Preoperative C‐reactive protein to prealbumin ratio is independently associated with prognosis in patients with resectable colorectal cancer

Abstract

Background: Increasing attention has been drawn the prognostic value of inflammatory indices for colorectal cancer (CRC). However, the prognostic value of the preoperative C-reactive protein to prealbumin ratio (CPAR) in CRC remains unclear. Methods: A retrospective study was conducted with 794 patients who had CRC and underwent radical surgical resection. The predictive performance of the inflammatory indices was analyzed and compared using the area under the timedependent receiver operating characteristic curve. A competing risk regression model and Cox proportional hazard model were used to analyze the effects of CPAR on disease-free survival (DFS) and overall survival (OS), respectively. Results: Patients with high CPAR (>7.25) had poor survival outcome. The CPAR had the best predictive performance among all inflammatory indices, and was significantly associated with several characteristics of tumor invasion, including histological grade, tumor stage, and tumor size. Multivariate analysis showed that high CPAR was independently associated with poor DFS (subdistribution hazard ratio = 2.28, 95% confidence interval [CI]: 1.74-2.82) and OS (hazard ratio = 1.78, 95% CI: 1.60-1.96). Conclusion:Preoperative CPAR assessment could serve as an effective and reliable tool for prognostic prediction in patients with resectable CRC.colorectal cancer, C-reactive protein to prealbumin ratio, disease-free survival, inflammatory index, overall survival | INTRODUCTIONGlobally, colorectal cancer (CRC) is the third most common malignancy and the second leading cause of cancer death. 1 There have been great improvements in our understanding of its etiology, risk factor, molecular biology, and clinical aspects over the past decades, but it still accounts for nearly 10% of the global cancer burden, with over 1.9 million new diagnoses and 0.9 million deaths in 2020. 2 Radical surgery is the preferred treatment for patients with resectable CRC, but for patients who undergo radical resection, the prognosis is still poor, with 60% of patients surviving for 5 years. 3 Tumor progression, including recurrence and distant metastasis, remains a major concern for patients after surgery.

Preoperative c‐reactive protein to prealbumin ratio is independently associated with prognosis in patients with resectable colorectal cancer

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Mortality patterns of patients with tonsillar squamous cell carcinoma: a population-based study

“…The Cox model also ignores the mutually exclusive relationship between target and competing events, leading to the overestimation of true observations. The competing risk model is suitable for the processing of event data and can obtain approximately unbiased results that are close to the truth ( 18 ). The choice of survival analysis method is critical in the nomogram construction process.…”

Inflammatory and nutritional markers in patients with resectable pancreatic cancer

“…Recently, the CRP to prealbumin ratio (CPAR), which is an inflammatory and nutritional marker, has been investigated as a potential prognostic indicator in various cancers [ 6 , 8 ]. In this issue of the Korean Journal of Clinical Oncology , Kwon et al [ 9 ] demonstrated the utility of CPAR in predicting the prognosis of PDAC.…”

“…breast cancer [3,[5][6][7]. Furthermore, prealbumin has a shorter halflife which is about 2 to 3 days, and is considered more sensitive and accurate biomarker than albumin.…”