Prealbumin is a more sensitive marker than albumin to assess the nutritional status in patients undergoing radiotherapy for head and neck cancer

Abstract

Aim of the studyThe aim of this prospective study was to determine the prevalence of malnutrition and to evaluate a more sensitive marker to assess the nutritional status in patients undergoing RT for head and neck cancer.Material and methodsThe prospective study included 51 (mean age of 57.6 ±11.2 years) patients undergoing RT for head and neck cancer. Malnutrition was defined as weight loss > 5% of baseline.ResultsForty-six (90.2%) of 51 patients were male. Malnutrition developed in 33 (64.7%) patients during RT. Mean prealbumin level was significantly lower in patients with malnutrition than in those without malnutrition (17 ±5 g/dl vs. 22 ±5 g/dl, respectively, p = 0.004). On the other hand, there was no significant difference between the two groups in terms of other nutrition parameters including total protein, albumin, total cholesterol, triglyceride, and glucose (p > 0.05). The percentage of weight loss negatively correlated with prealbumin (r = –0.430, p = 0.002), but not with other nutrition parameters including total protein, albumin, triglyceride, total cholesterol, HDL cholesterol, LDL cholesterol, and glucose (p > 0.05).ConclusionsThe prevalence of malnutrition was high in patients with head and neck cancer. Prealbumin was a more sensitive marker than albumin to assess the nutritional status in these patients.

Malnutrition and cachexia in patients with head and neck cancer treated with (chemo)radiotherapy

“…On the other hand, the albumin level did not differ significantly between the two groups. 42,43 In immunocompetent patients, a total lymphocyte count lower than the range 1200-1500 mm -3 was recognised as another indicator of malnutrition. 40 …”

Prognostic Significance of C-reactive Protein-to-prealbumin Ratio in Patients with Esophageal Cancer

“…Previous studies showed that prealbumin has a shorter half-life of 2-3 days and its amount in the body is low. 21 Therefore, measurement of prealbumin is a good marker of visceral protein status and prealbumin is affected earlier by acute variations in protein balance. 37,38 Serum albumin is commonly used as a surrogate marker of nutrition; however, its half-life of 21 days and its steady state level of 100 days limit its utility and value.…”

“…37 Therefore, prealbumin is considered superior to albumin in nutritional assessment. 21 Furthermore, prealbumin has recently been identified as an independent prognostic factor in various cancers. 39,40 Based on this theoretical advantage, CRP/PAlb may be more sensitive and superior to CRP/Alb for tumor prognosis.…”

“…Several studies have shown that prealbumin has a short half-life and can be used as a parameter in nutritional status evaluation with demonstrated superiority to albumin. [18][19][20][21] Prealbumin is also associated with postoperative recovery and is an independent predictor of prognosis in patients with malignancies. 22,23 Recently, the preoperative CRP/prealbumin ratio (CRP/PAlb ratio) was reported to have a better predictive value for the recurrence of gastric cancer than traditional inflammatory indices.…”

CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized phase III trial

“…Liu found that C-Reactive protein/Albumin (CRP/ ALB) was superior to traditional inflammatory indices in predicting long-term survival of GC [6]. Studies have shown that prealbumin can be used as a parameter of nutritional status evaluation [7] and is superior to albumin (ALB) [8]. What's more, prealbumin is also associated with postoperative recovery [9,10] and is an independent predictor of prognosis in patients with malignancies [11][12][13][14].…”