Clinical burden of preoperative albumin-globulin ratio in esophageal cancer patients

Satoshi Oki, Yuji Toiyama, Yoshinaga Okugawa, Tadanobu Shimura, Masato Okigami, Hiromi Yasuda, Hiroyuki Fujikawa, Yoshiki Okita, Shigeyuki Yoshiyama, Junichiro Hiro, Minako Kobayashi, Masaki Ohi, Toshimitsu Araki, Yasuhiro Inoue, Yasuhiko Mohri, Masato Kusunoki

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)


Background: Lower albumin-globulin ratio (AGR) is associated with increased mortality in several cancers. However, no studies have evaluated the relationship between the AGR and prognostic outcome in esophageal cancer (EC) patients. Methods: To identify indicators of early recurrence and poor prognosis, we assessed the clinicopathological findings and preoperative laboratory data (carcinoembryonic antigen [CEA], squamous cell carcinoma antigen, total protein, and albumin) of 112 EC patients who underwent surgery. The AGR was calculated as albumin/(total protein–albumin). Results: A lower AGR was significantly associated with tumor progression. The CEA level was an independent predictor for overall survival (OS) and disease-free survival (DFS). The AGR and CEA combination was identified as a feasible indicator of poor prognosis and early recurrence. Among EC patients without lymph node metastasis, those with lower AGR had poorer DFS and OS than those with higher AGR. Conclusion: AGR was identified as a significant predictor of OS and DFS in EC patients. Among EC patients without lymph node metastasis, AGR may help identify candidates who might benefit from more intensive adjuvant therapy.

Original languageEnglish
Pages (from-to)891-898
Number of pages8
JournalAmerican Journal of Surgery
Issue number5
Publication statusPublished - 11-2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery


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