Identification of high risk patients with preoperative low albumin for advanced gastric antrum cancer based on nomogram model

Abstract:

Objective To explore the high risk factors of hypoalbuminemia before radical gastrectomy，and influence on prognosis.Methods From June 2008 to June 2015，a total of 497 patients with gastric antrum cancer treated by surgery in Fujian Cancer Hospital were included in the study，then they were divided into low albumin group（< 35 g/L，194 cases）and normal albumin group（≥35 g/L，303 cases）according to the preoperative serum albumin level. The high risk factors of hypoalbuminemia before radical operation and its impact on prognosis were analyzed.Results The univariate study found that there were significant differences in age，tumor size，differentiation degree and tumor stage between hypoalbuminemia group and normal albuminemia group. The multivariate study found that age，tumor size，TNM stage were independent risk factors for preoperative hypoalbuminemia. The nomogram risk prediction model was established. The 1-year，3-year and 5-year survival rates of low albumin group were 96.3%，85.7% and 78.7% respectively. The 1-year，3-year and 5-year survival rates of normal albumin group were 94.1%，76.0% and 62.9% respectively（P<0.001）. The results of univariate and multivariate analysis showed that age，T stage，TNM stage and preoperative albumin were independent prognostic factors for patients（P<0.05）.Conclusion For patients with gastric antrum cancer，age，tumor size and TNM stage are independent risk factors of preoperative hypoalbuminemia. That is an indication of poor prognosis of patients with gastric antrum cancer. For these patients，identification and intervention measures should be strengthened.