ALP has been shown to be a significant independent factor for advanced pancreatic cancer18 and that a 1.8-fold increase of ALP was associated with poor prognosis in a veterans’ cohort, independently of tumor stage.19 Serum albumin was strongly correlated with survival in our multivariable model; this is consistent with the report of Schnelldorfer et al who found that preoperative low albumin was a negative predictor of survival in patients with pancreatic adenocarcinoma undergoing a Whipple procedure; however they failed to prove its independent prognostic value.3 Here, ALB is linked to neoplasm.