C-reactive protein to albumin ratio predicts the outcome in renal cell carcinoma: A meta-analysis

Zhou, Wei; Zhang, Guang-Lin

doi:10.1371/journal.pone.0224266

Cited by 19 publications

(16 citation statements)

References 32 publications

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“…40 In addition, a recent meta-analysis showed that a high pretreatment CAR was associated with worse OS and DFS/PFS in patients with renal cell carcinoma (RCC), and a high CAR was also correlated with a variety of clinicopathological features. 41 The pooled results in the present metaanalysis on pancreatic cancer also suggested that an elevated CAR was associated with poor OS, PFS, and DFS, consistent with the findings from other types of cancer. We also found that a high CAR was associated with male sex; that is, male patients with pancreatic cancer tend to have a higher CAR.…”

Section: Discussionsupporting

confidence: 87%

Prognostic and Clinicopathological Significance of C-Reactive Protein to Albumin Ratio in Patients With Pancreatic Cancer: A Meta-Analysis

Xie¹,

Wang²,

Zheng³

2020

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Background: This meta-analysis explored the correlation between the C-reactive protein to albumin ratio (CAR) and survival outcomes and clinicopathological characteristics in patients with pancreatic cancer. Methods: PubMed, Embase, Web of Science, and Cochrane Library databases were comprehensively searched through October 17, 2019. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were used to evaluate the association between CAR and overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) in pancreatic cancer. Results: The meta-analysis included 11 studies comprising 2271 patients. The pooled results showed that a high CAR was predictive of worse OS (HR = 1.84, 95% CI = 1.65-2.06, P < .001), PFS (HR = 1.53, 95% CI = 1.27-1.85, P < .001), and DFS (HR = 1.77, 95% CI = 1.30-2.41, P < .001). An elevated CAR was also associated with male sex (OR = 1.38, 95% CI = 1.10-1.74, P = .006). Conclusion: Elevated pretreatment CAR effectively predicts inferior survival outcomes in patients with pancreatic cancer and may be a powerful prognostic indicator for these patients.

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Section: Discussionsupporting

confidence: 87%

Prognostic and Clinicopathological Significance of C-Reactive Protein to Albumin Ratio in Patients With Pancreatic Cancer: A Meta-Analysis

Xie¹,

Wang²,

Zheng³

2020

Dose-Response

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“…Another recent meta-analysis suggested that an elevated pretreatment CRP/Alb ratio could independently predict poor OS in patients with pancreatic cancer (33). Zhou et al observed that a high pretreatment CRP/Alb ratio predicted poor survival in patients with renal cell carcinoma (36). In our meta-analysis, the CRP/Alb ratio was correlated with poor OS, PFS, and DFS and also predicted advanced FIGO stages.…”

Section: Discussionsupporting

confidence: 52%

Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis

2021

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BackgroundMany studies have investigated the prognostic role of the C-reactive protein/albumin ratio (CRP/Alb ratio) in patients with gynecological cancers; however, there is lack of consensus owing to conflicting results across studies. We performed a meta-analysis to determine the prognostic role of the CRP/Alb ratio in gynecological cancers.MethodsWe searched the PubMed, Embase, the Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang electronic databases since inception to April 2021. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were used to estimate the prognostic effect of the CRP/Alb ratio in gynecological cancers. Pooled odds ratios (ORs) and 95% CIs were used to investigate the association between the CRP/Alb ratio and clinicopathological features.ResultsThe meta-analysis included seven studies with 1,847 patients. The pooled results showed that a high pretreatment CRP/Alb ratio was associated with poor overall survival (HR, 1.84; 95% CI, 1.41–2.40; p < 0.001) and progression-/disease-free survival (HR, 2.58; 95% CI, 1.42–4.68; p = 0.002). Additionally, a high CRP/Alb ratio was significantly associated with stages III–IV disease (the International Federation of Gynecology and Obstetrics classification) (OR, 2.98; 95% CI, 1.45–6.14; p = 0.003). However, we observed a non-significant correlation between the CRP/Alb ratio and lymph node metastasis, tumor size, and histopathological grade.ConclusionsThe CRP/Alb ratio is a convenient and accurate predictor of survival outcomes in gynecological cancers. A high CRP/Alb ratio also predicts tumor progression.

