High preoperative serum prealbumin predicts long-term survival in resected esophageal squamous cell cancer

PURPOSE: The current study aimed to explore the prognostic role of preoperative prealbumin in resectedesophageal squamous cell carcinoma (ESCC). METHODS: A total of 1374 resected ESCC patients were retrospectively reviewed. Serum for prealbumin analyses was taken within 1–3 days before the operation. Overall survival (OS) was determined using the Kaplan-Meier method; the univariate log-rank test and the multivariate Cox proportional hazard model were used to evaluate the prognostic role of prealbumin. A receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated to compare the prediction accuracy of prealbumin and albumin for OS. RESULTS: Finally, 532 patients were included in this study. The 5-year OS rate was favourable for the high prealbumin group versus the median and low prealbumin groups (58.1% vs 44.6% and 31.1%, respectively; P<0.001). Univariate and multivariate analyses identified serum prealbumin, T stage, N stage, differentiation and albumin as independent prognostic factors for OS. ROC curves indicated that prealbumin may be superior to albumin as a prognostic predictor in ESCC patients, but the difference between the two AUCs was not statistically significant (P=0.068). CONCLUSION: Prealbumin is an independent prognostic factor and a prognostic indicator of postoperative outcomes in ESCC patients. Future prospective studies are warranted to confirm our results.