Purpose: The preoperative albumin-globulin ratio (AGR) is an inflammation-associated factor related to the overall survival in various malignancies. The objective of this study was to investigate preoperative serum AGR, albumin, and globulin level for the survival rate of GC.
Methods: This study was a retrospective cohort study comprising 771 GC patients who underwent the first-time gastrectomy between 1st January 2014 to 31st December 2018 at the Second People’s Hospital of Wuhu City, Anhui Province, China. For the eligible patients, we followed them since the first day of the operation to death, immigrate, or 31st of May 2021 (end of the study), whichever came first. Serum AGR and proteins were grouped according to quartiles (Q1 as the reference group). Cox proportional hazards regression models were applied for the analysis.
Results: Of 771 GC patients, 322 (41.8%) died during a median 41.00 moths of follow-up. Multivariate Cox analysis adjusting for confounders showed that, preoperative AGR level were significantly associated with GC mortality risk, i.e., following by the serum levels increased, the survival rate increased (Q2: HR =0.727, Q3: HR = 0.676, Q4: HR = 0.656, p for trend = 0.007). Albumin level showed a similar protective pattern but not globulin. Stratification analysis showed among the patients who were advance age, higher weight, advanced pTNM stage, and M0 group, higher preoperative AGR level, higher survival rate (p < 0.05).
Conclusion: These results showed that higher level of preoperative AGR and albumin were protective against risk of death in GC patients with first gastrectomy