Blood serum albumin as prognostic factor in patients with colorectal carcinoma.

Abstract

740 Background: During the las decades, Colorectal carcinoma (CRC) has become the commonest gastrointestinal neoplasm in Mexico, being stages III and IV the most frequent, reaching thus,, diagnosed by colonoscopy and biopsyand a dismal prognosis. Basal blood serum albumin has been reported as significant prognostic factor in several diseases and in several cancers. Therefore, our aim is to define the role of the basal measurement of blood serum albumin at diagnosis as prognostic factor. Methods: Consecutive cases with CRC diagnosed by colonoscopy and biopsy and treated at a single cancer center in Mexico City from January 2010 to December 2014, were included in this cohort. Clinical history and laboratory data were registered, and patients were treated according to standard guidelines. Follow-up continued until September 2015; the Kaplan-Meier method and the Cox model were used to analyze the association of prognostic factors and overall survival (OS). Results: There were 567 patients with CRC: 258 women (45.5%) and 309 males (55.5%); mean age was 60.04 years (SD 15.6). Fifty-seven, 155, 113 and 242 were stages I, II, III and IV, respectively; 132 were located in right colon, 33 in transverse, 35 in left, 114 in sigmoid, 239 in rectum and 14 in anal canal. Neither gender, age, blood hemoglobin, lymphocyte count, albumin-lymphocyte interaction, nor Nutritional prognostic index were significantly associated with OS. Serum albumin was associated to OS, by bivariate and by multivariate analysis. This association remainded significant after adjustment for TNM stages, locations, and other clinically relevant factors. Conclusions: Serum albumin at diagnosis is an independent, significant, simple, cheap and widely available prognostic factor in patients with CRC in Mexico, adding significant prognostic information to TNM classification. Feasibly, it can be used to develop multivariate prognostic models with clinical impact.