The clinical significance of preoperative C-reactive protein/albumin ratio in patients with resected extrahepatic bile duct cancer

Song, Du; Cho, In Kuk; Shin, Dong Woo; Lee, Jong Chan; Cho, Jai Young; Yoon, Yoo Seok; Hwang, Jin Hyeok; Han, Ho Seong; Kim, Jaihwan

doi:10.1007/s00595-020-02188-z

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…However, there was a problem in which the tumor locations included and scores indicating usefulness were different depending on reports, resulting in a lack of reproducibility and generalizability. Our results were similar to those reported by Yasukawa et al [17] and Song et al [23] in the two respects mentioned above; however, we also considered different scores additionally. These findings suggest that CAR may be more valuable as a prognostic factor in extrahepatic cholangiocarcinoma.…”

Section: Discussionsupporting

confidence: 93%

Prognostic Impact of Inflammation-Based Scores for Extrahepatic Cholangiocarcinoma

et al. 2022

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Introduction: Although the relationship between systemic inflammatory responses and prognosis has been known in various cancers, it remains unclear which scores are most valuable for determining the prognosis of extrahepatic cholangiocarcinoma. We aimed to verify the usefulness of various inflammation-based scores as prognostic factors in patients with resected extrahepatic cholangiocarcinoma. Methods: We analyzed consecutive patients undergoing surgical resection for extrahepatic cholangiocarcinoma at our institution between January 2000 and December 2019. The usefulness of the following inflammation-based scores as prognostic factor was investigated: Glasgow prognostic score (GPS), modified Glasgow prognostic score (mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), prognostic nutrition index (PNI), C-reactive protein to albumin ratio (CAR), controlling nutritional status (CONUT), and prognostic index (PI). Results: A total of 169 patients were enrolled in this study. Of the nine scores, CAR and CONUT indicated prognostic value. Furthermore, multivariate analysis for overall survival revealed that high CAR (>0.23) was an independent prognostic factor (HR: 1.816, 95%CI: 1.135-2.906, p=0.0129), along with lymph node metastasis and curability. There was no difference in tumor staging and short-term outcomes between the low CAR (≤ 0.23) and high CAR groups. Conclusions: CAR was the most valuable prognostic score in patients with resected extrahepatic cholangiocarcinoma.

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Section: Discussionsupporting

confidence: 93%

Prognostic Impact of Inflammation-Based Scores for Extrahepatic Cholangiocarcinoma

et al. 2022

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“…[25][26][27] Therefore, inflammatory markers may predict the prognosis of various cancers, including BTC. Elevated serum C-reactive protein levels reflect a nonspecific inflammatory [15] China 144 63 Retrospective Surgery GBC Mixed 0.069 OS 6 Matsumoto et al (2020) [19] Japan 72 66 Retrospective Surgery ICC Mixed 0.020 OS/RFS 7 Utsumi et al (2020) [20] Japan 53 73 Retrospective Surgery GBC Mixed 0.070 OS/RFS 6 Yasukawa et al (2020) [21] Japan 271 70 Retrospective Surgery Ecca Mixed 0.031 OS/RFS 7 Demir et al (2020) [23] Turkey 178 65 Retrospective Chemotherapy BTC Mixed 0.660 OS 7 Ito et al (2020) [22] Japan 82 65 Retrospective Surgery ICC Mixed 0.089 OS/RFS 6 Kano et al (2020) [18] Japan 88 68 Retrospective Surgery ICC Mixed 0.033 OS/RFS 7 Song et al (2021) [16] Korea 235 70 Retrospective Surgery eBDC Mixed 0.180 OS/RFS 7 Asakura et al (2022) [17] Japan response to tumor necrosis or local tissue damage and cause a favorable environment for the establishment and growth of distant metastases. [28] In an experimental study, it has been shown that serum C-reactive protein inhibits cancer cell apoptosis.…”

Section: Discussionmentioning

confidence: 99%

“…After Title and Abstract screening, 82 records were discarded. Sixteen full-text articles were examined, and 9 (n = 1292 participants) [15][16][17][18][19][20][21][22][23] were included in the meta-analysis. Seven records were excluded because they did not report the necessary data (n = 5) or because they were Conference Abstracts (n = 2).…”

