Predictive Value of High Preoperative Serum Total Protein and Elevated Hematocrit in Patients with Non-Small-Cell Lung Cancer after Radical Resection.

BACKGROUND

The relationship between the dynamic alterations of nutritional indexes before and after surgery, and the prognosis of non-small-cell lung cancer (NSCLC) after radical surgery are unclear. This study enrolled 100 NSCLC patients in stages I-III who received radical surgery. The preoperative and postoperative 6-month levels of nine nutrition-related indicators were assessed in patients. Survival was analyzed using Kaplan-Meier curves as well as Cox regression models.

RESULTS

Patients had better disease-free survival (DFS) with baseline total protein (TP) >76.66 g/L (75% vs. 50%,  = .027), baseline albumin (ALB) >37.7 g/L (60% vs. 26.7%,  = .002), baseline albumin to globulin ratio (AGR) >1.31 (63.5% vs. 40.5%,  = .006), or baseline globulin (GLOB) <31.42 g/L (39.4% vs. 62.7%,  = .037). Moreover, patients with increased hematocrit (HCT) (69.8% vs. 43.9%  = .013) and mean corpuscular volume (MCV) (73.2% vs. 42.4%,  = .014) at the postoperative 6-month examination had superior DFS. Cox proportional hazards regression analyses demonstrated that age >65 years, adenocarcinoma (pathological type), higher baseline TP, and post-surgery elevated HCT independently predicted favorable DFS.

CONCLUSION

Lower baseline TP and decreased postoperative HCT levels are independent predictors of prognosis in NSCLC following radical surgical procedures.