Preoperative hypoalbuminemia as a prognostic factor in patients with gastric cancer undergoing radical gastrectomy: Construction of a nomogram.

ObjectiveTo investigate the association of preoperative hypoalbuminemia (serum albumin <35 g/L) with clinicopathological characteristics and survival outcomes in patients with gastric cancer undergoing radical gastrectomy and to construct a nomogram based on prognostically relevant clinicopathological variables.MethodsThis retrospective cohort study included patients with gastric cancer who underwent radical gastrectomy. Clinicopathological variables and survival outcomes were compared between groups. Univariate and multivariable analyses were performed to identify variables associated with prognosis, and a nomogram was constructed based on significant predictors.ResultsPreoperative hypoalbuminemia was significantly associated with adverse clinicopathological characteristics, including anemia, lymphocyte depletion, advanced American Joint Committee on Cancer stage, vascular invasion, and perineural invasion. Kaplan-Meier analysis showed that hypoalbuminemia was associated with poorer overall survival. In multivariable Cox regression analysis, lymph node metastasis remained independently associated with overall survival, whereas preoperative hypoalbuminemia was not an independent prognostic factor.ConclusionsPreoperative hypoalbuminemia may reflect unfavorable nutritional and inflammatory status and was associated with adverse clinicopathological characteristics and poorer survival in univariate analysis. However, it was not independently associated with overall survival after multivariable adjustment. Lymph node metastasis remained an independent prognostic factor.