Association between reduced preoperative serum albumin and prognosis in patients with adrenocortical carcinoma after primary resection: A retrospective study

Abstract Purpose To assess the correlation between preoperative serum albumin level and prognosis in patients with adrenocortical carcinoma after primary surgery. Methods We reviewed medical information of 71 included patients with diagnosis of ACC who underwent primary resection. Univariate and multivariate analysis were performed using Cox’s proportional hazards model. Survival analysis was conducted by Kaplan–Meier method with log-rank test. Receiver operating characteristic (ROC) curve and Jordan index were generated to explore cut-off value for serum albumin. Statistical significance was defined as P < 0.05. Results Among included patients, 33 patients (46.5%) relapsed at the end of follow-up, while 39 patients (54.9%) died. The median OS of overall included patients was 17 (range 1–104) months and median RFS was 10 (range 0–104) months. In univariate analysis, the albumin significantly associated with OS and RFS (HR:0.491, 95%CI: 0.260–0.930, P = 0.029 and HR:0.383, 95%CI: 0.192–0.766, P = 0.007, respectively). In multivariate analysis, the albumin level as an independent prognostic factor of OS was confirmed(HR:0.351, 95%CI: 0.126–0.982, P = 0.046). Meanwhile, the present results indicates the trend that albumin might be an independent predictor of RFS ( HR:0.423, 95%CI: 0.176–1.018, P = 0.055) Conclusion The preoperative serum albumin level is significantly correlated to prognosis of patients with ACC after primary resection. Reduced preoperative albumin level was proven to be a risk factor of clinical outcomes for ACC. Appropriate nutritional intervention prior to surgery may be beneficial to improve the prognosis of ACC patients.