The number of
colon cancer patients is increasing worldwide.
Malnutrition and comorbidities are frequently associated with these patients. The relationships between the preoperative
malnutrition and the outcomes of
colon cancer patients are unclear; this study aimed to clarify these issues.
METHODS: A total of 3,849 consecutive
colon cancer patients were enrolled in an analysis of short-term outcomes and 2,529 patients were included in an analysis of the long-term outcomes. These patients were divided into the hypoalbuminemic and normal groups according to the definition of
hypoalbuminemia (
serum albumin < 35 g/L).
RESULTS: Advanced age, female gender, abnormal CEA levels, right colon or large
tumors,
mucinous adenocarcinoma, poor differentiation, stage II
cancer, TNM advancing T stage, old cardiovascular accident, diabetes, and
liver cirrhosis were more likely to be associated with
hypoalbuminemia. Hypoalbuminemic patients had a higher rate of postoperative mortality and morbidity, including complications related to
wounds, lungs, the urinary system, and anastomosis. The 5-year overall survival rates of patients with normal
albumin and
hypoalbuminemia were 78.0% and 60.0%, respectively (P < 0.0001), and the 5-year relapse-free survival rates were 78.9% and 73.5%, respectively (P = 0.0042). In a multivariate analysis, the
albumin level was also significantly correlated with 5-year overall survival (<35 vs. ≥ 35, HR 1.75; 95% CI 1.49-2.08) and 5-year relapse-free survival (<35 vs. ≥ 35, HR 1.28; 95% CI 1.04-1.56).
CONCLUSIONS: