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Early postoperative decrease of albumin is an independent predictor of major complications after oncological
Ismail Labgaa1, Styliani Mantziari1, Maxime Genety2
1Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Switzerland.
Journal of Surgical Oncology
|December 8, 2020
Summary
Serum albumin perioperative decrease (∆Alb) is a key indicator of surgical stress. This study found ∆Alb effectively predicts major complications after esophagectomy for cancer, aiding in patient outcome assessment.
Area of Science:
- Oncology
- Surgical Gastroenterology
- Biomarker Discovery
Background:
- Perioperative serum albumin decrease (∆Alb) indicates physiological stress.
- Its predictive value for adverse outcomes is established, but data in esophageal surgery are limited.
- Esophagectomy for cancer involves significant surgical stress.
Purpose of the Study:
- To investigate the role of ∆Alb in predicting major complications after esophagectomy for cancer.
- To establish ∆Alb as a potential biomarker in oncological esophagectomy outcomes.
Main Methods:
- Multicenter retrospective study (2006-2017) in five high-volume centers.
- Included consecutive patients undergoing esophagectomy for cancer.
- ∆Alb calculated on postoperative day 1; primary endpoint: major complications (Clavien classification).
Main Results:
- Esophagectomy caused a rapid albumin drop; a cut-off of 11 g/L distinguished patients with adverse outcomes.
- ∆Alb independently predicted major complications (OR, 1.06; 95% CI, 1.01-1.11; p=.014).
- Higher BMI and laparoscopy correlated with lower ∆Alb; findings validated across cohorts.
Conclusions:
- ∆Alb is a promising biomarker for predicting adverse outcomes after oncological esophagectomy.
- This marker aids in identifying patients at higher risk for complications.
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