Retrospective Study
Copyright ©The Author(s) 2023.
World J Gastrointest Surg. Jun 27, 2023; 15(6): 1125-1137
Published online Jun 27, 2023. doi: 10.4240/wjgs.v15.i6.1125
Table 1 Clinical and surgical characteristics of patients with gastric cancer according albumin-bilirubin risk groups, n (%)
Variables
Low-ALBI group (< -2.82), n = 211
High-ALBI group (≥ -2.82), n = 150
P value
Sex0.712
    Female72 (34.1)54 (36.0)
    Male139 (65.9)96 (64.0)
Age (yr)0.005
    mean (SD)62.0 (12.0)65.6 (12.2)
BMI (kg/cm²)0.856
    mean (SD)25 (4.5)25.2 (16.5)
Hemoglobin (g/dL)< 0.001
    mean (SD)12.7 (2.1)11.1 (2.1)
Albumin (g/dL)< 0.001
    mean (SD)4.3 (0.3)3.5 (0.5)
Bilirubin (mg/dL)0.072
    mean (SD)0.41 (0.22)0.47 (0.33)
Neutrophil to lymphocyte ratio0.092
    mean (SD)2.48 (2.29)2.91 (2.56)
American Society of Anesthesiologists0.001
    I/II178 (84.4)105 (70.0)
    III/IV33 (15.6)45 (30.0)
Charlson–Deyo Comorbidity Index10.344
    0141 (66.8)93 (62.0)
    ≥ 170 (33.2)57 (38.0)
Type of gastrectomy0.562
    Subtotal126 (59.7)85 (56.7)
    Total85 (40.3)65 (43.3)
Lymphadenectomy0.003
    D134 (16.1)44 (29.3)
    D2177 (83.9)106 (70.7)
Preoperative chemotherapy0.477
    No175 (82.9)120 (80)
    Yes36 (17.1)30 (20)
Table 2 Pathological characteristics of patients with gastric cancer according albumin-bilirubin groups, n (%)
Variables
Low-ALBI group (< -2.82), n = 211
High-ALBI group (≥ -2.82), n = 150
P value
Lauren type0.367
    Intestinal124 (58.8)81 (54.0)
    Diffuse/mixed87 (41.2)69 (46.0)
Histological differentiation0.993
    Well/moderately differentiated107 (59.7)76 (50.7)
    Poorly differentiated104 (49.3)74 (49.3)
Lymphatic invasion0.132
    No121 (57.3)74 (49.3)
    Yes90 (42.7)76 (50.7)
Venous invasion0.196
    No150 (71.1)97 (64.7)
    Yes61 (28.9)53 (35.3)
Perineural invasion0.743
    No112 (53.1)77 (51.3)
    Yes99 (46.9)73 (48.7)
T status0.105
    pT1/T291 (43.1)52 (34.7)
    pT3/T4120 (56.9)98 (65.3)
No of dissected lymph nodes0.543
    mean (SD)40.9 (17.7)39.8 (17.2)
pN status0.239
    pN099 (46.9)61 (40.7)
    pN+112 (53.1)89 (59.3)
pTNM0.222
    I/II122 (57.8)77 (51.3)
    III89 (42.2)73 (48.7)
Table 3 Postoperative and surgical outcomes of patients with gastric cancer according albumin-bilirubin groups, n (%)
Variables
Low-ALBI group (< -2.82), n = 211
High-ALBI group (≥ -2.82), n = 150
P value
Length of hospital stay (d)0.673
    Median (IQR)9 (6.0-13.3)10 (7.0-13.8)
Postoperative complications (Clavien)0.029
    Non/minor POC (I-II)183 (86.7)117 (78)
    Major POC (III-IV)28 (13.3)33 (22)
Postoperative chemotherapy0.917
    No117 (55.5)84 (56)
    Yes94 (44.5)66 (44)
Chemotherapy-all (pre or postoperative)0.766
    No99 (46.9)68 (45.3)
    Yes112 (53.1)82 (54.7)
30-d motality0.023
    No206 (97.6)138 (92.6)
    Yes5 (2.4)11 (7.4)
90-d motality0.030
    No198 (94.7)130 (88.4)
    Yes11 (5.3)17 (11.6)
Table 4 Univariate and multivariate analysis for disease-free survival
Disease-free survival
Univariate
Multivariate
Variables
HR
95%CI
P value
HR
95%CI
P value
Male (vs female)1.150.81-1.610.438---
Age > 65 yr (vs < 65 yr)1.180.86-1.620.312---
Charlson > 1 (vs 0)1.481.07-2.040.0191.390.94-2.060.102
ASA III/IV (vs ASA I/II)1.841.29-2.640.0011.430.93-2.210.106
Total gastrectomy (vs distal)1.431.04-1.970.0301.431.03-1.980.031
Diffuse/mixed (vs others)1.210.87-1.670.255---
pT3/T4 (vs pT1/T2)2.571.76-3.76< 0.0012.031.33-3.120.001
pN+ (vs pN0)2.261.60-3.19< 0.0011.541.04-2.270.030
non-CMT (vs CMT)1.150.83-1.580.399---
Low-ALBI (vs High-ALBI)2.091.51-2.88< 0.0011.831.32-2.53< 0.001
Table 5 Univariate and multivariate analysis for overall survival
Overall survival
Univariate
Multivariate
Variables
HR
95%CI
P value
HR
95%CI
P value
Male (vs female)1.200.85-1.710.306---
Age > 65 yr (vs < 65 yr)1.280.94-1.790.137---
Charlson > 1 (vs 0)1.421.02-1.980.0411.250.83-1.890.282
ASA III/IV (vs ASA I/II)1.941.35-2.80< 0.0011.601.02-2.520.041
Total gastrectomy (vs distal)1.501.08-2.080.0161.561.12-2.180.009
Diffuse/mixed (vs others)1.290.93-1.790.133---
pT3/T4 (vs pT1/T2)2.441.65-3.61< 0.0011.871.20-2.910.006
pN+ (vs pN0)2.241.57-3.20< 0.0011.581.06-2.370.026
non-CMT (vs CMT)1.180.85-1.640.327---
Low-ALBI (vs High-ALBI)1.971.41-2.74< 0.0011.681.20-2.350.003