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“…At different stages of tumorigenesis, invasion, and metastasis, tumor cells and related inflammatory cells release a large amount of cytokines, chemokines, and other inflammatory factors to promote tumor initiation ( 10 , 36 ). Thus, the systemic inflammatory response is significantly associated with the outcome of patients and related inflammatory indicators, such as the NLR, and this may be used as a biomarker for the prognosis of patients with cancer, and may effectively estimate the prognosis of these patients ( 37 , 38 ). Neutrophils can promote cancer progression by directly acting on tumor cells or indirectly altering the tumor microenvironment ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker for Patients With Metastatic Renal Cell Carcinoma Treated With Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis

2021

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There is increasing evidence to suggest that the neutrophil-to-lymphocyte ratio (NLR) is related to the prognosis of patients with renal cell carcinoma (RCC) treated with immune checkpoint inhibitors (ICIs). However, these findings are inconsistent. The present study was performed with the aim of exploring the utility of NLR in patients with RCC treated with ICIs. For this purpose, a comprehensive search of PubMed, Web of Science, and Embase was performed to find studies evaluating the prognostic value of NLR. The overall survival (OS) and progression-free survival (PFS) were the assessed clinical outcomes. All statistical analysis was performed using Stata version 12.0 software. The combined hazard ratios (HRs) and 95% confidence intervals (CIs) of NLR for OS and PFS were calculated using the random-effect models. Heterogeneity was evaluated based on the I2 value and Cochran’s Q test. Egger’s and Begg’s tests were applied to precisely assess the publication bias. The “trim and fill” method was adopted to perform the sensitivity analysis to determine whether the results were stable. In total, 12 studies encompassing 1,275 patients were included in the final analysis. The results revealed that a high NLR at baseline or pre-therapy was associated with a poor OS (HR, 2.23; 95% CI, 1.84–2.70; p < 0.001) and PFS (HR, 1.78; 95% CI, 1.72–2.09; p < 0.001). During the course of treatment, a decrease in the NLR was associated with a significantly longer OS (HR, 0.34; 95% CI, 0.20–0.56; p < 0.001) and PFS (HR, 0.44; 95% CI, 0.30–0.63; p < 0.001) compared to an increase in NLR. As a preliminary screening of other risk factors, age, sex, race, and IMDC risk may have a certain prognostic value for RCC treated with ICIs. People over 70 years old had better OS compared to people younger than 70 (HR, 0.65; 95% CI, 0.48–0.89). Non-Caucasians treated with immunotherapy had a worse OS (HR, 8.67; 95% CI, 2.87–26.2) and PFS (HR, 2.65; 95% CI, 1.28–5.48) than Caucasians. Males had a worse OS than females (HR, 1.48; 95% CI, 1.14–1.93). Compared with the IMDC favorable risk group, the OS of the IMDC poor risk group was worse (HR, 2.59; 95% CI, 1.56–4.32). There was no significant publication bias or heterogeneity observed in the present study. On the whole, the present study demonstrated that an elevated NLR is associated with an adverse OS and PFS in patients with RCC treated with ICIs. The NLR may thus be used as a readily available prognostic biomarker for these patients. Age, sex, race, and IMDC risk may have potential predictive value for the prognosis of RCC treated with ICIs. However, further investigations are warranted to validate these results.

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C-reactive protein to albumin ratio predicts the outcome in renal cell carcinoma: A meta-analysis

Cited by 19 publications

References 32 publications

Prognostic and Clinicopathological Significance of C-Reactive Protein to Albumin Ratio in Patients With Pancreatic Cancer: A Meta-Analysis

Prognostic and Clinicopathological Significance of C-Reactive Protein to Albumin Ratio in Patients With Pancreatic Cancer: A Meta-Analysis

Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis

Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker for Patients With Metastatic Renal Cell Carcinoma Treated With Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis

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