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©The Author(s) 2015.
World J Gastrointest Surg. Dec 27, 2015; 7(12): 370-377
Published online Dec 27, 2015. doi: 10.4240/wjgs.v7.i12.370
Published online Dec 27, 2015. doi: 10.4240/wjgs.v7.i12.370
Table 1 Pretreatment serum albumin and colorectal cancer
Ref. | Design | Objective | Sample size | Findings | Comments |
Heys et al[7] | Retrospective cohort study | ALB's prognostic value in localized and metastatic CRC | 431 patients | On multivariate analysis, reduced OS with lower ALB | First report of ALB's prognostic value in CRC |
Boonpipattanapong et al[26] | Retrospective cohort study | Preoperative CEA and ALB's prognostic value in CRC following curative surgery | 384 patients | Combination of CEA ≥ 5 ng/dL and ALB ≤ 3.5 g/dL predicts lower 5-yr OS. No statistically significant association of either alone with survival | Linking a tumor marker (CEA) to a host marker (ALB) can have a prognostic significance |
Lai et al[35] | Retrospective cohort study | Preoperative ALB's value in predicting postoperative outcomes in CRC | 3849 patients | Short-term: More complications related to wounds, anastomosis, lungs and urinary system in low ALB group | No difference in short-term postoperative GI and cardiovascular complications |
Long-term: Lower 5-yr OS (60% vs 78%) and 5-yr RFS (73.5% vs 78.9%) in low compared to normal ALB group | |||||
Cengiz et al[36] | Retrospective cohort study | Pretreatment ALB and cholesterol's prognostic value in CRC following curative surgery | 99 patients | 2.8 RR of death in low compared to normal ALB group. No survival effect for cholesterol on multivariate analysis | No difference in CRC recurrence between low and normal ALB groups |
Chandrasinghe et al[37] | Retrospective cohort study | Pretreatment ALB's prognostic value in rectal cancer following curative surgery | 226 patients | Lower 5-yr OS (47% vs 69%) and RFS (69.7% vs 83%) in low compared to normal ALB group. No differences in 30-d postoperative mortality/complications | First report on ALB's long-term prognostic value in rectal cancer |
Gupta et al[38] | Systematic review | Relationship between pretreatment ALB and cancer survival | 59 studies in total; 29 on GI cancers including 12 on CRC | 26 of 29 studies on GI cancers had higher OS with higher ALB on multivariate analysis | Inter-study differences in definition of low ALB (continuous variable vs cut-off points) |
Table 2 Pretreatment albumin-to-globulin ratio and colorectal cancer
Ref. | Design | Objective | Sample size | Findings | Comments |
Azab et al[43] | Retrospective cohort study | AGR's prognostic value in CRC-related mortality | 534 patients | 75% lower 4-yr mortality in high AGR (> 1.32) compared to low AGR tertile (< 1.03), independent of ALB | Study excluded patients who received preoperative chemotherapy |
Shibutani et al[44] | Retrospective cohort study | AGR's prognostic value in unresectable metastatic CRC treated with palliative chemotherapy | 66 patients | High AGR group had higher OS (HR = 2.25, P = 0.03) and PFS (HR = 2.66, P = 0.03) than low AGR group on multivariate analysis | No statistically significant difference in ORR between high and low AGR groups |
Suh et al[45] | Retrospective cohort study | Relationship between AGR and cancer incidence among healthy adults | 26974 adults (30 ≤ age ≤ 80) | Low AGR (< 1.1) had higher cancer incidence, an OR = 3.28 for CRC development and higher cancer mortality compared to AGR > 1.1 | First report on association of low AGR with the risk of cancer incidence and mortality in healthy adults |
Table 3 Glasgow prognostic score and colorectal cancer
Ref. | Design | Objective | Sample size | Findings | Comments |
Petrelli et al[50] | Systematic review and meta-analysis | Quantification of impact of mGPS on OS in CRC | 2227 patients from 9 studies | High mGPS was associated with worse OS (HR = 1.69) and CSS (HR = 1.84) | Studies in meta-analysis did not control for concurrent conditions that may affect mGPS, such as sepsis or medications |
McMillan et al[51] | Systematic review | Relationship between mGPS and cancer outcome | 60 studies with 18 on CRC | Higher mGPS in CRC predicted numerous worse outcomes (e.g., postoperative infections, toxicity, survival, etc.) | Study looked at all cancer patients. CRC studies were geographically restricted to the United Kingdom and Japan |
Richards et al[52] | Prospective cohort study | Correlation between parameters of body composition and systemic inflammatory response in operable CRC | 174 patients | Elevated mGPS was associated with low skeletal muscle index (P = 0.001) | No association seen between skeletal mass index and tumor-related variables such as tumor stage |
Read et al[55] | Prospective cohort study | Relationship between inflammatory/nutritional prognostic factors and outcomes in advanced CRC | 51 patients | High GPS was associated with worse OS (HR = 2.27), while the nutritional status as measured by validated scores was not on multivariate analysis | Small and heterogeneous study population |
- Citation: Nazha B, Moussaly E, Zaarour M, Weerasinghe C, Azab B. Hypoalbuminemia in colorectal cancer prognosis: Nutritional marker or inflammatory surrogate? World J Gastrointest Surg 2015; 7(12): 370-377
- URL: https://www.wjgnet.com/1948-9366/full/v7/i12/370.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v7.i12.370