Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2022; 14(6): 580-593
Published online Jun 27, 2022. doi: 10.4240/wjgs.v14.i6.580
Prognostic significance of the preoperative hemoglobin to albumin ratio for the short-term survival of gastric cancer patients
Ce-Gui Hu, Bai-E Hu, Jin-Feng Zhu, Zheng-Ming Zhu, Chao Huang
Ce-Gui Hu, Bai-E Hu, Jin-Feng Zhu, Zheng-Ming Zhu, Chao Huang, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: Hu BE and Hu CG designed the study and contributed equally to this work; Hu BE, Hu CG and Zhu JF collected the clinical data; Hu BE analyzed the data and wrote the manuscript with contributions from all authors; Zhu ZM and Huang C provided critical comments for this paper; All authors read and approved the final version of the paper.
Supported by National Natural Science Foundation of China, No. 81560389; and Key Research and Development Program of Jiangxi Province, No. 20181BBG70015.
Institutional review board statement: The study was reviewed and approved by the Medical Research Ethics Committee of the Second Affiliated Hospital of Nanchang University Institutional Review Board (Approval No. 20191130).
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao Huang, PhD, Doctor, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang 330006, Jiangxi Province, China. huangchao8041@163.com
Received: January 11, 2022
Peer-review started: January 11, 2022
First decision: March 12, 2022
Revised: March 20, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: June 27, 2022
Processing time: 166 Days and 22.7 Hours
Abstract
BACKGROUND

Hemoglobin and albumin are associated with the prognosis of gastric cancer (GC) patients. However, the prognostic value of the hemoglobin to albumin ratio (HAR) for the short-term survival of GC patients with D2 radical resection has not been studied.

AIM

To investigate the significance of the HAR in evaluating the short-term survival of GC patients after D2 radical resection and to construct a nomogram to predict the prognosis in GC patients after surgery, thus providing a reference for the development of postoperative individualized treatment and follow-up plans.

METHODS

Cox regression and Kaplan-Meier analysis was used for prognostic analysis. Logistic regression was used to analyze the relationships between HAR and the clinicopathological characteristics of the GC patients. A prognostic nomogram model for the short-term survival of GC patients was constructed by R software.

RESULTS

HAR was an independent risk factor for the short-term survival of GC patients. GC patients with a low HAR had a poor prognosis (P < 0.001). Low HAR was markedly related to high stage [odds ratio (OR) = 0.45 for II vs I; OR = 0.48 for III vs I], T classification (OR = 0.52 for T4 vs T1) and large tumor size (OR = 0.51 for ≥ 4 cm vs < 4 cm) (all P < 0.05). The nomogram model was based on HAR, age, CA19-9, CA125 and stage, and the C-index was 0.820.

CONCLUSION

Preoperative low HAR was associated with short-term survival in GC patients. The prognostic nomogram model can accurately predict the short-term survival of GC patients with D2 radical resection.

Keywords: Gastric cancer; Hemoglobin to albumin ratio; Short-term survival; Prognosis; Nomogram

Core Tip: Hemoglobin and albumin are associated with the prognosis of gastric cancer (GC) patients. However, the prognostic value of the hemoglobin to albumin ratio (HAR) for the short-term survival of GC patients with D2 radical resection has not been studied. HAR was an independent risk factor for the short-term survival of GC patients. GC patients with a low HAR had a poor prognosis. Low HAR was markedly related to high stage, T classification and tumor size. The nomogram model was based on HAR, age, CA19-9, CA125 and stage and can accurately predict the short-term survival of D2 radical resection GC patients.