The C-reactive protein/albumin ratio predicts overall survival of patients with advanced pancreatic cancer

Abstract

Recent studies have demonstrated the prognostic value of the C-reactive protein/albumin (CRP/Alb) ratio in cancer. However, the role of the CRP/Alb ratio in advanced pancreatic cancer (PC) has not been examined. A retrospective study of 233 patients with advanced PC was conducted. We investigated the relationship between the CRP/Alb ratio, clinicopathological variables, and overall survival (OS). The optimal cutoff point of the CRP/Alb ratio was 0.54. A higher CRP/Alb ratio was significantly associated with an elevated neutrophil-lymphocyte ratio (NLR) (P < 0.001) and higher modified Glasgow prognostic score (mGPS) (P < 0.001). Using univariate analyses, we found that the age (P = 0.009), disease stage (P < 0.001), NLR (P < 0.001), mGPS (P < 0.001), and CRP/Alb ratio (P < 0.001) were significant predictors of OS. Patients with a higher CRP/Alb ratio had a worse OS than patients with a lower CRP/Alb ratio (hazard ratio (HR) 3.619; 95 % CI 2.681–4.886; P < 0.001). However, the CRP/Alb ratio was identified as the only inflammation-based parameter with an independent prognostic ability in the multivariate analyses (P < 0.001). The pretreatment CRP/Alb ratio is a superior prognostic and therapeutic predictor of OS in advanced PC.

Pretreatment values of bilirubin and albumin are not prognostic predictors in patients with advanced pancreatic cancer

“…Pancreatic cancers of the body and tail were found to have lower rates of survival . However, in Liu et al and Wu et al’s study, no statistically significant relationship was found between tumor location and OS . In this study, with the univariate analysis, cancerization at head of pancreas was statistically significantly associated with poor prognosis.…”

Pancreas Cancer-Associated Weight Loss

“…The GPS was recently studied as a predictive factor for response to a novel therapeutic in advanced PC . Recent studies have also suggested that CRP:Albumin ratio and neutrophil:lymphocyte ratio also have prognostic validity . In routine practice, this score could help identify patients at high risk for PAWL and cachexia and could promote early intervention.…”

Inflammatory markers as prognostic indicators in pancreatic cancer patients who underwent gemcitabine-based palliative chemotherapy

“…In many studies, these values are combined into calculated inflammatory variables (NLR, PLR, and CRP-albumin ratio). These variables have been validated as prognostic markers [12][13][14][15]. Based on results of the present study, these calculated variables (NLR, PLR, and CRP-albumin ratio) were found to be more predictive than other markers of inflammation.…”

“…Therapeutic strategies considering proper prognostic markers could help clinicians bypass worthless toxicities of aggressive therapies. Recently, various inflammatory markers have been validated as prognostic indicators in many cancers including PC [12][13][14][15]. However, few studies have systematically evaluated these markers.…”