ALB and cancer: Second, there were several confounding factors in each study group, including clinical staging, the site of distant metastasis, number of metastasis site, adjuvant treatment.[26] The OS of the patients with spontaneous perforation of the cancer was reduced but no statistically significant difference in DFS.[27] Lai et al[28] reported the hypoalbuminemic patients had significantly poorer OS and DFS rates compared to patients with normal serum albumin.