, Volume 15, Issue 3, pp 190–197 | Cite as

Impact of change in serum albumin level during and after chemoradiotherapy in patients with locally advanced esophageal cancer

  • Kazuya Takeda
  • Rei Umezawa
  • Noriyoshi Takahashi
  • Haruo Matsushita
  • Maiko Kozumi
  • Yojiro Ishikawa
  • Takaya Yamamoto
  • Ken Takeda
  • Keiichi Jingu
Original Article



In patients with locally advanced esophageal cancer treated by concurrent chemoradiotherapy (CCRT), baseline malnutrition and its progression have been shown to be associated with a poor outcome. We conducted this study to determine the variation in four blood test parameters including serum albumin level (ALB), creatinine (Cre), hemoglobin (Hb) and platelet (Plt) during CCRT for stage III esophageal cancer patients and its effect on patients’ outcome.


One hundred eighty-three patients diagnosed with stage III esophageal cancer were retrospectively investigated. In addition to known prognostic factors, baseline level of the four blood test parameters and their variation at day 105 (ΔALB, ΔCre, ΔHb and ΔPlt, respectively) were analyzed.


The median observation period for patients who survived was 57.2 months, and the 5-year overall survival rate was 35.6% (95% CI 34.2–36.9%). In multivariate analyses, baseline ALB (≥ 3.6 g/dL), higher ΔALB (≥ + 0.3 g/dL) were independent predictors for overall survival (p = 0.001 and < 0.001, respectively), in addition to other clinical factors including T stage and overall treatment time (OTT). For disease-free survival, ΔALB was only a predictor in hematological parameters (p = 0.001) in addition to T stage and OTT. No hematological and clinical parameters had significant correlation with local control in multivariate analysis. Furthermore, ΔALB showed significant correlation with OS and DFS in log-rank test (p = 0.002 and 0.002, respectively).


Our results suggest improvement in ALB after treatment might be a favorable prognostic factor in esophageal cancer patients treated by CCRT.


Esophageal cancer Chemoradiotherapy Prognostic factors Nutritional status Serum albumin 


Compliance with ethical standards

Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute for it was obtained from all patients for being included in the study. The institutional review board approved this retrospective study (2014-1-543).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Japan Esophageal Society and Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiation OncologyTohoku University Graduate School of MedicineSendaiJapan
  2. 2.Department of Radiological Technology, School of Health Sciences, Faculty of MedicineTohoku UniversitySendaiJapan

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