Clinicopathologic and prognostic significance of C-reactive protein/albumin ratio in patients with solid tumors: an updated systemic review and meta-analysis

Zhou, Haihong; Tan, Wenkai; Chen, Lin; Huang, Zhe; Mai, Shao

doi:10.18632/oncotarget.24172

Cited by 40 publications

(37 citation statements)

References 59 publications

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“…Pre-operative biomarker values were similar in females and males, however, after surgery, females showed a more significant decrease in NLR. A recent meta-analysis suggested that an elevated CAR was indicative, not only of sepsis, but also of unfavorable clinico-pathological findings in solid tumors [16]. In the present study, although unchanged after surgery, CAR values were nearly three times higher in the bigger tumor size group.…”

Section: Discussioncontrasting

confidence: 56%

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Changes in neutrophil to lymphocyte ratio after non-small cell lung cancer resection: a retrospective cohort study

Hazar¹,

Metin²

2020

Curr Thorac Surg

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Background: Increasing neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) define and grade systemic inflammation in lung cancer patients. We hypothesized a decrease in NLR and PLR after tumor resection, and their potential prognostic value in follow-up. Materials and Methods: Adult patients diagnosed previously (and/or histopathologically after lung surgery) with NSCLC were enrolled from the1st January 2016 to 1st January 2018. Patients were grouped according to tumor size (≥ 5 cm and < 5 cm) and sub-grouped by gender and type of surgery (lobectomy and pneumonectomy). Patient information was recorded from the hospital database and included age, gender, hemogram and blood biochemistry values, results, and before and after lung resection. Total leukocyte count, neutrophil count, NLR, PLR, PLT/MPV, and C-reactive protein (CRP) were recorded and calculated. Mortality was recorded during the follow-up period. Results: Among the 314 included patients (56, 18% female, mean age 60 years, SD=11) pneumonectomy and lobectomy numbers were 56 (18%) and 258 (82%), respectively, and 92 (29%) patients had larger tumors and 222 (71%) had smaller tumors NLR, PLR and CRP median values immediately before and after tumor resection were 17.08 vs. 10.03, P < 0.001, 315.61 vs. 215.10, P < 0.001, and 9.0 vs. 9.5, P = 0.10, respectively. Median follow-up was 300 days (IQR 198-381), and 36 (11.5%) patients died. Cox regression showed that a post-operative NLR ≥ 12.0 was a significant prognostic indicator (HR: 2.09, CI 95% [1.08-4.06], and P = 0.029). Conclusions: NLR >12 after lung resection may be an important prognostic value for six-month mortality. NLR and PLR may be useful biomarkers in NSCLC immediately post-surgery and for long-term follow-up.

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Section: Discussioncontrasting

confidence: 56%

“…C-reactive protein/serum albumin ratio (CAR): Defined as the ratio of CRP to serum albumin as a prognostic value of pretreatment in solid tumors [16].…”

Section: Definitions and Calculationsmentioning

confidence: 99%

Changes in neutrophil to lymphocyte ratio after non-small cell lung cancer resection: a retrospective cohort study

Hazar¹,

Metin²

2020

Curr Thorac Surg

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“…Previous meta-analyses assessed some of these relationships and revealed that the systemic inflammatory markers had predictive value for OS of GC patients [ 75 – 77 ]. However, none of the three markers have been linked to the GC survival rate.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory markers for predicting overall survival in gastric cancer patients: A systematic review and meta-analysis

Kim

Choi

et al. 2020

PLoS ONE

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Systemic inflammatory biomarkers have begun to be used in clinical practice to predict prognosis and survival of cancer patients, but the approach remains controversial. We conducted a meta-analysis to determine the predictive value of the c-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and Glasgow prognostic score (GPS)/modified Glasgow prognostic score (mGPS) in the clinical outcome of gastric cancer (GC) patients. We searched literature databases to identify relevant studies. All articles identified in the search were independently reviewed based on predetermined selection criteria. Meta-analysis was conducted to calculate the hazard ratio (HR) and 95% confidence intervals (CI) of overall survival of the included studies. A total of 41 eligible cohort studies, involving a total of 18,348 patients meeting the inclusion criteria, were considered for meta-analysis. Increases in CRP (

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“…Both CAR and GPS have been considered as independent risk factors for the prognosis of various tumors. 36 , 37 However, since the relationship between CAR and bladder cancer remains unclear, the investigators attempted to combine CRP with albumin to form a new prognostic factor in bladder cancer after RC.…”

Section: Discussionmentioning

confidence: 99%

Preoperative C-reactive protein/albumin ratio is a significant predictor of survival in bladder cancer patients after radical cystectomy: a retrospective study

Guo

Cai

Mao

et al. 2018

CMAR

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PurposeEarlier studies have indicated the prognostic value of the pretreatment C-reactive protein (CRP)/albumin ratio (CAR) in multiple tumor types. The present study attempts to investigate the predictive role of preoperative CAR in patients with bladder cancer after radical cystectomy (RC), and explores its prognostic index value.Patients and methodsA total of 131 patients with bladder cancer after RC between 2009 and 2015 were analyzed in the present study. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method and Cox regression analyses. Prediction accuracy was evaluated through the area under the receiver operating characteristic curve (AUC).ResultsThe median follow-up time for all patients in the present retrospective study was 39.72 months (15.51–53.26 months). The Kaplan–Meier curve analysis indicated that bladder cancer patients with high preoperative CAR (>0.2) were significantly associated with decreased PFS and OS (all, P<0.001). The multivariate analysis confirmed CAR as a common independent prognostic factor for PFS and OS. Furthermore, the effective combination of CAR and pathological T staging constituted a new index (CART), and was observed to be an independent risk factor for OS (CART score =2, HR=0.264; 95% CI: 0.106–0.660, P=0.004; CART score =3, HR =0.371; 95% CI: 0.208–0.661, P=0.001). However, CART did not show any prognostic significance for PFS. Importantly, the AUC values of CAR for OS and PFS were higher than other conventional clinical indices.ConclusionThe present study demonstrated that CAR can be used as a new prognostic indicator of OS and PFS in patients with bladder cancer after RC. Combining the CAR score with pathological T staging as the CART score appears to be a more effective prognostic indicator of poor OS, but not PFS.

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Clinicopathologic and prognostic significance of C-reactive protein/albumin ratio in patients with solid tumors: an updated systemic review and meta-analysis

Cited by 40 publications

References 59 publications

Changes in neutrophil to lymphocyte ratio after non-small cell lung cancer resection: a retrospective cohort study

Changes in neutrophil to lymphocyte ratio after non-small cell lung cancer resection: a retrospective cohort study

Inflammatory markers for predicting overall survival in gastric cancer patients: A systematic review and meta-analysis

Preoperative C-reactive protein/albumin ratio is a significant predictor of survival in bladder cancer patients after radical cystectomy: a retrospective study

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