Aim To investigate the relationship between preoperative level of serum albumin in patients with colorectal cancer (CRC), stage of CRC and postoperative complications. Methods This cross-sectional retrospective study was conducted at the Clinic for General and Abdominal Surgery of the University Clinical Centre Sarajevo (UCCS). A total of 107 patients surgically treated for CRC in the period between 2013 and 2018 were enrolled in this study and divided into two groups: with hypoalbuminemia (group A) and without hypoalbuminemia (group B). Results The average level of albumin in group A was 29 (25-32) g/L versus 39 (37-41) g/L in group B (p<0.05). The average length of hospital stay in group A was 18 (13-25) days, and in group B 14.5 (12-21) days. Patients with hypoalbuminemia (group A) had wound dehiscence more often and more re-interventions compared to group B (p<0.05). Binary logistic regression found that serum protein, albumin and globulin levels were not statistically significant in the prediction of CRC stadium or postoperative complications (p>0.05). Conclusion Study results show that preoperatively measured levels of serum albumin are not associated with the stage of colorectal cancer and cannot serve as predictors for postoperative complications.
Siegel R, Miller K, Fedewa S, Ahnen D, Meester R, Barzi A, et al. CA Cancer J Clin. 2017. p. 177–93.
2.
Tevis S, Kennedy G. Hot topics in colorectal surgery: postoperative complications: looking forward to a safer future. Clin Colon Rectal Surg. 2016. p. 246–52.
3.
Limaye K, Yang J, Hinduja A. Role of admission serum albumin levels in patients with intracerebral hemorrhage. Acta Neurol Belg. 2016. p. 27–30.
4.
Mosli R, Mosli H. Obesity and morbid obesity associated with higher odds of hypoalbuminemia in adults without liver disease or renal failure. Diabetes Metab Syndr Obes. 2017. p. 467–72.
5.
Chang D, Xu X, Ferrante A, Jr, Krakoff J. Reduced plasma albumin predicts type 2 diabetes and is associated with greater adipose tissue macrophage content and activation. Diabetol Metab Syndr. 2019. p. 14.
6.
Truong A, Hanna M, Moghadamyeghaneh Z, Stamos M. Implications of preoperative hypoalbuminemia in colorectal surgery. World J Gastrointest Surg. 2016. p. 353–62.
7.
Lai C, You J, Yeh C, Chen J, Tang R, Wang J, et al. Low preoperative serum albumin in colon cancer: a risk factor for poor outcome. Int J Colorectal Dis. 2011. p. 473–81.
8.
Gupta D, Lis C. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010. p. 69.
9.
Gibbs J, Cull W, Henderson W, Daley J, Hur K, Khuri S. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg. 1999. p. 36–42.
10.
Hennessey D, Burke J, Ni-Dhonochu T, Shields C, Winter D, Mealy K. Preoperative hypoalbuminemia is an independent risk factor for the development of surgical site infection following gastrointestinal surgery: a multi-institutional study. Ann Surg. 2010. p. 325–9.
11.
Ge X, Dai X, Ding C, Tian H, Yang J, Gong J, et al. Early postoperative decrease of serum albumin predicts surgical outcome in patients undergoing colorectal resection. Dis Colon Rectum. 2017. p. 326–34.
12.
Don B, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004. p. 432–7.
13.
Nazha B, Moussaly E, Zaarour M, Weerasinghe C, Azab B. Hypoalbuminemia in colorectal cancer prognosis: nutritional marker or inflammatory surrogate? World J Gastrointest Surg. 2015. p. 370–7.
14.
Kumar S, Prakash D, Pottendla V. Preoperative serum albumin level as a predictor of surgical complications after emergency abdominal surgery. Int Surg J. 2019. p. 361–4.
15.
AJCC Cancer Staging Manual. Springer-Verlage Inc; 2010.
16.
Brennan C, Garrett W. Gut Microbiota, inflammation, and colorectal cancer. Annu Rev Microbiol. 2016. p. 395–411.
17.
Ying H, Liao Y, Sun F, Peng H, Cheng X. The role of cancer-elicited inflammatory biomarkers in predicting early recurrence within stage II-III colorectal cancer patients after curable resection. J Inflamm Res. 2021. p. 115–29.
