Valor predictivo de la hipoalbuminemia pre-tratamiento sobre el pronóstico del cáncer colorrectal resecado / Predictive value of pre-treatment hypoalbuminemia in prognosis of resected colorectal cancer
Gastroenterol. hepatol. (Ed. impr.)
; 37(5): 289-295, mayo 2014. ilus, tab
Article
in Es
| IBECS
| ID: ibc-124588
Responsible library:
ES1.1
Localization: BNCS
RESUMEN
INTRODUCCIÓN: La albúmina forma parte de la respuesta sistémica inflamatoria antitumoral, por lo que analizaremos su valor en el pronóstico pre-operatorio del carcinoma colorrectal (CCR).Pacientes y métodos Estudio retrospectivo y observacional de una serie de CCR resecados consecutiva y programadamente. Efectuamos un análisis estadístico univariante y multivariante de la supervivencia entre los casos con y sin hipoalbuminemia pretratamiento (< 3,5 g/dl), globalmente y en el subgrupo en estadio pTNM II . Adicionalmente, comparamos el índice de mortalidad debida al tumor a los 5 años entre los casos con y sin hipoalbuminemia. Resultados Revisamos 207 pacientes (mediana de seguimiento: 81 meses). En el análisis multivariante global los casos con normoalbuminemia presentaron unas curvas de supervivencia superiores a las de los pacientes con hipoalbuminemia: (HR = 2,82; IC 95% = [1,54-5,19]; p = 0,001). Este mejor pronóstico de la normoalbuminemia se mantiene en el estadio pTNM II: (HR = 3,76; IC 95% = [1,40-10,08]; p = 0,009). El índice de mortalidad a los 5 años fue inferior en los casos con normoalbuminemia: global=18,8 versus 42,9% (OR = 3,24; IC 95% = [1,48-7,12]; p = 0,001); estadio pTNM II=13,3 versus 44,4% (OR = 5,2; IC 95% = [1,36-20,34]; p = 0,004). CONCLUSIÓN: Una hipoalbuminemia pre-tratamiento < 3,5g/dl se relaciona, de modo independiente, con una menor supervivencia tras la resección, tanto globalmente como en los CCR en estadio pTNM II. De confirmarse estos resultados la hipoalbuminemia constituiría un sencillo y significativo marcador de mal pronóstico, disponible desde el momento del diagnóstico
ABSTRACT
INTRODUCTION: Albuminemia is part of the antitumoral systemic inflammatory response. We therefore analyzed its possible value in establishing the preoperative prognosis of colorectal carcinoma (CRC). PATIENTS AND METHODS: We conducted a retrospective, observational study of a series of consecutive patients who underwent CRC resection. Univariate and multivariate analyses of survival curves were performed in patients with and without pre-treatment hypoalbuminemia (< 3.5 g/dl), both in the overall group of patients and in the subgroup of those with pTNM stage II tumors. In addition, we compared the 5-year tumor-related mortality in patients with and without hypoalbuminemia. RESULTS: A total of 207 patients were reviewed (median follow-up: 81 months). In the overall multivariate analysis, survival curves were better in patients with normal albumin levels than in those with hypoalbuminemia (HR = 2.82; CI 95% = [1.54-5.19]; P = .001). This better prognostic value of normal albumin levels was also significant in pTNM stage II tumors: (HR = 3.76; CI 95% = [1.40-10.08]; P = .009). The 5-year mortality index was lower in patients with normal albumin levels: overall series = 18.8% vs 42.9% (OR =3.24; CI 95% = [1.48-7.12]; p = 0.001); pTNM stage ii=13.3% vs 44.4% (OR = 5.2; CI 95% = [1.36-20.34]; P = 0.004). CONCLUSIONS: Pre-treatment hypoalbuminemia (< 3.5 g/dl) was independently related to shorter survival after tumor resection, both in the overall series of patients and in pTNM stage II CRC. If these results are confirmed, hypoalbuminemia would be a simple and significant marker of poor prognosis, available at the initial diagnosis
Full text:
1
Collection:
06-national
/
ES
Database:
IBECS
Main subject:
Colorectal Neoplasms
/
Hypoalbuminemia
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
Es
Journal:
Gastroenterol. hepatol. (Ed. impr.)
Year:
2014
Document type:
Article