Pre-operative Serum Albumin Levels as a Marker of Post-operative Complications in Ovarian Masses Referred to a Tertiary Cancer Institute with Suspicion of Malignancy

Objective- Hypo-albuminemia is a known risk factor for post-operative complications in Gynaecological patients. This study aims to evaluate the pre-operative albumin levels as a marker of post-operative complications in patients undergoing surgery for ovarian masses who were referred to our tertiary Cancer Institute with suspicion of malignancy. Methods-This is a prospective study which includes 40 patients with Ovarian masses with suspicion of malignancy. They They underwent surgery in a Gynaecologic Oncology units at The Gujrat Cancer Research Institute, Ahmedabad from January2016 to August2016. Hypo-albuminemia was defined as pre-operative serum albumin level less than 3.5mg/dl. Surgical complications were graded as per the Clavien Dindo Classification. Results- The incidence of pre-operative hypo-albuminemia in the entire cohort was 30 %. Low albumin is associated with mild complications in 30 % cases& severe complications in 15 % cases. Hypo-albuminemia both pre-operative& even falling levels in post-operative period are an important predictive marker for severe post-operative complications after adjusting established prognostic markers like age, tumor stage& performance status. Conclusion- Pre-operative albumin level can be used as independent marker for predicting severe post-operative complications& even falling levels in post-operative period have a bearing on the final surgical outcome. Low albumin levels were associated with mild complications in benign disease whereas severe complications were seen in 3 patients with malignant histology. Surgical time& turn around time of frozen section report does add to morbidity in benign disease. Hence albumin levels may be included in future clinical trials as a valuable marker. However, further study is needed to delineate whether nutritional supplementation may reduce infection.