Annals of Surgical Oncology

, Volume 14, Issue 2, pp 381-389

First online:

Serum Albumin as a Significant Prognostic Factor for Patients with Gastric Carcinoma

  • Luis F. Oñate-OcañaAffiliated withClínica de Neoplasias Gástricas, Gastroenterology Department, Instituto Nacional de Cancerología Email author 
  • , Vincenzo Aiello-CrocifoglioAffiliated withClínica de Neoplasias Gástricas, Gastroenterology Department, Instituto Nacional de Cancerología
  • , Dolores Gallardo-RincónAffiliated withMedical Oncology Department, Instituto Nacional de Cancerología
  • , Roberto Herrera-GoepfertAffiliated withPathology Department, Instituto Nacional de Cancerología
  • , Rocío Brom-ValladaresAffiliated withComputed Tomography, Ultrasound and Magnetic Resonance Department, Instituto Nacional de Cancerología
  • , José F. CarrilloAffiliated withSurgery Division, Instituto Nacional de Cancerología
  • , Eduardo CerveraAffiliated withHematology Department, Instituto Nacional de Cancerología
  • , Alejandro Mohar-BetancourtAffiliated withUnidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología/Instituto de Biomédicas. Universidad Nacional Autónoma de México

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The definition of prognostic factors in gastric carcinoma (GC) remains controversial. The potential of serum albumin as a prognostic factor for GC is emphasized because the technique to measure it is simple as well as being cheap and widely available. Our aim was to define the prognostic role of serum albumin in GC.


A cohort treated from January 1987 to December 2002 was studied. Relevant clinical, pathological and therapeutic variables were recorded. Kaplan–Meier and Cox’s methods were used to define prognostic factors associated with cancer-related survival.


One thousand and twenty-three patients were included. Serum albumin did impact survival, showing a dose-response effect. This effect was present after adjustment for other prognostic factors, including Tumor-Node-Metastasis (TNM) stage, surgical resection and type of lymphadenectomy. In multivariate analysis, TNM stage [Stage Ia and Ib Hazard Ratio [HR] 1, Stage II HR 1.6 (95% confidence interval [CI], 0.56–4.7), Stage IIIa HR 4.4 (95% CI 1.7–11.3), Stage IIIb HR 5.6 (95% CI 2.6–17.2), Stage IV HR 6.8 (95% CI 2.7–17.5), high albumin HR 1, medium albumin HR 1.2 (95% CI 0.8–1.7), low albumin HR 1.2 (95% CI 0.8–1.8), very low albumin HR 1.8 (95% CI 1.3–2.6), D2 dissection HR 1, D1 dissection HR 1.9 (95% CI 1.3–2.97), and no resection HR 3.7 (95% CI 2.4–5.7)] were the most significant prognostic factors associated to survival (model P = 0.00001).


Pretherapeutic serum albumin level is a significant prognostic factor, which should be evaluated along with other well-defined prognostic factors in decisions concerning therapy for GC.


Stomach neoplasm Adenocarcinoma Prognostic factor Serum albumin