Predictive value of serum albumin in prognosis of elderly patients with advanced non-small cell lung cancer undergoing systemic chemotherapy

Objective To investigate the predictive value of serum albumin in the prognosis of elderly patients with advanced non-small cell lung cancer (NSCLC) undergoing systemic chemotherapy. Methods Ninety-two elderly patients with advanced NSCLC diagnosed in our hospital between January 2012 and January 2018 were included in the study. According to different treatment methods, all patients were divided into chemotherapy group (n=50) and best supportive care group (BSC group, n=42) . The differences in the clinical parameters and prognosis between the two groups were compared. The prognostic factors were determined by univariate and multivariate Logistic regression analysis. According to serum albumin level, the differences in the survival time between patients with different serum albumin levels receiving chemotherapy or BSC were compared. Results The median overall survival (mOS) time in the elderly patients with advanced NSCLC was 8 and 5.2 months in the chemotherapy and BSC groups, respectively (P=0.003) . Univariate and multivariate analyses showed that brain metastasis and serum albumin level were independent prognostic factors for elderly patients with advanced NSCLC undergoing systemic chemotherapy. When the optimal cut-off value of serum albumin level was 3.2 g/dl, which was determined by ROC curve analysis, the sensitivity and specificity were 86.2% and 65.5%, respectively. When the serum albumin level≥3.2 g/dl, the mOS time was 12 and 5.8 months in the chemotherapy and BSC groups, respectively (P<0.001) . When the serum albumin level <3.2 g/dl, the mOS time was 6.2 and 4.8 months in the chemotherapy and BSC groups, respectively (P<0.001) . Conclusion Hypoproteinemia is an independent risk factor for poor prognosis in elderly patients with advanced NSCLC. Examination of serum albumin level at the baseline shows certain guiding significance for individualized treatment of patients. Key words: Serum albumin; Non-small cell lung cancer; Systemic chemotherapy; Best supportive care; Prognosis