Combining the Fibrinogen/Albumin Ratio and Systemic Inflammation Response Index Predicts Survival in Resectable Gastric Cancer

Abstract

Aims. Predicting the prognosis of gastric cancer using tumour-node-metastasis (TNM) staging is difficult as patients with the same TNM stage exhibit different prognoses. Methods. This study investigated the prognostic value of the preoperative fibrinogen/albumin ratio (FAR)-systemic inflammation response index (SIRI) score in resectable gastric cancer (rGC). Results. Clinicopathological features of 231 rGC patients were analysed retrospectively. Patients were divided into three groups: FAR-SIRI score 2 (FAR≥0.071 and SIRI≥0.84), 1 (FAR<0.071 and SIRI≥0.84), and 0 (SIRI<0.84). Higher FAR-SIRI scores were associated with larger tumours, poorer differentiation, and advanced TNM stage (P<0.05). Compared to those with FAR-SIRI scores of 0, patients with scores of 2 had poorer overall survival (OS). The FAR-SIRI score was an independent prognostic factor for OS in rGC. Conclusion. The present data demonstrated that FAR-SIRI scores predicted radical gastric cancer surgical outcomes and may serve as a blood marker for identifying high-risk patients.

Prognostic value of the systemic inflammation response index in human malignancy

“…We included 14 published articles through systematic search, including 21 cohort studies, and a total of 6,035 cases (Table 1 ). [ 10 , 14 – 26 ] One article included three cohort studies, five articles included two cohort studies, and the remaining eight articles included one cohort study. This meta-analysis involved various malignancies, including pancreatic cancer, [ 10 ] gastric adenocarcinoma, [ 14 ] hepatocellular carcinoma, [ 15 ] esophageal squamous cell carcinoma, [ 16 ] nasopharyngeal carcinoma, [ 17 ] adenocarcinoma of the esophagogastric junction, [ 18 ] clear cell renal cell carcinoma, [ 19 ] pancreatic ductal adenocarcinoma, [ 20 ] non-small-cell lung cancer, [ 21 ] upper tract urothelial carcinoma, [ 22 ] metastatic pancreatic cancer, [ 23 , 25 ] breast cancer, [ 24 ] and resectable gastric cancer.…”

“…This meta-analysis involved various malignancies, including pancreatic cancer, [ 10 ] gastric adenocarcinoma, [ 14 ] hepatocellular carcinoma, [ 15 ] esophageal squamous cell carcinoma, [ 16 ] nasopharyngeal carcinoma, [ 17 ] adenocarcinoma of the esophagogastric junction, [ 18 ] clear cell renal cell carcinoma, [ 19 ] pancreatic ductal adenocarcinoma, [ 20 ] non-small-cell lung cancer, [ 21 ] upper tract urothelial carcinoma, [ 22 ] metastatic pancreatic cancer, [ 23 , 25 ] breast cancer, [ 24 ] and resectable gastric cancer. [ 26 ] The publication years were between 2016 and 2020, the sample capacity ranged from 76 to 542, and the cutoff of SIRI ranged from 0.54 × 10 9 to 2.3 × 10 9 . As for the quality assessment of included studies, the NOS score of 17 cohort studies was 8, one cohort study had score 7, and three studies had score 6.…”

Fibrinogen/Albumin Ratio as a Promising Marker for Predicting Survival in Pancreatic Neuroendocrine Neoplasms

“…Many studies have reported that plasma fibrinogen levels are positively correlated with many inflammation scores, such as the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and lymphocyte/monocyte ratio. 23,31 Fibrinogen can also induce the synthesis of interleukin 6 to promote tumor progression. 32 Albumin is the most abundant circulating protein in the plasma and is not only a nutritional indicator but can also be involved in the inflammatory response.…”

“…18,19 Some studies have reported that the combination of fibrinogen and albumin can be used to predict the prognosis of cancer patients. 20,21 The baseline FAR was found to be an independent prognostic factor in patients with esophageal squamous cell carcinoma, 20 soft tissue sarcoma, 21 hepatocellular carcinoma, 22 gastric cancer, 23 and so on. In addition, researchers found that a high FAR was significantly associated with deeper tumor infiltration, lymph node metastasis and distant metastasis.…”

<p>Combining the Fibrinogen-to-Pre-Albumin Ratio and Prognostic Nutritional Index (FPR-PNI) Predicts the Survival in Elderly Gastric Cancer Patients After Gastrectomy</p>

“… 23 Therefore, we proposed using a novel marker, the FPR-PNI score, representing a combination of inflammation, coagulation function and nutritional status, to investigate its prognostic impact in patients with resectable gastric cancer. 24 …”