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Vol. 71. Issue 4.
Pages 204-211 (July - August 2020)
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Vol. 71. Issue 4.
Pages 204-211 (July - August 2020)
Original article
Prognostic Significance of Albumin Levels Prior to Treatment in Patients With Head and Neck Squamous Cell Carcinoma
Significado pronóstico de los niveles de albúmina previos al tratamiento en los pacientes con carcinoma escamoso de cabeza y cuello
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Xavier Leóna,b,
Corresponding author
xleon@santpau.cat

Corresponding author.
, Laura Pardoc, Aina Sansaa, Rocio Puigd, Cristina Serranoe, Montserrat Lópeza, Miquel Quera, Cristina Valerof
a Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
b Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
c Servicio de Otorrinolaringología, Hospital Germans Trias i Pujol, Universidat Autònoma de Barcelona, Badalona, Barcelona, Spain
d Servicio de Endocrinología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
e Servicio de Dietética y Nutrición, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
f Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
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Tables (3)
Table 1. Average Albumin Level According to Patient Characteristics.
Table 2. Disease-specific Survival at 5 years and Hazard Ratios in Keeping With Albumin Level Categories Obtained Using Recursive Partitioning Analysis.
Table 3. Results of Multivariate Analysis.
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Additional material (1)
Abstract
Introduction and objectives

Pre-treatment albumin levels have been shown to have prognostic capacity in oncological patients. The aim of this study is to analyse the relationship between albumin levels and prognosis in patients with head and neck squamous cell carcinoma (HNSCC).

Methods

We performed a retrospective study in a cohort of 741 patients with HNSCC and a plasmatic albumin testing within the 4 weeks prior to the start of treatment. The relationship between disease-specific survival and plasma albumin levels was analysed by a recursive partitioning analysis.

Results

Albumin levels showed a directly proportional and statistically significant association with disease-specific survival. According to the results of the recursive partitioning analysis, the cut-off points with a higher prognostic capacity were 37.5 g/L and 46.1 g/L. Taking patients with albumin levels > 46.1 g/L as the benchmark, patients with albumin levels between 37.5−46.1 g/L had a 1.44 times higher risk of disease-specific death (CI 95%: .95−2.19, P = .081), and patients with levels <37.5 g L had a 3.19 times higher risk (CI 95%: 2.01−5.04, P = .0001). The differences in survival based on albumin levels were only seen in patients with advanced stage tumours (stages III-IV).

Conclusion

Pre-treatment plasmatic albumin is an independent prognostic factor for patients with advanced stage HNSCC (III-IV), 37.5 g/L being the cut-off point with the highest prognostic capacity.

Keywords:
Albumin
Head and neck squamous cell carcinoma
Hypoalbuminaemia
Prognosis
Nutrition
Resumen
Introducción y objetivos

Los niveles de albúmina pretratamiento han demostrado tener valor pronóstico en pacientes oncológicos. El objetivo del presente estudio es analizar la relación entre las cifras de albúmina pretratamiento y el pronóstico en pacientes con un carcinoma escamoso de cabeza y cuello (CECC).

Métodos

Estudio retrospectivo de una cohorte de 741 pacientes con CECC con una determinación de albúmina plasmática dentro de las 4 semanas previas al inicio del tratamiento. Se analizó la relación entre la supervivencia específica y los niveles de albúmina mediante un análisis de partición recursiva.

Resultados

Los niveles de albúmina tuvieron una relación directamente proporcional y estadísticamente significativa con la supervivencia específica. De acuerdo con los resultados del análisis de partición recursiva, los puntos de corte con una mayor capacidad pronóstica fueron 37,5 g/L y 46,1 g/L. En relación a los pacientes con albúmina > 46,1 g/L, los pacientes con albúmina entre 37,5-46,1 g/L contaron con un riesgo 1,44 veces superior de morir como consecuencia del tumor (IC 95%: 0,95-2,19, P = 0,081), y los pacientes con unas cifras de albúmina < 37,5 g/L con un riesgo 3,19 veces superior (IC 95%: 2,01-5,04, P = 0,0001). Las diferencias en supervivencia en función del valor de albúmina se observaron de forma exclusiva en los pacientes con tumores avanzados (estadios III-IV).

Conclusión

Las concentraciones de albúmina plasmática previas al tratamiento son un factor pronóstico independiente de supervivencia en los pacientes con CECC en estadios avanzados (III-IV), siendo el punto de corte de 37,5 g/L el de mayor capacidad pronóstica.

Palabras clave:
Albúmina
Carcinoma escamoso de cabeza y cuello
Hipoalbuminemia
Pronóstico
Nutrición

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