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Prognostic value of pretreatment albumin–globulin ratio in predicting long-term mortality in gastric cancer patients who underwent D2 resection

Authors Liu J, Chen S, Geng Q, Liu X, Kong P, Zhan Y, Xu D

Received 27 October 2015

Accepted for publication 31 March 2016

Published 13 April 2017 Volume 2017:10 Pages 2155—2162

DOI https://doi.org/10.2147/OTT.S99282

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Yu An

Peer reviewer comments 2

Editor who approved publication: Professor Min Li

Jianjun Liu,1,2,* Shangxiang Chen,1,2,* Qirong Geng,1,3 Xuechao Liu,1,2 Pengfei Kong,1,2 Youqing Zhan,1,2 Dazhi Xu1,2

1State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 2Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, 3Department of Hematology Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China

*These authors contributed equally to this work

Background: Several studies have highlighted the prognostic value of the albumin–globulin ratio (AGR) in various kinds of cancers. Our study was designed to assess whether AGR is associated with the prognosis of gastric cancer patients.
Patients and methods: A total of 507 gastric cancer patients between 2005 and 2012 were included. The AGR was defined as the ratio of serum albumin to nonalbumin and calculated by the equation: albumin/(total protein - albumin). Furthermore, AGR was divided into two groups (low and high) using the X-tile software. Survival analysis stratified by AGR groups was performed.
Results: The mean survival time for each group was 36.62 months (95% CI: 33.92–39.32) for the low AGR group and 48.95 months (95% CI: 41.93–55.96, P=0.003) for the high AGR group. Patients in the high group (AGR ≥1.93) had a significantly lower 5-year mortality in comparison with the low group (AGR <1.93) (52.4% vs 78.5%, P=0.003). The high AGR group showed obviously better overall survival than the low AGR group according to Kaplan–Meier curves (P=0.003). Multivariate analysis showed that AGR was an independent predictive factor of prognosis in gastric patients.
Conclusion: Pretreatment AGR is a significant and independent predictive factor of prognosis.

Keywords: gastric cancer, survival, inflammation, albumin–globulin ratio

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