Postoperative changes in nutritional status may be important in early-stage NSCLC outcomes, according to a study published in PLoS One. Although preoperative nutritional status is an important host-related prognostic factor for NSCLC, researchers noted, the significance of postoperative changes in nutritional status remains unclear. The study team aimed to explain the significance of postoperative decreases in serum albumin (ΔAlb) on the outcomes of early-stage NSCLC. They analyzed 443 training cohort (TC) and 642 validation cohort (VC) patients with pStage IA NSCLC who underwent surgery and did not have a recurrence within 1 year. They measured preoperative serum albumin levels (preAlb) and postoperative levels 1 year after surgery (postAlb), and calculated ΔAlb as (preAlb – postAlb)/preAlb × 100%. Patients were divided into ΔAlb-decreased and ΔAlb-stable groups, including 100 (22.6%) and 343 (77.4%) in the TC, and 58 (9.0%) and 584 (90.1%) in the VC. The study team found that ΔAlb-decrease was associated with male sex, smoking, and non-adenocarcinoma in the TC, and pT1b and non-adenocarcinoma in the VC. Multivariable analysis identified ΔAlb as an independent prognostic factor for disease-free survival (DFS) and overall survival (OS) in both cohorts (VC DFS HR, 1.9; 95% CI, 1.10-3.15 & OS HR, 2.0; 95% CI: 1.13-3.45). Moreover, subgroup analysis demonstrated that the prognostic value of ΔAlb was consistent for age, sex, smoking history, surgical procedure, and histological type.
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