Abstrakt: |
Background: The medical literature shows several examples of an inverse relationship between serum albumin and mortality in patients with advanced cancer. Because malnutrition can be a frequent manifestation in ovarian cancer, we investigated the prognostic role of serum albumin in patients with ovarian cancer treated in an integrative cancer treatment setting. Materials and Methods: We evaluated 213 histologically confirmed case series of ovarian cancer patients treated at Cancer Treatment Centers of America® between January 2001 and May 2006. Serum albumin was divided into 2 categories of >/= 3.6 g/dL and = 3.5 g/dL. The Kaplan-Meier method was used to calculate survival. Cox proportional hazard models were constructed to evaluate the prognostic effect of serum albumin independent of other prognostic factors. Results: Of 213 patients, 41 were newly diagnosed at our hospital, and 172 had received previous treatment elsewhere. Thirty had stage I disease at diagnosis, 17 stage II, 128 stage III, and 24 stage IV. A total of 135 patients had a serum albumin score of >/= 3.6 g/dL, and 78 patients had a score of = 3.5 g/dL. Patients with >/= 3.6 g/dL scores had a median survival of 23.3 months (95% CI, 16.5-30.1 months), whereas those with = 3.5 g/dL scores had a median survival of 7.3 months (95% CI, 4.8-9.8 months); P < .001. Multivariate Cox modeling found that every 1 gm/dL increase in serum albumin was associated with a relative risk of 0.39 (95% CI, 0.29-0.53; P < .001). Conclusion: Univariate and multivariate survival analysis found that low levels of serum albumin adversely affected survival by a statistically significant level across all stages of ovarian cancer independent of stage at diagnosis, serum cancer antigen-125, and previous treatment history. [ABSTRACT FROM AUTHOR] |