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Impact of preoperative prealbumin levels on long-term prognosis in patients with gastric cancer after gastrectomy: a retrospective cohort study

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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Data availability

The datasets generated and/or analyzed in the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank Ms. Ayumi Shimomugi for data collection.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-Ku, Tokyo, 135-8550, Japan

    Ryota Matsui, Satoshi Ida, Motonari Ri, Rie Makuuchi, Masaru Hayami, Koshi Kumagai, Manabu Ohashi, Takeshi Sano & Souya Nunobe

Authors
  1. Ryota Matsui
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  2. Satoshi Ida
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  3. Motonari Ri
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  4. Rie Makuuchi
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  5. Masaru Hayami
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  6. Koshi Kumagai
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  7. Manabu Ohashi
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  8. Takeshi Sano
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  9. Souya Nunobe
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by RM. The first draft of the manuscript was written by RM and SI and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Souya Nunobe.

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Conflict of interests

The authors declare no conflicts of interest.

Ethics approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Declaration of Helsinki of 1964 and its later versions. Informed consent to be included in the study, or the equivalent, was obtained from all patients (authorization number: 2022-GB-078).

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Supplementary Information

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10120_2024_1472_MOESM1_ESM.pptx

Supplementary file1 Supplementary Fig. 1 Study design. Supplementary Fig. 2a Relationship between PNI and overall survival. Supplementary Fig. 2b Relationship between prealbumin levels and overall survival in patients with PNI > 40. Supplementary Fig. 3a Relationship between GNRI and overall survival. Supplementary Fig. 3b Relationship between prealbumin levels and overall survival in patients with GNRI > 92. Supplementary Fig. 4a Relationship between mGPS and overall survival. Supplementary Fig. 4b Relationship between prealbumin levels and overall survival in patients with a mGPS score of 0 (PPTX 191 KB)

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Matsui, R., Ida, S., Ri, M. et al. Impact of preoperative prealbumin levels on long-term prognosis in patients with gastric cancer after gastrectomy: a retrospective cohort study. Gastric Cancer 27, 611–621 (2024). https://doi.org/10.1007/s10120-024-01472-y

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  • DOI: https://doi.org/10.1007/s10120-024-01472-y

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