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Clinical significance of postoperative recovery of serum albumin levels in patients with esophageal cancer who underwent transthoracic esophagectomy

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Abstract

Purpose

We evaluated postoperative recovery after transthoracic esophagectomy using postoperative serum albumin (Alb) levels and investigated the correlation between postoperative Alb recovery and the survival of patients with esophageal cancer.

Methods

Esophageal cancer patients who underwent transthoracic esophagectomy were retrospectively reviewed. To evaluate postoperative Alb recovery, the recovery rate of Alb was used. We investigated the correlation between Alb recovery, clinicopathological factors, and the survival. Furthermore, the postoperative systemic inflammatory response was evaluated using serum C-reactive levels, and its impact on the Alb recovery was examined.

Results

Ninety-seven (51 %) of 191 patients were classified as having insufficient Alb recovery. In the multivariate survival analysis, pStage and insufficient Alb recovery (hazard ratio 1.863; P = 0.021) were significantly independent predictive factors for the overall survival. Patients with pStage IB–IV with insufficient Alb recovery had a significantly shorter recurrence-free survival (5-year recurrence-free survival rate, 59.5 vs. 41.5 %; P = 0.035) and significantly higher serum CRP levels at POM 3 compared with patients with sufficient Alb recovery.

Conclusions

Insufficient Alb recovery correlates with the systemic postoperative inflammatory response and a poor prognosis. Further studies are warranted to investigate the survival benefit of intervention to enhance postoperative Alb recovery.

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Authors and Affiliations

  1. Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan

    Satoru Matsuda, Masahiro Niihara, Yasuhiro Tsubosa, Katsushi Takebayashi & Keisuke Kawamorita

  2. Department of Surgery, Division of Upper Gastrointestinal Tract, International Medical Center, Saitama University, 1397-1, Yamane, Hidaka-Shi, Saitama, 350-1298, Japan

    Hiroshi Sato

  3. Clinical Trial Coordination Office, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan

    Keita Mori

  4. Division of Gastrointestinal Oncology, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan

    Takahiro Tsushima & Hirofumi Yasui

  5. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Hiroya Takeuchi & Yuko Kitagawa

Authors
  1. Satoru Matsuda
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  2. Masahiro Niihara
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  3. Yasuhiro Tsubosa
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  4. Hiroshi Sato
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  5. Katsushi Takebayashi
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  6. Keisuke Kawamorita
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  7. Keita Mori
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  8. Takahiro Tsushima
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  9. Hirofumi Yasui
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  10. Hiroya Takeuchi
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  11. Yuko Kitagawa
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Corresponding author

Correspondence to Masahiro Niihara.

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The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

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Matsuda, S., Niihara, M., Tsubosa, Y. et al. Clinical significance of postoperative recovery of serum albumin levels in patients with esophageal cancer who underwent transthoracic esophagectomy. Surg Today 46, 1138–1145 (2016). https://doi.org/10.1007/s00595-015-1300-6

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  • DOI: https://doi.org/10.1007/s00595-015-1300-6

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