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

  • Gynecologic Oncology
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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.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, School of Medicine, Başkent University, Ankara, Turkey

    Ali Ayhan, İrem Alyazıcı & Polat Dursun

  2. Department of Obstetrics and Gynecology, Keçioren Training and Research Hospital, Pınarbası Mah. Sanatoryum Cad. Ardahan Sok. No: 25, Kecioren, 06380, Ankara, Turkey

    Emre Günakan

  3. Department of Pathology, School of Medicine, Başkent University, Ankara, Turkey

    Nihan Haberal

  4. Department of Medical Oncology, School of Medicine, Başkent University, Ankara, Turkey

    Özden Altundağ

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  1. Ali Ayhan
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Contributions

EG: project development, data collection and management, data analysis, manuscript writing, and editing. İAK: project development, data collection, manuscript writing, and literature search. NH: data analysis and editing. ÖÖA: project development and data management investigation. PD: manuscript writing and editing, and supervision. AA: project development, data management, data analysis, manuscript editing, and supervision.

Corresponding author

Correspondence to Emre Günakan.

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Ethics statement

Ethical approval for the present study was not required, as it was retrospectively performed.

Conflict of interest

The authors declare there are no conflicts of interest—financial or otherwise—related to the material presented herein.

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Ayhan, A., Günakan, E., Alyazıcı, İ. et al. The preoperative albumin level is an independent prognostic factor for optimally debulked epithelial ovarian cancer. Arch Gynecol Obstet 296, 989–995 (2017). https://doi.org/10.1007/s00404-017-4511-9

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  • DOI: https://doi.org/10.1007/s00404-017-4511-9

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