The Prognostic Prediction Role of Preoperative Serum Albumin Level in Patients with Intahepatic Cholangiocarcinoma Following Hepatectomy

Abstract

Background: There is little information regarding the role of preoperative serum albumin (ALB) in intrahepatic cholangiocarcinoma (ICC) patients who underwent liver resection. Methods: Clinicopathological characteristics and survival rate of 91 ICC patients who underwent surgery between 2009 and 2013 were included in this study. The optimal cut-off for ALB were determined by plotting the receiver operating characteristics curves of ALB in predicting overall survival (OS) and utilizing the Youden index. Long-term outcome was calculated by Kaplan-meire method. Results: The pathological characteristics were similar in both groups. The 1- and 3-year disease-free survival (DFS) rates between the high ALB group and the lower ALB group were 62.7 vs. 25.5% and 27.0 vs. 11.1% respectively (p < 0.001). The 1- and 3-year OS rates between the high ALB group and the lower ALB group were 78.4 vs. 57.5% and 42.6 vs. 6.7% respectively (p < 0.001). The ALB level as continuous variable in multivariate analysis remained a favorable factor for DFS and OS (p < 0.05). Furthermore, ALB could distinguish the prognoses in non-cirrhotic patients. Multivariate analysis showed other pathological risk factors like lymph node involvement, positive surgical margin, satellite lesions, and carbohydrate antigen 19-9 were associated with DFS and OS (p < 0.05 for all). Conclusions: A higher preoperative serum ALB level is associated with better long-term survival in ICC patients.

Preoperative Risk Grade Predicts the Long-Term Prognosis of Intrahepatic Cholangiocarcinoma: A Retrospective Cohort Analysis

“…Thus, high PLR is associated with poor prognosis in various cancers, including the ICC in the present study [23,35]. It has been reported that the ALB level might correlate with the systemic in ammation [27]. Besides, the ALB is commonly used as the marker for assessing patient's nutritional status [27].…”

“…Chen and colleagues have reported that the PLR was an independent adverse prognostic factor for survival of ICC [13,23,25]. The ALB have been widely reported to be associated with the long-term outcomes of various cancers, including ICC [26,27]. In ammation-based scores consisting of CRP and ALB as the Glasgow prognostic score have been proven to be signi cantly associated with survival in various cancers [28,29].…”

“…It has been reported that the ALB level might correlate with the systemic in ammation [27]. Besides, the ALB is commonly used as the marker for assessing patient's nutritional status [27]. Malignancy frequently causes patient malnutrition re ected in hypoalbuminemia, which may in turn affect the host immune response to tumors [27,36].…”

“…Besides, the ALB is commonly used as the marker for assessing patient's nutritional status [27]. Malignancy frequently causes patient malnutrition re ected in hypoalbuminemia, which may in turn affect the host immune response to tumors [27,36]. Thus, hypoalbuminemia suggests the systemic in ammation as well as immune suppression, and therefore associated with the prognosis of various cancers [24,27,37,38].…”

Preoperative risk grade predicts the long-term prognosis of intrahepatic cholangiocarcinoma: a retrospective cohort analysis

“…Although several previous studies have reported the relationship between the PLR and hepato-pancreatico-biliary malignancies, only Chen and colleagues have reported that the PLR was an independent adverse prognostic factor for survival of ICC [13,24,28]. The ALB has been widely reported to be associated with the long-term outcomes of various cancers, including ICC [29,30]. In ammation-based scores consisting of CRP and ALB as the Glasgow prognostic score have been proven to be signi cantly associated with survival in various cancers [31,32].…”