Table 2

Serum albumin and survival - lung cancer

First author, year of publication, place

Year of data collection

Study design, Sample size

Cancer type

Groups being compared

RR (95%Cl), p-value

Variables adjusted for


Win T, 2008, UK [70]

2 years up to December 2006

Prospective consecutive case series, 110

Non Small Cell Lung

Continuous variable

Univariate: 0.93 (0.88-0.98), 0.006

Female gender, age, pneumectomy, chronic obstructive pulmonary disease, Smoking, Diabetes, Coronary disease, BMI, global quality of life


Forrest LM, 2005, UK [71]

January 2002 to December 2003

Prospective, 101

Non Small Cell Lung

>=3.5 g/dL

<3.5 g/dL

Median Survival (months) (95% CI)

For >/=3.5 g/dL = 8.7 (6.9-10.5)

For <3.5 g/dL = 1.2 (0.0-2.8), p = <0.01

Age, sex, stage, hemoglobin, WBC, CRP, PS, GPS, treatment


Maeda T, 2000, Japan [9]

1978-1992

Retrospective, 261

Non Small Cell Lung

<3.5 g/dL

>=3.5 g/dL

Median survival in months

<3.5 g/dL = 5.0

>=3.5 g/dL = 9.6; p = <0.001

Multivariate: 1.69 (1.19-2.41), 0.0037

Age, gender, histology, PS, LFTs, Stage IV, bilirubin, CEA, liver metastases


Tas F, 1999, Turkey [10]

1991 to 1997

Retrospective, 207

Small Cell Lung

Normal: >=3.5 g/dL

Low: <3.5 g/dL

Univariate: p = <0.001

Multivariate: p = 0.03

Age, gender, performance status, weight loss, clinical stage, hemoglobin, LDH, response to chemotherapy


Ray P, 1998, France [4]

NA

Retrospective, 99 patients with SCLC and 202 patients with NSCLC

Small cell lung and Non-Small cell lung

NA

Serum albumin levels were not found to be associated with survival

Tumor, node, metastasis status, PS, body weight loss, WBC, serum sodium, LDH, ALP, serum NSE, serum TPS, and CYFRA 21-1


Lai SL, 1998, Taiwan [72]

NA

Prospective, 150

Non Small Cell Lung

NA

Patients who died within six months after diagnosis had significantly lower values of all nutritional parameters than those who survived more than 6 months

Weight/height ratio, percent of standard triceps skin-fold thickness, percent of standard arm muscle circumference, transferrin, creatinine height index and total lymphocyte count


Maestu I, 1997, Spain [73]

November 1981 to January 1993

Retrospective, 341

Small cell lung

<3.4 g/dL

>=3.4 g/dL

Univariate: 0.0057

Multivariate : coefficient = -0.3457, p = 0.001

LDH, disease extent, CK, neutrophils, PS, glycemia, ESR, sodium, potassium, ALP, urea, uric acid, age


Muers MF, 1996, UK [74]

NA

Retrospective consecutive case series, 207

Non Small Cell Lung

NA

Prognostic Index = -0.42 × distant metastases + 1.1 × hoarseness + 0.47 × malaise - 0.34 × immediate treatment intent + 0.72 × lymphocyte count + 0.94 × serum albumin + 0.62 × sodium - 0.98 × ALP

Sex, the activity score, the presence of malaise, hoarseness and distant metastases at presentation, and lymphocyte count, sodium and ALP levels


Hespanhol V, 1995, Portugal [75]

1984 to 1990

Prospective, 411

Non Small Cell Lung

<3.5 g/dL

>=3.5 g/dL

Univariate: 1.92, (1.55-2.36), 0.000

Multivariate: 0.588 (0.46-0.74), 0.000

PS, Weight loss, Hoarseness, stage, lymphocyte, LDH, sex


Espinosa E, 1995, Spain [76]

1980-1992

Retrospective onsecutive case series, 292

Non Small Cell Lung

>=4 g/dL

<4 g/dL

Univariate: Median survival in months

For >=4 g/dL = 9 For <4 g/dL = 7, p = 0.004; Multivariate:

Coefficient = -2.52, p = 0.0001

Number of metastases, LDH, PS, sedimentation rate


Gupta and Lis Nutrition Journal 2010 9:69   doi:10.1186/1475-2891-9-69

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