Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literature

<p>Abstract</p> <p>Background</p> <p>There are several methods of assessing nutritional status in cancer of which serum albumin is one of the most commonly used. In recent years, the role of malnutrition as a predictor of survival in cancer has received considerable attention. As a result, it is reasonable to investigate whether serum albumin has utility as a prognostic indicator of cancer survival in cancer. This review summarizes all available epidemiological literature on the association between pretreatment serum albumin levels and survival in different types of cancer.</p> <p>Methods</p> <p>A systematic search of the literature using the MEDLINE database (January 1995 through June 2010) to identify epidemiologic studies on the relationship between serum albumin and cancer survival. To be included in the review, a study must have: been published in English, reported on data collected in humans with any type of cancer, had serum albumin as <it>one of the </it>or <it>only </it>predicting factor, had survival as one of the outcome measures (primary or secondary) and had any of the following study designs (case-control, cohort, cross-sectional, case-series prospective, retrospective, nested case-control, ecologic, clinical trial, meta-analysis).</p> <p>Results</p> <p>Of the 29 studies reviewed on cancers of the gastrointestinal tract, all except three found higher serum albumin levels to be associated with better survival in multivariate analysis. Of the 10 studies reviewed on lung cancer, all excepting one found higher serum albumin levels to be associated with better survival. In 6 studies reviewed on female cancers and multiple cancers each, lower levels of serum albumin were associated with poor survival. Finally, in all 8 studies reviewed on patients with other cancer sites, lower levels of serum albumin were associated with poor survival.</p> <p>Conclusions</p> <p>Pretreatment serum albumin levels provide useful prognostic significance in cancer. Accordingly, serum albumin level could be used in clinical trials to better define the baseline risk in cancer patients. A critical gap for demonstrating causality, however, is the absence of clinical trials demonstrating that raising albumin levels by means of intravenous infusion or by hyperalimentation decreases the excess risk of mortality in cancer.</p

Impact of tail-nipping on mortality, growth and reproduction of Arenicola marina

The impact of predation by amputation of regenerating body parts (tail tips) of the lugworm Arenicola marina on species mortality, growth and reproduction has been studied under laboratory conditions by the artificial removal of tail tips at different frequencies. The loss of body weight by amputation was not compensated for by an increased growth. Within a wide range of amputation frequencies, total growth (body growth + amount of tail tip amputated) and reproduction of the lugworm were not affected. Also, both egg development and amount of energy stored in reproduction remained the same. Only at the highest frequency of amputation (once a week) did total growth decrease in the course of time, resulting even in a loss of body weight. The amount of energy stored in reproduction was also significantly less at the highest rate of amputation. Lugworms appeared to be unable to sustain this high level of amputation and the anaerobic sediment conditions in the cuvettes suggest a reduced pumping activity and food intake. Mortality in this group was also higher than in the other groups. The consequences of tail-nipping by flatfish for A. marina in the field situation are discussed. © 1988.link_to_subscribed_fulltex

Impacts of chronic trawling disturbance on meiofaunal communities

Bottom trawling causes chronic and widespread disturbance to the seabed in shelf seas. Meiofauna may be impacted directly or indirectly by this disturbance, since the passage of trawls causes immediate mortality or displacement, changes sediment structure and geochemistry and affects the abundance of predators or competitors. Since meiofauna make a significantly greater contribution to benthic production than the larger macrofauna, there are compelling reasons to assess their response to chronic trawling disturbance. In this study, we determined the effects of trawling disturbance, season, sediment type and depth on the structure and diversity of nematode communities. Our analyses were based on comparisons between nematode communities in three beam-trawl fishing areas in the central North Sea. These areas were trawled with mean frequencies of 1 (low disturbance), 4 (medium) and 6 (high) times year-1 respectively. Our analyses showed that trawling had a significant impact on the composition of nematode assemblages. In two sampling seasons, the number of species, diversity and species richness of the community were significantly lower in the area subject to high levels of trawling disturbance than in the areas subject to low or medium levels of disturbance. However, levels of disturbance at the 'low' and 'medium' sites may have been insufficient to cause marked long-term changes in community structure. Many of the observed changes were consistent with responses to other forms of physical disturbance. The extent to which the observed changes in community structure reflect changes in the production of the nematode community remains unknown, although overall abundance was not significantly affected by trawling disturbance