Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study.
<h4>Background</h4>Preoperative nutritional status is an important host-related prognostic factor for non-small cell lung carcinoma (NSCLC); however, the significance of postoperative changes in nutritional status remains unclear. This study aimed to elucidate the significance of postope...
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2021
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oai:doaj.org-article:45818bcccba940b7855bb5d0bde08ae32021-12-02T20:08:36ZPrognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study.1932-620310.1371/journal.pone.0256894https://doaj.org/article/45818bcccba940b7855bb5d0bde08ae32021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256894https://doaj.org/toc/1932-6203<h4>Background</h4>Preoperative nutritional status is an important host-related prognostic factor for non-small cell lung carcinoma (NSCLC); however, the significance of postoperative changes in nutritional status remains unclear. This study aimed to elucidate the significance of postoperative decreases in serum albumin (ΔAlb) on the outcomes of early-stage NSCLC.<h4>Methods</h4>We analyzed 443 training cohort (TC) and 642 validation cohort (VC) patients with pStage IA NSCLC who underwent surgery and did not recur within 1 year. We measured preoperative serum albumin levels (preAlb) and postoperative levels 1 year after surgery (postAlb), and calculated ΔAlb as (preAlb - postAlb)/preAlb × 100%. A cutoff value of 11% for ΔAlb was defined on the basis of the receiver operating characteristic curve for the TC.<h4>Results</h4>Patients were divided into ΔAlb-Decreased and ΔAlb-Stable groups, including 100 (22.6%) and 343 (77.4%) in the TC, and 58 (9.0%) and 584 (90.1%) in the VC. ΔAlb-Decreased was associated with male sex (p = 0.0490), smoking (p = 0.0156), and non-adenocarcinoma (p<0.0001) in the TC, and pT1b (p = 0.0169) and non-adenocarcinoma (p = 0.0251) in the VC. Multivariable analysis identified ΔAlb as an independent prognostic factor for disease-free survival (DFS) and overall survival (OS) in both cohorts (VC: DFS, HR = 1.9, 95%CI: 1.10-3.15, p = 0.0197; OS, HR = 2.0, 95%CI: 1.13-3.45, p = 0.0173). Moreover, subgroup analysis demonstrated that the prognostic value of ΔAlb was consistent for age, sex, smoking history, surgical procedure, and histological type.<h4>Conclusion</h4>We demonstrated a negative impact of postoperative decrease of the serum albumin on the prognosis of patients with early-stage NSCLC. Postoperative changes in nutritional status might be important in NSCLC outcomes.Fumihiko KinoshitaTetsuzo TagawaTakanori YamashitaTomoyoshi TakenakaTaichi MatsubaraGouji ToyokawaKazuki TakadaTaro ObaAtsushi OsoegawaKoji YamazakiMitsuhiro TakenoyamaMototsugu ShimokawaNaoki NakashimaMasaki MoriPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0256894 (2021) |
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Medicine R Science Q |
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Medicine R Science Q Fumihiko Kinoshita Tetsuzo Tagawa Takanori Yamashita Tomoyoshi Takenaka Taichi Matsubara Gouji Toyokawa Kazuki Takada Taro Oba Atsushi Osoegawa Koji Yamazaki Mitsuhiro Takenoyama Mototsugu Shimokawa Naoki Nakashima Masaki Mori Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study. |
| description |
<h4>Background</h4>Preoperative nutritional status is an important host-related prognostic factor for non-small cell lung carcinoma (NSCLC); however, the significance of postoperative changes in nutritional status remains unclear. This study aimed to elucidate the significance of postoperative decreases in serum albumin (ΔAlb) on the outcomes of early-stage NSCLC.<h4>Methods</h4>We analyzed 443 training cohort (TC) and 642 validation cohort (VC) patients with pStage IA NSCLC who underwent surgery and did not recur within 1 year. We measured preoperative serum albumin levels (preAlb) and postoperative levels 1 year after surgery (postAlb), and calculated ΔAlb as (preAlb - postAlb)/preAlb × 100%. A cutoff value of 11% for ΔAlb was defined on the basis of the receiver operating characteristic curve for the TC.<h4>Results</h4>Patients were divided into ΔAlb-Decreased and ΔAlb-Stable groups, including 100 (22.6%) and 343 (77.4%) in the TC, and 58 (9.0%) and 584 (90.1%) in the VC. ΔAlb-Decreased was associated with male sex (p = 0.0490), smoking (p = 0.0156), and non-adenocarcinoma (p<0.0001) in the TC, and pT1b (p = 0.0169) and non-adenocarcinoma (p = 0.0251) in the VC. Multivariable analysis identified ΔAlb as an independent prognostic factor for disease-free survival (DFS) and overall survival (OS) in both cohorts (VC: DFS, HR = 1.9, 95%CI: 1.10-3.15, p = 0.0197; OS, HR = 2.0, 95%CI: 1.13-3.45, p = 0.0173). Moreover, subgroup analysis demonstrated that the prognostic value of ΔAlb was consistent for age, sex, smoking history, surgical procedure, and histological type.<h4>Conclusion</h4>We demonstrated a negative impact of postoperative decrease of the serum albumin on the prognosis of patients with early-stage NSCLC. Postoperative changes in nutritional status might be important in NSCLC outcomes. |
| format |
article |
| author |
Fumihiko Kinoshita Tetsuzo Tagawa Takanori Yamashita Tomoyoshi Takenaka Taichi Matsubara Gouji Toyokawa Kazuki Takada Taro Oba Atsushi Osoegawa Koji Yamazaki Mitsuhiro Takenoyama Mototsugu Shimokawa Naoki Nakashima Masaki Mori |
| author_facet |
Fumihiko Kinoshita Tetsuzo Tagawa Takanori Yamashita Tomoyoshi Takenaka Taichi Matsubara Gouji Toyokawa Kazuki Takada Taro Oba Atsushi Osoegawa Koji Yamazaki Mitsuhiro Takenoyama Mototsugu Shimokawa Naoki Nakashima Masaki Mori |
| author_sort |
Fumihiko Kinoshita |
| title |
Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study. |
| title_short |
Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study. |
| title_full |
Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study. |
| title_fullStr |
Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study. |
| title_full_unstemmed |
Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study. |
| title_sort |
prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: a multicenter retrospective study. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/45818bcccba940b7855bb5d0bde08ae3 |
| work_keys_str_mv |
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