Does the Albumin to Globulin Ratio Predict Short-term Complications in Gastric Cancer Patients?

Abstract

Objective: Gastric cancer (GC) is a cancer with poor prognosis despite advances in diagnosis and treatment methods, and postoperative morbidity and mortality rates are high. The aim of this study was to evaluate the predictive and early prognostic effect of the pre-treatment albumin to globulin ratio (AGR) in patients with gastric adenocarcinoma (GAC). Methods: The study included male and female patients who were operated on with the diagnosis of GAC in our general surgery clinic between January 2016 and November 2020. The demographic and postoperative histopathological findings, postoperative complications, and in-hospital mortality findings of the patients were evaluated retrospectively from the hospital data. Results: Evaluation was made of a total of 70 patients operated on with the diagnosis of GAC. In the ROC curve analysis applied to the AGR ratio, the optimum cut-off value was 1.54. A statistically significant difference was found between the high (≥1.54) and low (<1.54) AGR groups in terms of intensive care unit (ICU) length of stay, serious postoperative complications, anastomotic leakage, and in-hospital mortality (p = 0.050, p = 0.016, p = 0.011; p = 0.005). In univariate analysis with postoperative serious complications, statistically significant results were found with age> 65 years, high American Society of Anesthesiologist (ASA) score, and low AGR (p = 0.035, p <0.001, p = 0.016), whereas in multivariate analysis, only high ASA score was found to be an independent risk factor (p = 0.031). Conclusion: The results of this study demonstrated the relationship between low AGR and serious postoperative complications, anastomotic leakage and early mortality risk in GAC. The AGR ratio, which can be calculated from the albumin and globulin values used in routine clinical practice, can be used as a suitable prognostic factor in this patient group to enable the clinician to take the necessary preoperative precautions.

Keywords

• Gastric adenocarcinoma
• albumin / globulin ratio
• postoperative complication

Albümin-Globulin Oranı Mide Kanseri Hastalarında Kısa Dönem Komplikasyonları Öngörür mü?

Abstract

Amaç: Gastrik kanser (GK), tanı ve tedavi metodlarındaki gelişmelere rağmen kötü prognozlu bir kanser olup, postoperatif morbidite ve mortalite oranları yüksek seyretmektedir. Bu çalışmada tedavi öncesi bakılan albümin-globülin oranı (AGO)’ nun gastrik adeno kanser (GAK) hastalarındaki prediktif ve erken dönem prognostik etkisini değerlendirmeyi amaçladık. Metod: Ocak 2016 ile kasım 2020 arasında, genel cerrahi kliniğimizde GAK tanısı ile opere edilen kadın ve erkek hastalar çalışmaya dahil edildi. Hastaların demografik ve postoperatif histopatolojik bulguları, postoperatif komplikasyonları ve hastane içi mortalite bulguları hastane veri datasından retrospektif olarak değerlendirildi. Bulgular: GAK tanısı ile ameliyat edilen toplam 70 hastanın değerlendirmesi yapıldı. AGO oranına uygulanan ROC eğri analizinde en uygun kesme değeri 1.54 idi. Yüksek (≥1.54) ve düşük (<1.54) AGO grupları arasında yoğun bakım ünitesi (YBÜ) kalış süresi, postoperatif ciddi komplikasyon, anastomoz kaçağı ve hastane içi mortalite gelişimi için istatisksel anlamlı fark tespit edildi ( p=0.050, p=0.016, p=0.011; p=0.005). Postoperatif ciddi komplikasyon ile univarite analizde >65 yaş, yüksek American Society of Anesthesiologist (ASA) skoru ve düşük AGO ile istatsisksel anlamlı sonuç bulunurken ( p=0.035, p<0.001, p=0.016), multivarite analizde ise sadece yüksek ASA skoru, bağımsız risk faktörü olarak bulundu ( p=0.031). Sonuç: AGO ile GAK’ da postoperatif ciddi komplikasyon, anastomoz kaçağı ve erken mortalite riski arasındaki ilişki çalışmamızda ortaya konmuş , bu hasta grubunda rutin klinik pratikle ölçülebilen düşük maliyetli AGO oranı preoperatif dönemde klinisyeni gerekli önlemleri alması için uyaran uygun bir prognostik araç olarak kullanılabilir.

Keywords

• Gastrik adenokanser
• albümin / globülin oranı
• postoperatif komplikasyon

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