Preoperative Serum Prealbumin Level and Adverse Prognosis in Patients With Hepatocellular Carcinoma After Hepatectomy: A Meta-Analysis

Abstract

BackgroundPrealbumin is a sensitive indicator of liver function and nutritional status.ObjectivesThis meta-analysis aimed to examine the association of the serum prealbumin level with the prognosis of patients with hepatocellular carcinoma (HCC) undergoing hepatectomy.MethodsWe comprehensively searched the PubMed, Embase, Wanfang, China Academic Journals (CNKI), and SinoMed databases up to September 1, 2021. Eligible studies should report the association of the serum prealbumin level with prognosis and provide the multivariable-adjusted risk estimates of the outcomes of interest in HCC patients undergoing hepatectomy.ResultsA total of 11 studies with 7,442 HCC patients were identified and analyzed. Meta-analysis of a fixed effects model showed that a low serum prealbumin level was associated with poor overall survival [hazard ratio (HR) = 1.54, 95% confidence interval (CI) = 1.42–1.68], recurrence-free survival (HR = 1.34, 95% CI = 1.17–1.52), and a higher risk of postoperative hepatic insufficiency (HR = 2.21; 95% CI = 1.36–3.60) in HCC patients. Sensitivity and subgroup analyses confirmed the robustness of low serum prealbumin in predicting poor overall survival.ConclusionsThis meta-analysis indicated that a low preoperative serum prealbumin level was significantly associated with adverse prognosis in HCC patients undergoing hepatectomy.

Prognostic value of preoperative prealbumin levels in patients with unresectable hepatocellular carcinoma undergoing transcatheter arterial chemoembolisation

“…Some studies have confirmed the association between preoperative prealbumin levels and the prognosis of patients with HCC undergoing radical resection. Patients with low preoperative PAB levels often have a poor prognosis [ 18 , 19 , 34 ].…”

Plasma transthyretin is a nutritional biomarker in human morbidities

“…In the meantime, the use of TTR is encouraged in most Asian countries such as China [72][73][74][91][92][93][94], Japan [75,[95][96][97][98][99], and South Korea [100][101][102] focusing more specific attention on matters having major public health impact. Many other Eastern countries, notably Indonesia [103], Thailand [104], India [105], Iran [106], and Australia [107] are working along similar lines, having provided substantial contributions.…”

Inflammatory and nutritional markers in patients with resectable pancreatic cancer

“…It constitutes about 60% of the serum proteins by weight. Its hepatic synthesis is affected by osmotic colloid pressure and inflammatory states, but also, by nutritional status and hormones [ 5 ]. In patients with cancer, serum albumin has been found to be an independent prognostic factor for survival in various cancers such as melanoma, colorectal, pancreatic, lung, gastric, and breast cancer [ 3 , 5 – 7 ].…”

“…Its hepatic synthesis is affected by osmotic colloid pressure and inflammatory states, but also, by nutritional status and hormones [ 5 ]. In patients with cancer, serum albumin has been found to be an independent prognostic factor for survival in various cancers such as melanoma, colorectal, pancreatic, lung, gastric, and breast cancer [ 3 , 5 – 7 ]. Furthermore, prealbumin has a shorter half-life which is about 2 to 3 days, and is considered more sensitive and accurate biomarker than albumin.…”

“…breast cancer [3,[5][6][7]. Furthermore, prealbumin has a shorter halflife which is about 2 to 3 days, and is considered more sensitive and accurate biomarker than albumin.…”