Purpose: We evaluated postoperative recovery after transthoracic esophagectomy using postoperative serum albumin (Alb) levels and investigated the correlation between postoperative Alb recovery and the survival of patients with esophageal cancer. Methods: Esophageal cancer patients who underwent transthoracic esophagectomy were retrospectively reviewed. To evaluate postoperative Alb recovery, the recovery rate of Alb was used. We investigated the correlation between Alb recovery, clinicopathological factors, and the survival. Furthermore, the postoperative systemic inflammatory response was evaluated using serum C-reactive levels, and its impact on the Alb recovery was examined. Results: Ninety-seven (51 %) of 191 patients were classified as having insufficient Alb recovery. In the multivariate survival analysis, pStage and insufficient Alb recovery (hazard ratio 1.863; P = 0.021) were significantly independent predictive factors for the overall survival. Patients with pStage IB–IV with insufficient Alb recovery had a significantly shorter recurrence-free survival (5-year recurrence-free survival rate, 59.5 vs. 41.5 %; P = 0.035) and significantly higher serum CRP levels at POM 3 compared with patients with sufficient Alb recovery. Conclusions: Insufficient Alb recovery correlates with the systemic postoperative inflammatory response and a poor prognosis. Further studies are warranted to investigate the survival benefit of intervention to enhance postoperative Alb recovery.
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