ALB and malnutrition: On the other hand, albumin plays an important role in suppressing the growth of cancer cell through its antioxidant effect and stabilization of DNA replication.38 Malnutrition and inflammation suppress albumin synthesis and affect the survival of cancer patients.31, 39 In fact, it has been reported that hypoalbuminemia in cancer patients is associated with poor outcome.31, 38, 39 In fact, patients in the high GAR group (>0.80) had decreased serum albumin level and poor outcome after curative surgery compared as low GAR group (Table 2 and Figure 2).