Section: Literature Retrievalmentioning

confidence: 99%

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Preoperative C-reactive protein-to-albumin ratio as a prognostic factor in biliary tract cancer: A systematic review and meta-analysis

et al. 2023

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Background: The preoperative C-reactive protein-to-albumin ratio is a novel inflammation-based prognostic marker in various cancers. However, its prognostic role in biliary tract cancer is unknown. We conducted a systematic review and meta-analysis to evaluate the prognostic value of preoperative C-reactive protein-to-albumin ratio in biliary tract cancer.Methods: A systematic search of the literature for studies evaluating the prognostic value of C-reactive protein-to-albumin ratio in patients undergoing surgery for biliary tract cancer was conducted, and a random effects meta-analysis of overall survival and recurrence-free survival was performed.Results: Nine studies with 1292 participants were included. The preoperative C-reactive protein-to-albumin ratio negatively correlated with overall survival (hazard ratio, 2.44 [95% confidence interval: 1.98-2.90]; P < .001) and recurrence-free survival (hazard ratio, 2.73 [95% confidence interval: 2.01-3.70]; P < .001). Subgroup analysis showed that an elevated preoperative C-reactive protein-to-albumin ratio predicted poor overall survival, regardless of the cutoff value, sample size, histological type, and treatment.Conclusion: An elevated preoperative C-reactive protein-to-albumin ratio is significantly associated with poor prognosis in patients undergoing surgery for biliary tract cancer. The C-reactive protein-to-albumin ratio may be an independent prognostic biomarker for overall survival and recurrence-free survival in patients undergoing surgery for biliary tract cancer.Abbreviations: BTC = biliary tract cancer, CAR = C-reactive protein-to-albumin ratio, CI = confidence interval, HR = hazard ratio, OS = overall survival, RFS = recurrence-free survival.

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“…In clinical studies, ALB is often analyzed in combination with other tumor microenvironment-related factors to judge the prognosis of malignant tumors. The C-reactive protein–ALB ratio before treatment can be used as a potential prognostic biomarker in patients with head and neck cancer, esophageal cancer, and bile duct cancer; an elevated C-reactive protein–ALB ratio predicts a poorer prognosis [ 25 , 26 , 27 ]. The fibrinogen–ALB ratio effectively and independently predicts the tumor burden and long-term prognosis in patients with gastric cancer [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Nomograms Based on Fibrinogen, Albumin, Neutrophil-Lymphocyte Ratio, and Carbohydrate Antigen 125 for Predicting Endometrial Cancer Prognosis

Kong

et al. 2022

Cancers

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Background: This study aimed to determine the prognostic value of the preoperative levels of fibrinogen, albumin (ALB), neutrophil–lymphocyte ratio (NLR), and carbohydrate antigen 125 (CA125) in endometrial cancer and to establish nomograms for predicting patient survival. Methods: Patients with endometrial cancer (n = 1483) who underwent surgery were included in this study, and their preoperative fibrinogen, ALB, NLR, and CA125 levels and clinicopathological characteristics were collected. Patients were randomized into a training cohort (70%, n = 1038) and an external validation cohort (30%, n = 445). The Cox regression analysis was performed using the data for the patients in the training cohort to identify independent prognostic factors; nomograms for predicting prognosis were established and validated. Results: High fibrinogen (≥3.185 g/L), NLR (≥2.521 g/L), and CA125 (≥35 U/mL) levels and low ALB (<4.185 g/L) levels were independently associated with poor progression-free survival (PFS) and poor overall survival (OS) in patients with endometrial cancer. Prognostic prediction model nomograms were developed and validated based on these results. Calibration curves and C-indexes underscored the good predictive power of the nomograms, and both the net reclassification index (NRI) and integrated discrimination improvement (IDI) values of the prognostic prediction model nomograms were improved. Conclusion: Nomograms that are developed based on preoperative fibrinogen, ALB, NLR, and CA125 levels accurately predict PFS and OS in patients with endometrial cancer.

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The clinical significance of preoperative C-reactive protein/albumin ratio in patients with resected extrahepatic bile duct cancer

Cited by 5 publications

References 33 publications

Prognostic Impact of Inflammation-Based Scores for Extrahepatic Cholangiocarcinoma

Prognostic Impact of Inflammation-Based Scores for Extrahepatic Cholangiocarcinoma

Preoperative C-reactive protein-to-albumin ratio as a prognostic factor in biliary tract cancer: A systematic review and meta-analysis

Nomograms Based on Fibrinogen, Albumin, Neutrophil-Lymphocyte Ratio, and Carbohydrate Antigen 125 for Predicting Endometrial Cancer Prognosis

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