Does serum albumin explain observed racial disparities in mortality for cancer patients undergoing esophagectomy?

BACKGROUND

African Americans with esophageal cancer have a higher mortality rate than Caucasians. We hypothesized that nutritional status, as reflected by preoperative albumin, might explain these disparities.

METHODS

The National Surgical Quality Improvement Program database was queried for patients undergoing esophagectomy for esophageal cancer between 2005 and 2015. Preoperative albumin was divided into five categories (<3.0, 3.0-3.4, 3.5-3.9, 4.0-4.4, and >4.4). Univariate and multivariable regression statistics were performed to determine an association between preoperative albumin levels on mortality.

RESULTS

3228 patients were studied. While preoperative albumin was associated with lower body mass index, more severe preoperative weight loss, and more respiratory comorbidities (p-values <0.05), albumin levels were not associated with race. On multivariable models including race and other covariates, we found no association of serum albumin and mortality.

CONCLUSIONS

We found that race was an independent predictor of mortality for patients undergoing esophagectomy. However, preoperative albumin did not explain these disparities.