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Prognostic Value of Postoperative Neutrophil and Albumin: Reassessment One Month After Gastric Cancer Surgery

 Ali Guner  ;  Minah Cho  ;  Yoo-Min Kim  ;  Jae-Ho Cheong  ;  Woo Jin Hyung  ;  Hyoung-Il Kim 
 FRONTIERS IN ONCOLOGY, Vol.11 : 633924, 2021-03 
Journal Title
Issue Date
albumin ; inflammation ; neutrophils ; prognosis ; stomach neoplasms ; survival
Objective: The prognostic value of postoperative parameters reflecting the inflammatory and nutritional status of patients undergoing cancer surgery has been rarely studied. This study investigated the prognostic value of inflammatory and nutritional parameters measured preoperatively and 1 month after curative gastrectomy for gastric cancer. Methods: Data from a prospectively maintained database of 1,194 patients with gastric cancer who underwent curative surgery in 2009-2018 were retrospectively reviewed. Demographics, clinicopathologic characteristics, operative data, survival data, and laboratory parameters were extracted. Neutrophil counts, lymphocyte counts, and albumin levels before surgery and 1 month postoperatively were analyzed. Results: In multivariable analysis adjusted for age, sex, and pathologic stage, high neutrophil count (hazard ratio [HR] 1.09, 95% confidence interval [CI] 1.01-1.17, p = 0.022) and low albumin (HR 0.45, 95% CI 0.27-0.74, p = 0.002) 1 month postoperatively were independent prognostic factors for overall survival. High neutrophil count (HR 1.09, 95% CI 1.02-1.16, p = 0.015) 1 month postoperatively was also an independent prognostic factor for recurrence-free survival after adjusting for age, sex, body mass index, extent of gastrectomy, and pathologic stage. Patients were classified into risk groups based on thresholds of 4.2 × 103 cells/mm3 and 4.1 g/dl for 1-month neutrophil count and albumin. High-risk groups had a significantly worse prognosis than low-risk groups for overall survival (HR 5.87, 95% CI 3.28-10.51, p <0.001) and recurrence-free survival (HR 1.52, 95% CI 1.07-2.16, p = 0.021). Conclusions: Neutrophil count and albumin level 1 month after curative surgery reflect long-term prognosis better than preoperative values. These parameters can be used to stratify patients with the same stage into different prognostic groups.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yoo Min(김유민)
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Cho, Minah(조민아) ORCID logo https://orcid.org/0000-0003-3011-5813
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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