Prognostic value of the preoperative fibrinogen-to-albumin ratio in pancreatic ductal adenocarcinoma patients undergoing R0 resection

Abstract

BACKGROUND Inflammation plays an important role in tumor progression, and growing evidence has confirmed that the fibrinogen-to-albumin ratio (FAR) is an important prognostic factor for overall survival in malignant tumors. AIM To investigate the prognostic significance of FAR in patients undergoing radical R0 resection of pancreatic ductal adenocarcinoma (PDAC). METHODS We retrospectively analyzed the data of 282 patients with PDAC who underwent radical R0 resection at The Cancer Hospital of the Chinese Academy of Medical Sciences from January 2010 to December 2019. The surv_cutpoint function of the R package survminer via RStudio software (version 1.3.1073, ) was used to determine the optimal cut-off values of biological markers, such as preoperative FAR. The Kaplan-Meier method and log-rank tests were used for univariate survival analysis, and a Cox regression model was used for multivariate survival analysis for PDAC patients who underwent radical R0 resection. RESULTS The optimal cut-off value of FAR was 0.08 by the surv_cutpoint function. Higher preoperative FAR was significantly correlated with clinical symptoms ( P = 0.001), tumor location ( P < 0.001), surgical approaches ( P < 0.001), preoperative plasma fibrinogen concentration ( P < 0.001), and preoperative plasma albumin level ( P < 0.001). Multivariate analysis showed that degree of tumor differentiation ( P < 0.001), number of metastatic lymph nodes [hazard ratio (HR): 0.678, 95% confidence interval (CI): 0.509-0.904, P = 0.008], adjuvant therapy (HR: 1.604, 95%CI: 1.214-2.118, P = 0.001), preoperative cancer antigen 19-9 level (HR: 1.740, 95%CI: 1.288-2.352, P < 0.001), and preoperative FAR (HR: 2.258, 95%CI: 1.720-2.963, P < 0.001) were independent risk factors for poor prognosis in patients with PDAC who underwent radical R0 resection. CONCLUSION The increase in preoperative FAR was significantly related to poor prognosis in patients undergoing radical R0 resection for PDAC. Preoperative FAR can be used clinically to predict the prognosis of PDAC patients undergoing radical R0 resection.

The Prognostic Value and Immune Landscapes of a m6A/m5C/m1A-Related LncRNAs Signature in Head and Neck Squamous Cell Carcinoma

“…Principal Component Analysis (PCA) was applied to the typed samples to observe whether the samples could be intuitively distinguished ( Rapa et al, 2021 ). In order to understand the prognosis of samples with different classifications, the R package “survival” and “Survminer” ( Zhang L.-P. et al, 2020 ) were used to analyze the prognosis of the samples after classifications. Clinical data were included to observe whether different clinical features differed in different classifications.…”

Preoperative Fibrinogen-to-Albumin Ratio as Potential Predictor of Bladder Cancer: A Monocentric Retrospective Study

“…In addition, pretreatment serum albumin levels provide prognostic significance and risk stratification in cancer patients [ 19 ]. Based on these premises, the aim of our monocentric and retrospective study was to evaluate the role of a novel biomarker, the fibrinogen-to-albumin ratio (FAR), as a potential preoperative predictor of BC grade and stage, in addition to its proven efficacy as a marker related to the nutritional, coagulation, and inflammatory status of cancer patients [ 20 , 21 , 22 ].…”

Data of postoperative complications related to fibrinogen-to-albumin ratio in pancreatic resections

“…For example, the patients with high FAR had significantly worse survival than those with low FAR in the breast, esophageal and gastric cancer [7] , [8] , [9] . With regard to pancreatic surgery, similar outcomes have been analyzed founding that high FAR values are associated with a worse prognosis in patients undergoing radical resection for pancreatic adenocarcinoma [10] , similarly to what was found by associating the outcomes with the CA-19.9 dosage [11] . There have therefore been many efforts to define surrogate prognostic markers related to pancreatic cancer.…”