Clinical significance of preoperative serum albumin level for prognosis in surgically resected patients with non-small cell lung cancer Comparative study of normal lung, emphysema, and pulmonary fibrosis

Objectives: This study was performed to clarify whether preoperative serum albumin level is related to the prognosis of non-small cell lung cancer patients undergoing surgical resection, and the relationships between serum albumin level and clinicopathological characteristics of lung cancer patients with emphysema or pulmonary fibrosis. Materials and methods: We retrospectively evaluated 556 patients that underwent surgical resection for non small cell lung cancer. The correlation between preoperative serum albumin level and survival was evaluated. Patients were divided into three groups according to the findings on chest high-resolution computed tomography (normal lung, emphysema, and pulmonary fibrosis), and the relationships between serum albumin level and clinicopathological characteristics, including prognosis, were evaluated. Results: The cut-off value of serum albumin level was set at 4.2 g/dL. Patients with low albumin levels (albumin < 4.2) had significantly poorer prognosis than those with high albumin levels (albumin >= 4.2) with regard to both overall survival and recurrence-free survival. Serum albumin levels in the emphysema group (n = 48) and pulmonary fibrosis group (it = 45) were significantly lower than that in the normal lung group (n = 463) (p = 0.009 and < 0.001, respectively). Low serum albumin level was a risk factor in normal lung and pulmonary fibrosis groups, but not in the emphysema group. Conclusion: Preoperative serum albumin level was an important prognostic factor for overall survival and recurrence-free survival in patients with resected non-small cell lung cancer. Divided into normal lung, emphysema, and pulmonary fibrosis groups, serum albumin level showed no influence only in patients in the emphysema group.