ALB and metastasis: In two models resulting from an analysis of a series of patients undergoing CHT (Koo28, Lee29), the concomitant presence of the following factors was related to an estimated median survival of fewer than 3 months: ECOG performance status ≥ 2, high level of serum alkaline phosphatase, low level of serum albumin, lack of gastrectomy, presence of bone or lung metastasis, and ascites.