C-reactive protein/albumin ratio predicts survival after curative surgery in elderly patients with colorectal cancer

Tamai, Koki; Okamura, Shu; Makino, Shinji; Yamamura, Noriyuki; Fukuchi, Nariaki; Ebisui, Chikara; Yano, Masahiko

doi:10.1007/s13304-021-01011-9

Cited by 15 publications

(12 citation statements)

References 47 publications

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“…BMI, a major component of the GNRI, is considered a determinant of survival, and a low BMI before surgery indicates poor prognosis [21]. ALB, another major component of the GNRI, is an indicator of nutritional status and systemic inflammatory responses [22][23][24][25][26]. Albumin synthesis is attenuated by tumor necrosis factor-α or interleukin-6 [27].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, ALC is considered a marker of nutritional status [26]. ALB, another major component of the PNI, is considered an indicator of nutritional status and systemic inflammatory responses [22][23][24][25][26], and patients with decreased ALB levels experience adverse survival outcomes [2,25,[28][29][30]. Therefore, the clinical value of the PNI in determining survival outcomes may be attributed to the synergistic effects of its two major components-ALC and ALB.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the Clinical Value of the Geriatric Nutritional Risk Index and Prognostic Nutritional Index as Determinants of Survival Outcome in Patients with Gastric Cancer

An¹,

Eo²,

Lee³

2022

J. Cancer

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Background:The geriatric nutritional risk index (GNRI) is an important determinant of overall survival (OS) in patients with stage I-III gastric cancer (GC) across all ages; however, its value as a determinant of disease-free survival (DFS) is unclear. Moreover, the prognostic values between the GNRI and prognostic nutritional index (PNI) remains unclear. Methods: We retrospectively evaluated the value of the GNRI and PNI as determinants of OS and DFS in patients with stage I-III GC who underwent curative-intent gastrectomy. Cox regression analysis was used for evaluating the determinants of survival outcomes. The discriminative capacity of the prognostic model was determined using the concordance index (C-index), and then C-indices of related models were compared. Results: Data from 450 patients were analyzed. The median patient age was 60 years (range: 26-92 years). In total, 276 (61.3%) patients had stage I cancer, 83 (18.4%) had stage II cancer, and 91 (20.2%) had stage III cancer. Multivariate Cox regression analysis revealed that age, type of gastrectomy (TOG), T stage, tumor-node-metastasis (TNM) stage, and GNRI were determinants of OS. These five covariates constituted the GNRI model for the OS. In addition, multivariate analysis revealed that age, TOG, TNM stage, and GNRI were determinants of DFS. These four covariates constituted the GNRI model for DFS. When constructing the PNI model for OS (comprising age, TOG, T stage, TNM stage, and PNI), and PNI model for DFS (including age, TOG, TNM stage, and PNI), the C-indices of the GNRI and PNI models were nearly equal for OS (0.818 and 0.818, respectively; p=0.909) and DFS (0.805 and 0.808, respectively; p=0.653). Using the GNRI models, nomograms for predicting OS and DFS were established. When validating the nomograms using calibration curves, the predicted survival closely matched the actual survival rate. Conclusion:The GNRI and PNI were important determinants of both OS and DFS in patients with GC across all ages. In addition, the effects of the GNRI model on OS and DFS were similar to those of the PNI model.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of the Clinical Value of the Geriatric Nutritional Risk Index and Prognostic Nutritional Index as Determinants of Survival Outcome in Patients with Gastric Cancer

An¹,

Eo²,

Lee³

2022

J. Cancer

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“…The ratio was originally suggested to forecast the prognosis of acute hospitalized patients ( 7 ). Recently, various centers have explored the application of CAR as a prognostic biomarker for kinds of cancers, including gastric cancer ( 8 ), colorectal cancer ( 9 ), non-small-cell lung cancer ( 10 ), gallbladder cancer ( 11 ), etc. As for urinary neoplasms, a lot of studies have examined the prognostic value of CAR in RCC.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Role of Pretreatment C-Reactive Protein to Albumin Ratio in Urological Cancers: A Systematic Review and Meta-Analysis

Zhou²,

Chen

et al. 2022

Front. Oncol.

