Clinical Impact of Preoperative Albumin-Globulin Ratio in Patients with Rectal Cancer Treated with Preoperative Chemoradiotherapy.

Abstract

OBJECTIVE:

The serum albumin-globulin ratio (AGR) is associated with malignancy outcomes. However, among patients with rectal cancer (RC) who undergo neoadjuvant chemoradiotherapy (nCRT), the clinical and prognostic significance of the pretreatment AGR is unclear.

METHODS:

We investigated whether the pre-nCRT AGR can help predict oncological outcomes in patients with RC receiving nCRT. We analyzed 114 patients with RC who received nCRT followed by total mesorectal excision at our institution.

RESULTS:

A lower AGR in pre-nCRT serum was significantly correlated with shorter overall survival and disease-free survival in patients with nCRT-treated RC. In multivariate analysis, a high carcinoembryonic antigen (CEA) level and a low AGR in pre-nCRT serum were independent predictors of a poor prognosis in these patients. Furthermore, combining the AGR with CEA provided a more accurate indicator of poor prognosis and early recurrence in these patients. In particular, a low pre-nCRT AGR was a stronger indicator of a poor prognosis and early recurrence in patients without than with pathological lymph node metastasis. Combining the pre-nCRT AGR with CEA could more precisely stratify patients' oncological outcome risks.

CONCLUSION:

Assessment of the pretreatment AGR with or without CEA can guide postoperative treatment in patients with RC who undergo nCRT.

• Authors: Yuji Toiyama, Satoshi Oki, Yoshinaga Okugawa, Shozou Ide, Hiromi Yasuda, Hiroyuki Fujikawa, Shigeyuki Yoshiyama, Junichiro Hiro, Masaki Ohi, Yasuhiro Inoue, Toshimitsu Araki, Masato Kusunoki
• Journal: Oncology (Oncology) Vol. 95 Issue 5 Pg. 270-280 ( 2018) ISSN: 1423-0232 [Electronic] Switzerland
• PMID: 29996133 (Publication Type: Journal Article)
• Copyright: © 2018 S. Karger AG, Basel.

Chemical References

• ALB protein, human
• Biomarkers, Tumor
• Carcinoembryonic Antigen
• Globulins
• Serum Albumin, Human

Topics

• Adenocarcinoma (blood, mortality, secondary, therapy)
• Aged
• Biomarkers, Tumor (blood)
• Carcinoembryonic Antigen (blood)
• Chemoradiotherapy, Adjuvant (adverse effects, mortality)
• Clinical Decision-Making
• Decision Support Techniques
• Digestive System Surgical Procedures (adverse effects, mortality)
• Disease Progression
• Disease-Free Survival
• Female
• Globulins (analysis)
• Humans
• Kaplan-Meier Estimate
• Lymphatic Metastasis
• Male
• Middle Aged
• Multivariate Analysis
• Neoadjuvant Therapy (adverse effects, mortality)
• Neoplasm Recurrence, Local
• Predictive Value of Tests
• Proportional Hazards Models
• Rectal Neoplasms (blood, mortality, pathology, therapy)
• Risk Factors
• Serum Albumin, Human (analysis)
• Time Factors
• Treatment Outcome