Does the Albumin to Globulin Ratio Predict Short-term Complications in Gastric Cancer Patients?

Abstract

Objective: Gastric cancer (GC) is a cancer with poor prognosis despite advances in diagnosis and treatment methods, and postoperative morbidity and mortality rates are high. The aim of this study was to evaluate the predictive and early prognostic effect of the pre-treatment albumin to globulin ratio (AGR) in patients with gastric adenocarcinoma (GAC). Methods: The study included male and female patients who were operated on with the diagnosis of GAC in our general surgery clinic between January 2016 and November 2020. The demographic and postoperative histopathological findings, postoperative complications and in-hospital mortality findings of the patients were evaluated retrospectively from the hospital data. Results: Evaluation was made of a total of 70 patients operated on with the diagnosis of GAC. In the ROC curve analysis applied to the AGR ratio, the optimum cut-off value was 1.54. A statistically significant difference was found between the high (≥1.54) and low (<1.54) AGR groups in terms of intensive care unit (ICU) length of stay, serious postoperative complications, anastomotic leakage, and in-hospital mortality (p = 0.050, p = 0.016, p = 0.011; p = 0.005). In univariate analysis with postoperative serious complications, statistically significant results were found with age> 65 years, high American Society of Anesthesiologist (ASA) score and low AGR (p = 0.035, p <0.001, p = 0.016), whereas in multivariate analysis, only high ASA score was found to be an independent risk factor (p = 0.031). Conclusions:The results of this study demonstrated the relationship between low AGR and serious postoperative complications, anastomotic leakage and early mortality risk in GAC. The AGR ratio, which can be calculated from the albumin and globulin values used in routine clinical practice, can be used as a suitable prognostic factor in this patient group to enable the clinician to take the necessary preoperative precautions.