High preoperative serum prealbumin predicts long-term survival in resected esophageal squamous cell cancer.

Abstract

PurposeThe current study aimed to explore the prognostic role of preoperative prealbumin in resectedesophageal squamous cell carcinoma (ESCC).MethodsA total of 1374 resected ESCC patients were retrospectively reviewed. Serum for prealbumin analyses was taken within 1–3 days before the operation. Overall survival (OS) was determined using the Kaplan-Meier method; the univariate log-rank test and the multivariate Cox proportional hazard model were used to evaluate the prognostic role of prealbumin. A receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated to compare the prediction accuracy of prealbumin and albumin for OS.ResultsFinally, 532 patients were included in this study. The 5-year OS rate was favourable for the high prealbumin group versus the median and low prealbumin groups (58.1% vs 44.6% and 31.1%, respectively; P<0.001). Univariate and multivariate analyses identified serum prealbumin, T stage, N stage, differentiation and albumin as independent prognostic factors for OS. ROC curves indicated that prealbumin may be superior to albumin as a prognostic predictor in ESCC patients, but the difference between the two AUCs was not statistically significant (P=0.068).ConclusionPrealbumin is an independent prognostic factor and a prognostic indicator of postoperative outcomes in ESCC patients. Future prospective studies are warranted to confirm our results.