Low preoperative prealbumin increases non-gastric cancer mortality in patients with early or advanced gastric cancer after gastrectomy: a retrospective cohort study.

[PURPOSE] This study examined the relationship between preoperative prealbumin levels and long-term outcomes in patients with advanced gastric cancer after gastrectomy.

[METHODS] This study included patients who underwent radical gastrectomy for primary stage I-III gastric cancer with preoperative prealbumin levels measured from May 2006 to March 2017. The patients were categorized into 3 groups based on their preoperative prealbumin levels: high (≥ 22 mg/dL), moderate (15-22 mg/dL), and low (< 15 mg/dL).

[RESULTS] Of the 3,050 pStage I patients, 2488 (81.6%) were classified as high, 511 (16.8%) as moderate, and 51 (1.7%) as low. Of the 1682 patients with pStage II-III, 1161 (69.0%) were classified as high, 414 (24.6%) as moderate, and 107 (6.4%) as low. A comparison of the overall survival (OS) revealed that lower prealbumin levels were associated with a worse prognosis (P < 0.001). A multivariate analysis indicated that prealbumin levels of 15-22 mg/dL and < 15 mg/dL were independent poor prognostic factors for the OS, regardless of the pStage. When stratified by cause of death, prealbumin levels were associated with the other-cause survival but not the cancer-specific survival.

[CONCLUSIONS] Preoperative prealbumin levels were correlated with the OS, especially the other-cause survival, in patients with gastric cancer after gastrectomy. (200 words). Data Access Statement: Research data supporting this publication are available from the NN repository at located at www.NNN.org/download/ .