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Impacts of Preoperative Serum Albumin Level on Outcomes of Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Only few small studies in the literature have explored the impacts of preoperative serum albumin level and clinical outcomes of patients with peritoneal surface malignancy (PSM) who underwent cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy (PIC). This study aimed to evaluate the value of preoperative serum albumin as a prognostic factor for long-term survival outcomes after CRS and PIC in a large patient cohort and to determine whether preoperative serum albumin is correlated with perioperative complications.

Methods

This retrospective study examined prospectively collected data for patients with PSM who underwent CRS and PIC by one surgical team at St George Hospital in Sydney, Australia. The study used 35 g/L as the cuffoff for normal serum albumin level.

Results

The study enrolled 591 patients. Hypoalbuminemia was found to be associated with a significantly higher rate of major morbidity (p < 0.001), a longer ICU stay (p = 0.003), a longer HDU stay (p < 0.001), a longer total hospital stay (p < 0.001), and a shorter overall survival (OS) (p = 0.016). Factor analysis showed preoperative serum hypoalbuminemia to be a prognostic factor for a poor perioperative outcome (p = 0.018) and a poor OS (p = 0.026).

Conclusion

Preoperative hypoalbuminemia is associated with poor perioperative outcomes. More importantly, it is a predictor of poorer OS for patients with PSM independent of the PCI, age, and completeness of cytoreduction. In the future, strategies should be undertaken to improve preoperative nutrition of malnourished patients as a means of improving clinical outcomes for patients with PSM.

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Acknowledgment

We especially thank Jing Zhao, MD, for maintaining the peritonectomy database.

Author information

Authors and Affiliations

  1. St George Clinical School, University of New South Wales, Sydney, NSW, Australia

    Yeqian Huang BMed, MD & Ya Ruth Huo BMed (Hons), MD

  2. Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, University of New South Wales, Sydney, NSW, Australia

    Yeqian Huang BMed, MD, Nayef A. Alzahrani MBBS & David L. Morris MD, PhD

  3. College of Medicine, Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia

    Nayef A. Alzahrani MBBS

  4. Department of Surgery, Ryde Hospital, North Shore Ryde Health Service, St Leonards, Sydney, NSW, Australia

    Terence C. Chua MBBS, PhD, MRCS (Ed)

  5. Department of Medical Oncology, St George Hospital, University of New South Wales, Sydney, NSW, Australia

    Winston Liauw MBBS, MMedSci

Authors
  1. Yeqian Huang BMed, MD
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  2. Nayef A. Alzahrani MBBS
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  3. Terence C. Chua MBBS, PhD, MRCS (Ed)
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  4. Ya Ruth Huo BMed (Hons), MD
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  5. Winston Liauw MBBS, MMedSci
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  6. David L. Morris MD, PhD
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Corresponding author

Correspondence to David L. Morris MD, PhD.

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Huang, Y., Alzahrani, N.A., Chua, T.C. et al. Impacts of Preoperative Serum Albumin Level on Outcomes of Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy. Ann Surg Oncol 23, 2411–2418 (2016). https://doi.org/10.1245/s10434-016-5172-9

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  • DOI: https://doi.org/10.1245/s10434-016-5172-9

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