The preoperative albumin level is an independent prognostic factor for optimally debulked epithelial ovarian cancer

Abstract

The preoperative albumin level is an independent prognostic factor for overall survival in optimally debulked EOC patients. Further investigations about preoperative albumin level in prognostic models will contribute to the literature.

Prognostic significance of preoperative serum albumin in epithelial ovarian cancer patients: a systematic review and dose–response meta-analysis of observational studies

“…After screening the titles and abstracts, 23 articles qualified for a full-text review ( Figure 1 ). Finally, 12 cohort studies 8 , 12 – 21 , 36 were included in the present analysis.…”

“…Most (7/12, 58.3%) of the included studies were conducted in Europe, 8 , 15 , 16 , 18 , 20 – 22 while 4/12 (33.3%) were conducted in Asia, 12 – 14 , 17 and 1/12 (8.3%) was conducted in the USA. 19 Serum albumin was a categorical variable in 9/12 (75.0%) studies 8 , 12 , 14 – 19 , 21 and a continuous variable in 3/12 (25.0%) studies. 13 , 20 , 22 …”

“…To unify the comparison, the effective-count method proposed by Hamling et al 30 was used to recalculate the HRs of studies that did not use the category with the lowest level of serum albumin as the reference 12 , 15 – 17 as well as those that only provided the results of dose–response analysis instead of the highest compared with the lowest category. 20 , 22 Overall, summary estimates were calculated using inverse variance-weighted random-effects meta-analysis.…”

“…The rate of albumin synthesis is associated with nutritional and disease states 11 and has been described as a crucial parameter of long-standing malnutrition. 12 These previous experimental studies raised concern as to whether preoperative serum albumin is associated with increased mortality in EOC patients. However, the evidence from previous observational studies is controversial, 8 , 12 – 22 as some studies have suggested that lower preoperative serum albumin was associated with decreased mortality of EOC, 8 , 12 – 16 , 19 , 21 , 22 while others failed to find any evidence of such an association.…”

Advanced stage ovarian cancer patients with neoadjuvant chemotherapy suffered worse recurrence free survival

“…In our study, we found that the level of albumin was elevated after the course of NACT (37.47 ± 5.42 vs 42.61 ± 3.46, P 0.05). Cancer patients have low preoperative albumin levels, especially those with advanced-stage disease and patients with ascites 16 ; the mechanisms for this low level involve a decrease in amino acid intake and albumin synthesis 17 as well as an increase in albumin leakage to the extravascular space in patients with ascites. There were 21 (80.77%) patients with massive ascites upon diagnosis, and the largest mean diameter of the ascites assessed by ultrasound was 104.05 ± 31.75 mm.…”