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BackgroundTo investigate the potential prognostic role of C-reactive protein to albumin ratio (CAR) in patients with urinary cancers, including renal cell carcinoma (RCC), bladder cancer (BC), and prostate cancer (PC).MethodsWe searched and screened literatures with PubMed, Embase, Cochrane Library, and Web of Science in January 2022. We applied combined hazard ratios (HRs) and 95% confidence intervals (CIs) to assess the associations.ResultsThirteen studies including 2,941 cases were analyzed in our study. Merged results indicated that highly pretreated CAR was associated with inferior overall survival (HR 2.21, 95% CI 1.86-2.62, p < 0.001) and progression-free survival (HR 1.85, 95% CI 1.36-2.52, p < 0.001) for urinary cancers. In a subgroup analysis of OS by tumor type, CAR can be a predictor in RCC (HR 2.10, 95% CI 1.72-2.56), BC (HR 3.35, 95% CI 1.94-5.80), and PC (HR 2.20, 95% CI 1.43-3.37). In a subgroup analysis of PFS by tumor type, CAR can be a predictor in BC (HR 1.76, 95% CI 1.03-3.02), and RCC (HR 1.90, 95% CI 1.25-2.89). The reliability and robustness of results were confirmed.ConclusionsHigh pretreated CAR was effective predictor of poor survival in patients with urinary cancers and can act as prognostic factor for these cases.Systematic Review RegistrationPROSPERO (CRD42022306414).

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“…In recent years, studies have investigated the utility of the CRP/Alb ratio as a prognostic factor in various cancers (10,11). Previous studies have reported the independent prognostic value of the CRP/Alb ratio in colorectal cancer (CRC) (12), oral squamous cell carcinoma (13), gastric cancer (14), non-small-cell lung cancer (15), and gallbladder cancer (16). Many studies have also investigated the prognostic utility of the CRP/Alb ratio in patients with GC; however, the results remain inconclusive (17)(18)(19)(20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis

2021

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BackgroundMany studies have investigated the prognostic role of the C-reactive protein/albumin ratio (CRP/Alb ratio) in patients with gynecological cancers; however, there is lack of consensus owing to conflicting results across studies. We performed a meta-analysis to determine the prognostic role of the CRP/Alb ratio in gynecological cancers.MethodsWe searched the PubMed, Embase, the Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang electronic databases since inception to April 2021. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were used to estimate the prognostic effect of the CRP/Alb ratio in gynecological cancers. Pooled odds ratios (ORs) and 95% CIs were used to investigate the association between the CRP/Alb ratio and clinicopathological features.ResultsThe meta-analysis included seven studies with 1,847 patients. The pooled results showed that a high pretreatment CRP/Alb ratio was associated with poor overall survival (HR, 1.84; 95% CI, 1.41–2.40; p < 0.001) and progression-/disease-free survival (HR, 2.58; 95% CI, 1.42–4.68; p = 0.002). Additionally, a high CRP/Alb ratio was significantly associated with stages III–IV disease (the International Federation of Gynecology and Obstetrics classification) (OR, 2.98; 95% CI, 1.45–6.14; p = 0.003). However, we observed a non-significant correlation between the CRP/Alb ratio and lymph node metastasis, tumor size, and histopathological grade.ConclusionsThe CRP/Alb ratio is a convenient and accurate predictor of survival outcomes in gynecological cancers. A high CRP/Alb ratio also predicts tumor progression.

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C-reactive protein/albumin ratio predicts survival after curative surgery in elderly patients with colorectal cancer

Cited by 15 publications

References 47 publications

Comparison of the Clinical Value of the Geriatric Nutritional Risk Index and Prognostic Nutritional Index as Determinants of Survival Outcome in Patients with Gastric Cancer

Comparison of the Clinical Value of the Geriatric Nutritional Risk Index and Prognostic Nutritional Index as Determinants of Survival Outcome in Patients with Gastric Cancer

Prognostic Role of Pretreatment C-Reactive Protein to Albumin Ratio in Urological Cancers: A Systematic Review and Meta-Analysis

Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis

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