Prognostic significance of albumin levels prior to treatment in patients with head and neck squamous cell carcinoma

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 4weeks 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 37.5g/L and 46.1g/L. Taking patients with albumin levels >46.1g/L as the benchmark, patients with albumin levels between 37.5-46.1g/L had a 1.44 times higher risk of disease-specific death (95%CI: .95-2.19, P=.081), and patients with levels <37.5g/L had a 3.19 times higher risk (95%CI: 2.01-5.04, P=.0001). The differences in survival based on albumin levels were only seen in patients with advanced stage tumours (stagesIII-IV).

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

Keywords: Albumin; Albúmina; Carcinoma escamoso de cabeza y cuello; Head and neck squamous cell carcinoma; Hipoalbuminemia; Hypoalbuminaemia; Nutrición; Nutrition; Prognosis; Pronóstico.