Clinical ScienceClinical impact of preoperative albumin to globulin ratio in gastric cancer patients with curative intent

BackgroundLow albumin-to-globulin ratio (AGR) is associated with increased cancer mortality in patients with various cancers. However, there are no reports regarding the relation between pretreatment AGR and clinicopathological data, including oncological outcomes, in gastric cancer (GC) patients with curative intent.MethodsClinicopathological findings including preoperative laboratory data from 384 curative GC patients were assessed as indicators of early recurrence and poor prognosis in this retrospective study. AGR was calculated as albumin/(total protein − albumin)].ResultsSeveral pathological categories related to tumor progression were associated with low AGR levels. Among preoperative serum markers, AGR was an independent predictor of early recurrence in curative GC patients. By multivariate analysis using both preoperative serum markers and postoperative clinicopathological categories, 2 pathological factors, lymph node metastasis and serosal invasion, and low AGR were independently associated with early recurrence. Furthermore, GC patients with low AGR showed significantly poor disease-free survival in the lymph node metastasis and serosal invasion groups.ConclusionsAGR was a novel independent predictor of early recurrence in curative GC patients.