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Medical Oncology

, Volume 29, Issue 3, pp 2005–2009 | Cite as

Preoperative serum albumin is an independent prognostic predictor of survival in ovarian cancer

  • V. AsherEmail author
  • J. Lee
  • A. Bali
Original Paper

Abstract

Ovarian cancer is associated with high mortality due to asymptomatic nature of the disease and advance stage at presentation. In advanced stages, it is associated with cachexia and ascites leading to malnutrition. Nutritional status of a patient with cancer has been well known to be associated with survival and can be assessed by level of albumin in blood. Therefore, in this study, we sought to determine preoperative serum albumin as prognostic predictor of survival in patients with ovarian cancer. Preoperative serum albumin was determined in 235 patients undergoing surgery for ovarian cancer at Royal Derby Hospital. The prognostic predictive value of serum albumin, along with other prognostic markers was then analysed using univariate and multivariate analyses. Low serum albumin was associated with poor survival (P < 0.001) in patients with ovarian cancer. There was an inverse correlation between serum albumin levels and survival with lower levels having poor survival. Patients with serum albumin levels of <25 g/l had a median survival of 4.8 months (95% CI 0–13.1 months), whilst levels >35 g/l were associated with median survival of 43.2 months (95% CI 11.6–20.9). Serum albumin (P < 0.001) retained its significance as an independent predictor of poor survival on Cox’s multivariate regression analysis along with Age (P < 0.001) and FIGO stage (P < 0.001). Serum albumin can be used as an independent prognostic predictor of survival in patients with ovarian cancer.

Keywords

Preoperative serum albumin Prognostic predictor Ovarian cancer 

Notes

Conflict of interest

None.

References

  1. 1.
    Ferlay JSH, Bray F, Forman D, Mathers C, Parkin DM. GLOBCAN. Available from: http://globocan.iarc.fr/factsheets/populations/factsheet.asp?uno=900#WOMEN (2008).
  2. 2.
    SEER. Available from: www.cancer.gov/cancertopics/types/ovarian (2010).
  3. 3.
    Cancer Research UK Ovarian Cancer incidence statistics. Cancer Research, UK. Available from: http://info.cancerresearchuk.org/cancerstats/types/ovary/incidence/index.htm (2007).
  4. 4.
    Laky B, et al. Malnutrition among gynaecological cancer patients. Eur J Clin Nutr. 2007;61(5):642–6.PubMedGoogle Scholar
  5. 5.
    Terada KY, Christen C, Roberts JA. Parenteral nutrition in gynaecology. J Reprod Med. 1988;33(12):957–60.PubMedGoogle Scholar
  6. 6.
    Garth AK, et al. Nutritional status, nutrition practices and post-operative complications in patients with gastrointestinal cancer. J Hum Nutr Diet. 2010;23(4):393–401.PubMedCrossRefGoogle Scholar
  7. 7.
    Ottery FD.Supportive nutrition to prevent cachexia and improve quality of life. Semin Oncol. 1995;22(2 Suppl 3):98–111.Google Scholar
  8. 8.
    Burtis CA. A.E.T., textbook of clinical chemistry. Philadelphia: WB Saunders Company; 1999.Google Scholar
  9. 9.
    Andersson CE. Pretranslational regulation of albumin synthesis in tumor-bearing mice. The role of anorexia and undernutrition. Gastroenterology. 1991;100(4):938–45.PubMedGoogle Scholar
  10. 10.
    Heys SD, et al. Serum albumin: a prognostic indicator in patients with colorectal cancer. J R Coll Surg Edinb. 1998;43(3):163–8.PubMedGoogle Scholar
  11. 11.
    Schwartzbaum JA, et al. Presurgical serum albumin levels predict survival time from glioblastoma multiforme. J Neurooncol. 1999;43(1):35–41.PubMedCrossRefGoogle Scholar
  12. 12.
    Lien YC, et al. Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia. J Gastrointest Surg. 2004;8(8):1041–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Al Murri AM, et al. Evaluation of an inflammation-based prognostic score (GPS) in patients with metastatic breast cancer. Br J Cancer. 2006;94(2):227–30.PubMedCrossRefGoogle Scholar
  14. 14.
    Gadducci A et al. Malnutrition and cachexia in ovarian cancer patients: pathophysiology and management. Anticancer Res. 2001;21(4B):2941–2947.Google Scholar
  15. 15.
    Garcia-Luna PP, Parejo Campos J, Pereira Cunill JL. Causes and impact of hyponutrition and cachexia in the oncologic patient. Nutr Hosp. 2006;21 (Suppl 3):10–16.Google Scholar
  16. 16.
    Laky B, et al. Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynaecologic cancer patients. Am J Clin Nutr. 2008;87(6):1678–85.PubMedGoogle Scholar
  17. 17.
    Buzby GP, et al. Prognostic nutritional index in gastrointestinal surgery. Am J Surg. 1980;139(1):160–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Ingenbleek Y, Carpentier YA. A prognostic inflammatory and nutritional index scoring critically ill patients. Int J Vitam Nutr Res. 1985;55(1):91–101.PubMedGoogle Scholar
  19. 19.
    Bauer J, Capra S, Ferguson M. Use of the scored patient-generated subjective global assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr. 2002;56(8):779–85.PubMedCrossRefGoogle Scholar
  20. 20.
    Parker D, et al. Serum albumin and CA125 are powerful predictors of survival in epithelial ovarian cancer. Br J Obstet Gynaecol. 1994;101(10):888–93.PubMedCrossRefGoogle Scholar
  21. 21.
    Holschneider CH, Berek JS. Ovarian cancer: epidemiology, biology, and prognostic factors. Semin Surg Oncol. 2000;19(1):3–10.PubMedCrossRefGoogle Scholar
  22. 22.
    Fuhrman MP, Charney P, Mueller CM. Hepatic proteins and nutrition assessment. J Am Diet Assoc. 2004;104(8):1258–64.PubMedCrossRefGoogle Scholar
  23. 23.
    Spiekerman AM. Nutritional assessment (protein nutriture). Anal Chem. 1995;67(12):429R–36R.PubMedCrossRefGoogle Scholar
  24. 24.
    Campos AC, Meguid MM. A critical appraisal of the usefulness of perioperative nutritional support. Am J Clin Nutr. 1992;55(1):117–30.PubMedGoogle Scholar
  25. 25.
    Goonetilleke KS, Siriwardena AK. Systematic review of peri-operative nutritional supplementation in patients undergoing pancreaticoduodenectomy. JOP. 2006;7(1):5–13.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.School of Graduate Entry Medicine and HealthRoyal Derby HospitalDerbyUK
  2. 2.Department of Obstetrics and GynaecologyRoyal Derby HospitalDerbyUK

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