Pre-operative serum albumin is associated with post-operative complication rate and overall survival in patients with epithelial ovarian cancer undergoing cytoreductive surgery

Ataseven, Beyhan; Bois, Andreas du; Reinthaller, Alexander; Traut, Alexander; Heitz, Florian; Aust, Stefanie; Prader, Sonia; Polterauer, Stephan; Harter, Philipp; Grimm, Christoph

doi:10.1016/j.ygyno.2015.07.005

Cited by 137 publications

(112 citation statements)

References 42 publications

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“…However, by using a Cox regression model of multivariate analysis, we found that only CRP/Alb remained as an independent prognostic marker for poor survival in patients with ovarian cancer along with residual disease, tumor stage and age, suggesting that CRP/Alb has a substantial impact on patient outcome. Surprisingly, albumin is no longer an independent predictor of OS, and age is a marginally significant predictor of OS ( p = 0.046), conflicting with a recent study [36]. The reason for this difference is that our study included CRP/Alb.…”

Section: Discussioncontrasting

confidence: 85%

“…Malnutrition, in turn, is related to poor prognosis in patients with cancer [34]. Several previous studies reported that pre-operative low serum albumin levels are an independent predictor of poor survival in ovarian cancer [35, 36]. Improvement in nutritional status is associated with better survival in ovarian cancer [14] and other tumors [37].…”

Section: Discussionmentioning

confidence: 99%

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The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer

et al. 2017

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Background: Inflammation plays an important role in the pathogenesis of ovarian cancer. This study sought to investigate the association between the preoperative c-reactive protein/albumin ratio (CRP/Alb) and oncological outcomes in ovarian cancer patients. Methods: Two hundred patients with histologically verified ovarian cancer between June 2006 and July 2012 were retrospectively reviewed. Overall survival was evaluated by the Kaplan-Meier method and log-rank test. The significance of risk factors for overall survival was evaluated with the Cox proportional hazards model. Additionally, area under the receiver operating characteristic curve (AUC) was used to compare the predictive ability of CRP/Alb, Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), prognostic index (PI) and prognostic nutritional index (PNI). Results: The optimal cutoff value of CRP/Alb was 0.68. Increased CRP/Alb (≥0.68) was associated with advanced stage, residual tumor, ascites, elevated serum carbohydrate antigen(CA)-125 level, GPS, and mGPS (all p < 0.05). Patients with high CRP/Alb had poor overall survival compared to those with low CRP/Alb (p < 0.001). Multivariable analysis showed that CRP/Alb (Hazard Ratio (HR) 1.330, 95% confidence interval (CI) 1.131-1.564, p = 0.001), tumor stage (HR 1.577, 95% CI 1.189-2.091, p = 0.002), residual tumor (HR 2.337, 95% CI 1.518-3.597, p < 0.001) and age (HR 1.017, 95% CI 1.000-1.035, p = 0.046) were independent prognostic factors for overall survival. Additionally, the CRP/Alb showed greater AUC values at 1 year (0.692), 3 years (0.659), and 5 years (0.682) than GPS, mGPS and PNI. Conclusions: The CRP/Alb is a novel independent marker of poor prognosis among ovarian cancer patients and shows superior prognostic ability compared to the established inflammation-based prognostic indices.

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Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer

et al. 2017

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“…Decreased serum albumin is not only an indicator of malnutrition status of the host but also one part of the systemic inflammation response [26]. Hypoalbuminemia has been reported to be associated with decreased survival in malignancies [26,27]. Lymphocytes play a key role in the host reaction to growing cancers by inducing cytotoxic cell death and suppressing tumor cell proliferation and migration [28].…”

Section: Discussionmentioning

confidence: 99%

The clinical significance of systemic inflammation score in esophageal squamous cell carcinoma

et al. 2015

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The objective of this study was to investigate the clinical significance of systemic inflammation score (SIS) and prognostic nutritional index (PNI) in esophageal squamous cell carcinoma (ESCC) patients who underwent esophagectomy. Records from 206 patients with histologically diagnosed ESCC who underwent esophagectomy at Qilu Hospital of Shandong University from January 2007 to December 2008 were retrospectively reviewed. The median disease-free survival (DFS) of this cohort was 32.3 months and 5-year DFS was 34.5 %. The median overall survival (OS) was 39.5 months and 5-year OS was 40.8 %. We found that high SIS was significantly associated with increased tumor length (p = 0.021), increased depth of invasion (p = 0.001), lymph node metastasis (p = 0.038), and advanced pathological stage (p = 0.004). Kaplan-Meier survival analysis revealed that both high SIS and low PNI were significantly associated with inferior DFS (for the SIS, p = 0.005; for the PNI, p = 0.003) and OS (for the SIS, p = 0.007; for the PNI, p = 0.002). In multivariate analysis, SIS was an independent prognostic indicator for both DFS and OS. However, PNI was not an independent prognosticator in multivariate analysis. SIS was a novel and promising inflammation-based prognostic score than PNI in ESCC patients who underwent esophagectomy.

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“…The neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR), a marker of systemic inflammation response, had been previously shown to serve as an independent prognostic marker for adverse clinical outcomes in ovarian cancer [7]. Moreover, hypoalbuminemia was found to be associated with shortened overall survival in epithelial ovarian cancer [8]. However, there were few reports regarding the potential prognostic significance of these markers in ovarian clear cell carcinoma.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance and predictors of the system inflammation score in ovarian clear cell carcinoma

Zhang

Lü

Lu³

et al. 2017

PLoS ONE

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Chronic inflammation is a well-known epidemiologic factor of ovarian clear cell carcinomas (OCCC), but has an uncertain role in prognosis. We developed a systemic inflammation score (SIS) based on preoperative serum albumin and neutrophil-to-lymphocyte ratio (NLR) for predicting progression-free survival (PFS) and overall survival (OS) in OCCC patients. A retrospective review was performed in 155 patients with OCCC undergoing primary debulking and chemotherapy at a single institute between 1995 and 2010. Cox regression models were fitted to analyze the effect of prognostic factors on PFS and OS. Harrell’s concordance index was calculated to assess predictive accuracy. The SIS consisting of serum albumin and NLR was retained as an independent indicator adjusting for traditional clinicopathological features. A high SIS was significantly associated with aggressive tumor behavior, platinum resistance, and served as an independent predictor of reduced PFS (P = 0.006) and OS (P = 0.019). The SIS had a good discrimination ability for the predictive PFS (c-index = 0.712) and OS (c-index = 0.722). We have developed a system inflammation score for predicting prognosis of OCCC patients, which may help stratify patients for postsurgical management.

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Pre-operative serum albumin is associated with post-operative complication rate and overall survival in patients with epithelial ovarian cancer undergoing cytoreductive surgery

Cited by 137 publications

References 42 publications

The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer

The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer

The clinical significance of systemic inflammation score in esophageal squamous cell carcinoma

Prognostic significance and predictors of the system inflammation score in ovarian clear cell carcinoma

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