Preoperative C‐reactive protein‐to‐albumin ratio predicts long‐term outcomes in extrahepatic cholangiocarcinoma patients

Abstract

Background: Systemic inflammation may have prognostic value in some malignancies and association with lymph node metastasis. This study aimed to evaluate the impact of systemic inflammatory biomarkers on long-term and oncological outcomes as well as to assess the association between biomarkers with lymph node metastasis in extrahepatic cholangiocarcinoma patients. Methods: We enrolled 271 consecutive patients who underwent surgical resection for extrahepatic cholangiocarcinoma. Poor prognostic factors were compared to identify the biomarkers that were most associated with overall survival (OS) and disease-free survival (DFS) using receiver operating characteristic curves and multivariable analysis. Furthermore, we evaluated the relationship between biomarkers and lymph node metastasis. Results: Four and two biomarkers were predictive for OS and DFS, respectively, among which, the C-reactive protein-to-albumin ratio (CAR) had the highest area under the curve values (OS: 0.631, DFS: 0.624). Multivariable analysis showed that a high CAR was an independent prognostic factor for both OS and DFS (P = .002 and P < .001, respectively). Although a high CAR was not significantly correlated with lymph node metastasis (P = .645), carbohydrate antigen 19-9 showed a significant correlation (P < .001). Conclusions: Preoperative CAR is the most accurate prognostic factor for OS and DFS in extrahepatic cholangiocarcinoma patients and is independent of lymph node metastasis.

Preoperative Albumin-to-Fibrinogen Ratio Predicts Postoperative Pneumonia in Patients with Esophageal Squamous Cell Carcinoma: A Retrospective Study

“…As mentioned above, many studies have been conducted on albumin and AFR as independent in uencing factors to predict postoperative complications and prognosis in tumor patients.In this study, albumin levels were found to be statistically different between the two groups, consistent with previous ndings (12) and associated with postoperative complications in a study on the ratio of C-reactive protein to albumin (15).From the results, increasing albumin levels to a certain extent can prevent postoperative complications, which is correlated with previous reports that low serum albumin may lead to a higher risk of worsening disease and poor prognosis in cancer patients.This might be due to malnutrition can weaken the immune system, increase the chance of infection, and albumin may help stabilize the DNA replication and cell growth, regulate the body's reaction, enhance immunity, prevention of malignant disease (18).…”

“…In 2002,T. Nozoel proposed that preoperative nutritional status might predict postoperative complications in patients with esophageal cancer (7).Since then, a variety of nutritional factors, including neutrophils, lymphocytes, C-reactive protein, albumin, brinogen and related ratios,even grip strength, have been reported to be independent predictors of postoperative complications and prognosis (8)(9)(10)15). Albumin, as an important biochemical index to evaluate nutritional status, has been shown to be associated with postoperative complications and prognosis in patients with a variety of tumors, including esophageal cancer (11)(12)(13)(14)(15).Meanwhile, brinogen, as an indicator of blood coagulation, has a relatively short half-life and can be used as an acute response protein to re ect systemic in ammation.…”

“…Nozoel proposed that preoperative nutritional status might predict postoperative complications in patients with esophageal cancer (7).Since then, a variety of nutritional factors, including neutrophils, lymphocytes, C-reactive protein, albumin, brinogen and related ratios,even grip strength, have been reported to be independent predictors of postoperative complications and prognosis (8)(9)(10)15). Albumin, as an important biochemical index to evaluate nutritional status, has been shown to be associated with postoperative complications and prognosis in patients with a variety of tumors, including esophageal cancer (11)(12)(13)(14)(15).Meanwhile, brinogen, as an indicator of blood coagulation, has a relatively short half-life and can be used as an acute response protein to re ect systemic in ammation. Guan proposed that low preoperative brinogen level may be a potential risk factor for neurological complications after cardiac surgery (16).Recently, a new indicator, albumin-to-brinogen ratio(AFR), was proposed in a study to predict postoperative severe complications in elderly patients with gastric cancer (17).Although AFR has been proven to be associated with the prognosis of esophageal cancer (18), it is still unknown whether AFR can predict the occurrence of postoperative pneumonia in patients with esophageal cancer.…”

Preoperative C‐reactive protein‐to‐albumin ratio predicts long‐term outcomes in extrahepatic cholangiocarcinoma patients

“…We would like to thank the reader for taking an interest in our published article 1 We re-examined the data from our database and report the following:…”

The impact of C‐reactive protein‐albumin‐lymphocyte (CALLY) index on the prognosis of patients with distal cholangiocarcinoma following pancreaticoduodenectomy

“…Accumulating evidence suggests that the host inflammatory response plays an important role in the development, progression, and metastasis of cancer. 3 Various preoperative inflammation‐based prognostic markers, such as neutrophil‐lymphocyte ratio (NLR), 4 platelet‐lymphocyte ratio (PLR), 5 and C‐reactive protein (CRP)‐albumin ratio (CAR), 6 have been reported to predict long‐term survival in cancer patients. However, few reports have described prognostic markers for distal cholangiocarcinoma.…”