Abstract
15110 Background: New prognostic markers for pts (patients) undergoing surgery for colorectal cancer are urgently sought. Recent small series suggest that serum albumin, a marker of inflammation, is a potentially useful biomarker. However, the stage specific impact of a low albumin level (<35) has not been adequately explored. The possibility that a low albumin level is a surrogate of other adverse prognostic features has also yet to be excluded. Method: We examined our prospective multi-centre colorectal cancer database from January 2003 - August 2007 to determine the relationship between albumin level and tumour stage, ASA score, ECOG performance status, co-morbidity data (including diabetes), and survival outcomes. Results: 378 pts who had undergone surgery for stage I (n=72), II (n=175) or III (n=131) colon cancer were identified. 46 pts who had undergone emergency surgery were excluded. Median follow-up was 20.5 months. When individual stages were analysed, the survival curves overlapped for stage I cancers, however there was a significant difference for stage II cancers for PFS (p < 0.0001) and OS (p<0.0001). A trend was observed for stage III cancers for PFS (p=0.123) and OS (p=0.227), with 64% of pts with a normal albumin progression free at 21 months versus 43% of patients with a low albumin. For all pts albumin was a significant predictor of progression free (p=0.001) and overall survival (p<0.001). There was no significant relationship between albumin and markers of general health, or co-morbidity. Conclusion: Our data suggests that albumin level is an independent prognostic variable for tumour recurrence and survival for stage B colon cancer, and possibly for stage C cancer. Albumin level is a simple and potentially useful prognostic marker, but this needs to be validated in an adequately powered prospective study. No significant financial relationships to disclose.
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