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Association of Preoperative and Postoperative Serum Albumin Levels with Colorectal Cancer Outcomes: a Retrospective
Yaxue Chen1, Yanli Li2, Mengmei Liu3
1Department of Nursing, Dazhou Vocational and Technical College, Dazhou, 635000, Sichuan, China.
Purpose:
To elucidate the correlation between perioperative serum albumin concentrations and clinical outcomes in patients with colorectal carcinoma.
Methods:
This retrospective cohort investigation encompassed 2,217 individuals diagnosed with colorectal cancer who underwent surgical intervention between 2008 and 2019. Subjects were stratified into four cohorts based on pre- and post-operative albumin levels: persistently normal (A), initially low with normalization (B), initially normal with subsequent decline (C), and persistently low (D). Overall survival (OS) and recurrence-free survival (RFS) were assessed utilizing Kaplan-Meier estimates and Cox proportional hazards regression analysis.
Results:
Significant heterogeneity in baseline characteristics was observed among the cohorts. Five-year OS rates were 82.8%, 78.5%, 73.9%, and 52.2% for groups A, B, C, and D, respectively (p < 0.0001). Multivariate analysis revealed that hypoalbuminemia, both pre- and post-operatively, served as an independent prognostic factor for diminished OS (HR 2.23, 95% CI 1.52-3.87, p = 0.005), but not RFS. Additional variables associated with inferior OS included advanced age (> 65 years), N2 stage disease, perineural invasion, and elevated postoperative carcinoembryonic antigen (CEA) levels. Restricted cubic spline analysis unveiled a non-linear relationship between albumin fluctuations and OS.
Conclusion:
Perioperative serum albumin concentrations demonstrate prognostic utility in patients with colorectal carcinoma. Hypoalbuminemia, both before and after surgical intervention, is associated with abbreviated OS. Incorporation of albumin levels into prognostic models may facilitate the optimization of individualized treatment strategies and potentially ameliorate patient outcomes.
