.​1016/​j.​ygyno.​2011.​06.​031 (Epub 2011 Jul 26) CrossRefPubMed
30.
31.
Fotopoulou C, Jones BP, Savvatis K, Campbell J, Kyrgiou M, Farthing A, Brett S, Roux R, Hall M, Rustin G, Gabra H, Jiao L, Stümpfle R (2016) Maximal effort cytoreductive surgery for disseminated ovarian cancer in a UK setting: challenges and possibilities. Arch Gynecol Obstet 294(3):607–614. doi:10.​1007/​s00404-016-4080-3 (Epub 2016 Apr 4) CrossRefPubMed
32.
33.
Gupta D, Lmmersfeld C, Vashi PG, Dahlk S, Grutsch JF, Lis CG (2009) Is serum albumin an independent predictor of survival in ovarian cancer? Clin Ovarian Cancer 2:52–56CrossRef
34.
Alphs HH, Zahurak ML, Bristow RE, Diaz-Montes TP (2006) Predictors of surgical outcome and survival among elderly women diagnosed with ovarian and primary peritoneal cancer. Gynecol Oncol 103:1048–1053CrossRefPubMed
35.
Sharma R, Hook J, Kumar M, Gabra H (2008) Evaluation of an inflammation based prognostic score in patients with advanced ovarian cancer. Eur J Cancer 44:251–256CrossRefPubMed
36.
37.
Miao Y, Li S, Yan Q, Li B, Feng Y (2016) Prognostic significance of preoperative prognostic nutritional index in epithelial ovarian cancer patients treated with platinum-based chemotherapy. Oncol Res Treat 39(11):712–719 (Epub 2016 Oct 19) CrossRefPubMed
38.
Zhu J, Wang H, Liu CC, Lu Y, Tang H (2016) The Glasgow Prognostic Score (GPS) is a novel prognostic indicator in advanced epithelial ovarian cancer: a multicenter retrospective study. J Cancer Res Clin Oncol 142(11):2339–2345. doi:10.​1007/​s00432-016-2228-y (Epub 2016 Aug 26) CrossRefPubMed
Metadata
Title
The preoperative albumin level is an independent prognostic factor for optimally debulked epithelial ovarian cancer
Authors
Ali Ayhan
Emre Günakan
İrem Alyazıcı
Nihan Haberal
Özden Altundağ
Polat Dursun
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 5/2017
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-017-4511-9

Other articles of this Issue 5/2017

Archives of Gynecology and Obstetrics 5/2017 Go to the issue

Gynecologic Oncology

Long-term reliability of fractioned CO2 laser as a treatment for vulvovaginal atrophy (VVA) symptoms

Images in Obstetrics and Gynecology

Delayed presentation of uterine rupture in a didelphys uterus misdiagnosed as appendicitis: a case report and review of the literature

Images in Obstetrics and Gynecology

Autoimmune progesterone dermatitis

General Gynecology

Analysis of clinical factors correlated with the accuracy of colposcopically directed biopsy

Maternal-Fetal Medicine

Impact of maternal nutrition in hepatitis E infection in pregnancy

Maternal-Fetal Medicine

Estimation of neonatal outcome artery pH value according to CTG interpretation of the last 60 min before delivery: a retrospective study. Can the outcome pH value be predicted?