Preoperative serum prealbumin as a prognostic marker for survival after gallbladder cancer resection: a multicenter study

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PURPOSE: Prealbumin, a marker of nutritional and inflammatory status, has shown prognostic value in various malignancies. This study aimed to evaluate the prognostic significance of preoperative serum prealbumin levels in gallbladder cancer (GBC) patients undergoing radical resection. METHODS: A multicenter retrospective study included 210 patients who underwent radical GBC resection. The optimal prealbumin cutoff (221 mg/L) was identified via ROC analysis. Patients were stratified into high and low prealbumin groups. Kaplan-Meier and Cox regression analyses were used to assess the association between prealbumin levels and overall survival (OS) and recurrence-free survival (RFS). RESULTS: Patients with low prealbumin levels (n = 120) had 1-year OS and RFS rates of 65% and 44.1%, respectively. In contrast, high prealbumin patients (n = 90) showed significantly better OS (96.6%) and RFS (90%) (p < 0.001). Multivariate analysis confirmed prealbumin as an independent predictor of OS (HR = 0.179, 95% CI: 0.052-0.622, p = 0.007) and RFS (HR = 0.220, 95% CI: 0.102-0.474, p < 0.001). A combined model of prealbumin and hemoglobin improved predictive accuracy for OS (AUC = 0.762) and RFS (AUC = 0.771). CONCLUSION: Preoperative serum prealbumin is an independent prognostic biomarker in GBC patients undergoing radical resection. Combining prealbumin with hemoglobin enhances prediction of postoperative survival.