18.
Hu W, Eisenstein S, Parry L, Ramamoorthy S. Preoperative malnutrition with mild hypoalbuminemia associated with postoperative mortality and morbidity of colorectal cancer: a propensity score matching study. Nutr J. 2019. p. 33.
19.
Loftus T, Brown M, Slish J, Rosenthal M. Serum levels of prealbumin and albumin for preoperative risk stratification. Nutr Clin Pract. 2019. p. 340–8.
20.
Negrichi S, Taleb S. Evaluation of nutritional status of colorectal cancer patients from Algerian East using anthropometric measurements and laboratory assessment. Iran J Public Health. 2020. p. 1242–51.
21.
Zietarska M, Krawczyk-Lipiec J, Kraj L, Zaucha R, Malgorzewicz S. Nutritional status assessment in colorectal cancer patients qualified to systemic treatment. Contemp Oncol (Pozn). 2017. p. 157–61.
22.
Maykel J. Complexities in Colorectal Surgery: Decision-making and Management. Springer Science and Business Media; p. 29–44.
23.
Borda F, Borda A, Jimenez J, Zozaya J, Prieto C, Gomez M, et al. Predictive value of pre-treatment hypoalbuminemia in prognosis of resected colorectal cancer. Gastroenterol Hepatol. 2014. p. 289–95.
24.
Sun L, Chu K, Cheng S, Lu C, Kuo C, Hsieh J, et al. Preoperative serum carcinoembryonic antigen, albumin and age are supplementary to UICC staging systems in predicting survival for colorectal cancer patients undergoing surgical treatment. BMC Cancer. 2009. p. 288.
25.
Cengiz O, Kocer B, Sürmeli S, Santicky M, Soran A. Are pretreatment serum albumin and cholesterol levels prognostic tools in patients with colorectal carcinoma? Med Sci Monit. 2006. p. R240-247.
26.
Almasaudi A, Dolan R, Edwards C, Mcmillan D. Hypoalbuminemia reflects nutritional risk, body composition and systemic inflammation and is independently associated with survival in patients with colorectal cancer. Cancers (Basel). 2020.
27.
Alkan A, Koksoy E, Utkan G. Albumin to globulin ratio, a predictor or a misleader? Ann Oncol. 2015. p. 443–4.
28.
Lohsiriwat V, Chinswangwatanakul V, Lohsiriwat S, Akaraviputh T, Boonnuch W, Methasade A, et al. Hypoalbuminemia is a predictor of delayed postoperative bowel function and poor surgical outcomes in right-sided colon cancer patients. Asia Pac J Clin Nutr. 2007. p. 213–7.
29.
Gili-Ortiz E, González-Guerrero R, Béjar-Prado L, Ramírez-Ramírez G, López-Méndez J. Postoperative dehiscence of the abdominal wound and its impact on excess mortality, hospital stay and costs. Cir Esp. 2015. p. 444–9.
30.
Hegazy T, Soliman S. Abdominal wall dehiscence in emergency midline laparotomy: incidence and risk factors. Egypt J Surg. 2020. p. 489–97.
31.
Van Ramshorst G, Nieuwenhuizen J, Hop W, Arends P, Boom J, Jeekel J, et al. Abdominal wound dehiscence in adults: development and validation of a risk model. World J Surg. 2010. p. 20–7.
32.
Aksamija G, Mulabdic A, Rasic I, Aksamija L. Evaluation of risk factors of surgical wound dehiscence in adults after laparotomy. Med Arch. 2016. p. 369–72.
33.
Ramneesh G, Sheerin S, Surinder S, Bir S. A prospective study of predictors for post laparotomy abdominal wound dehiscence. J Clin Diagn Res. 2014. p. 80–3.
34.
Inagaki E, Farber A, Eslami M, Kalish J, Rybin D, Doros G, et al. Preoperative hypoalbuminemia is associated with poor clinical outcomes after open and endovascular abdominal aortic aneurysm repair. J Vasc Surg. 2017. p. 53–63.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
,
