Predictive Value of Serum Albumin Levels and Liver Enzymes for Survival in Patients with Pancreatic Cancer

Serum biomarkers such as albumin and liver enzymes may serve as prognostic indicators in pancreatic cancer. This study evaluated the association between serum levels of albumin and liver enzymes with survival in patients with pancreatic cancer. This cross-sectional study was conducted on 50 patients with confirmed pancreatic cancer in Guilan Province, Iran, and demographic, clinical, and laboratory data of patients were collected. Serum levels of albumin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were categorized into tertiles, and hypoalbuminemia was defined as albumin < 3.5 g/dL. Survival was assessed using Cox proportional hazards models (unadjusted and adjusted modes) with reported hazard ratio (HR). Kaplan-Meier curves and log-rank tests were used to compare survival according to the variables. The significance level was set at 0.05. Most patients were males (60%), and the mean age of patients was 62.8 ± 10.5 years, with the mean survival of 39.6 months. Results demonstrated that hypoalbuminemia was independently associated with increased mortality (HR = 3.89, 95% CI: 1.23-12.25, P = 0.020). For each 1 g/dL increase in serum albumin, the hazard of death decreased by 51% (HR = 0.49, 95% CI: 0.33-0.73, P < 0.001). Serum levels of AST ≥ 48 U/L and ALT > 93 U/L were significantly associated with a higher hazard of death in unadjusted and age-sex adjusted models (P < 0.05); however, after removing the effects of confounders, no statistically significant association was observed (P > 0.05). Our findings illustrated that hypoalbuminemia is a strong, independent predictor of poor survival in pancreatic cancer, and routine, cost-effective monitoring of albumin and liver enzymes offers practical value for guiding personalized care, especially in resource-limited settings.

The online version contains supplementary material available at 10.1007/s13193-025-02450-1.