Abstract:Background:We conducted a two-center study to investigate the prognostic value of preoperative fibrinogen-albumin ratio (FAR) in patients undergoing radical cystectomy (RC). Methods: The clinical and survival data of 267 patients with bladder cancer (BCa) treated with RC were collected, of which 140 patients from Xuzhou Central Hospital were divided into training set and 127 patients from The Second Affiliated Hospital of Nantong University were divided into validation set. X-tile software was used to obtain t… Show more
“…As usually, low level of albumin commonly indicated malnutrition and cachexia in malignant tumor patients, which are closely correlated with worse prognosis. 30 Similar to our results, the FAR, as a new biomarker combining with blood nutritional status and blood coagulation function, has already been proven as a valuable prognostic factor in the prediction of prognosis of various malignancies, such as HCC, ICC, pancreatic cancer, etc. 21 , 22 , 31 …”
Purpose
The fibrinogen/albumin ratio (FAR) is increasingly considered as a potential biomarker for predicting prognosis in various malignant tumors, whereas the value of the FAR in predicting the recurrence-free survival (RFS) in patients with combined hepatocellular cholangiocarcinoma (cHCC-CCA) after surgery has not been studied.
Patients and Methods
A total of 104 patients with surgical-pathologically proved cHCC-CCA were retrospectively analyzed. The best cut-off value of the FAR was calculated via receiver operating characteristic (ROC) curve analysis, and the cohort was then divided into two groups as high-FAR (H-FAR) group and low-FAR (L-FAR) group. The correlation between the preoperative FAR and clinicopathological characteristics was analyzed. Uni- and multi-variable analyses for RFS were evaluated using a Cox proportional hazards model to verify the predictive value of FAR on the RFS of cHCC-CCA. Additionally, a novel clinical nomogram based on FAR was developed to preoperatively predict the RFS of HCC-CCA. The C-index and calibration were conducted to evaluate the performance of the developed nomogram.
Results
According to the cut-off value of the FAR, the patients were grouped into the H-FARI (>0.075) and L-FARI (≤0.075) groups. FAR was significantly correlated with several clinical-pathological features, including age, cirrhosis, AFP, CA19-9, BCLC staging, NLR, and PLR. In the multi-variate analysis, FAR, cirrhosis and tumor size were independent prognostic predictors for poor RFS in cHCC-CCA patients after surgery. Moreover, the clinical nomogram based on FAR was constructed, showing well-predictive accuracy.
Conclusion
The preoperative FAR is a convenient and feasible serum biomarker for predicting the RFS of cHCC-CCA after surgery. Such developed FAR-based nomogram integrating tumor size and cirrhosis could be served as a feasible and convenient tool to assist the decision-making of clinical strategy.
“…As usually, low level of albumin commonly indicated malnutrition and cachexia in malignant tumor patients, which are closely correlated with worse prognosis. 30 Similar to our results, the FAR, as a new biomarker combining with blood nutritional status and blood coagulation function, has already been proven as a valuable prognostic factor in the prediction of prognosis of various malignancies, such as HCC, ICC, pancreatic cancer, etc. 21 , 22 , 31 …”
Purpose
The fibrinogen/albumin ratio (FAR) is increasingly considered as a potential biomarker for predicting prognosis in various malignant tumors, whereas the value of the FAR in predicting the recurrence-free survival (RFS) in patients with combined hepatocellular cholangiocarcinoma (cHCC-CCA) after surgery has not been studied.
Patients and Methods
A total of 104 patients with surgical-pathologically proved cHCC-CCA were retrospectively analyzed. The best cut-off value of the FAR was calculated via receiver operating characteristic (ROC) curve analysis, and the cohort was then divided into two groups as high-FAR (H-FAR) group and low-FAR (L-FAR) group. The correlation between the preoperative FAR and clinicopathological characteristics was analyzed. Uni- and multi-variable analyses for RFS were evaluated using a Cox proportional hazards model to verify the predictive value of FAR on the RFS of cHCC-CCA. Additionally, a novel clinical nomogram based on FAR was developed to preoperatively predict the RFS of HCC-CCA. The C-index and calibration were conducted to evaluate the performance of the developed nomogram.
Results
According to the cut-off value of the FAR, the patients were grouped into the H-FARI (>0.075) and L-FARI (≤0.075) groups. FAR was significantly correlated with several clinical-pathological features, including age, cirrhosis, AFP, CA19-9, BCLC staging, NLR, and PLR. In the multi-variate analysis, FAR, cirrhosis and tumor size were independent prognostic predictors for poor RFS in cHCC-CCA patients after surgery. Moreover, the clinical nomogram based on FAR was constructed, showing well-predictive accuracy.
Conclusion
The preoperative FAR is a convenient and feasible serum biomarker for predicting the RFS of cHCC-CCA after surgery. Such developed FAR-based nomogram integrating tumor size and cirrhosis could be served as a feasible and convenient tool to assist the decision-making of clinical strategy.
“…Hwang et al evaluated the prognostic influence of preoperative FAR in breast cancer, reporting a worse prognosis for patients with a higher FAR (>7.1) [ 21 ]. Analogously, a study by Xu et al reported unfavorable overall survival in gall bladder cancer patients with FAR > 0.08 compared to patients with lower values [ 33 ]. Finally, An et al reported high FAR (>7.75) as a worse prognostic factor in cervical cancer [ 20 ].…”
Background and objective: Fibrinogen and albumin are two proteins widely used, singularly and in combination, in cancer patients as biomarkers of nutritional status, inflammation and disease prognosis. The aim of our study was to investigate the preoperative fibrinogen-to-albumin ratio (FAR) as a preoperative predictor of malignancy as well as advanced grade in patients with bladder cancer. Materials and Methods: A retrospective analysis of patients who underwent TURBT at our institution between 2017 and 2021 was conducted. FAR was obtained from preoperative venous blood samples performed within 30 days from scheduled surgery and was analyzed in relation to histopathological reports, as was the presence of malignancy. Statistical analysis was performed using a Kruskal–Wallis Test, and univariate and multivariate logistic regression analysis, assuming p < 0.05 to be statistically significant. Results: A total of 510 patients were included in the study (81% male, 19% female), with a mean age of 71.66 ± 11.64 years. The mean FAR was significantly higher in patients with low-grade and high-grade bladder cancer, with values of 80.71 ± 23.15 and 84.93 ± 29.96, respectively, compared to patients without cancer (75.50 ± 24.81) (p = 0.006). Univariate regression analysis reported FAR to be irrelevant when considered as a continuous variable (OR = 1.013, 95% CI = 1.004–1.022; p = 0.004), while when considered as a categorical variable, utilizing a cut-off set at 76, OR was 2.062 (95% CI = 1.378–3.084; p < 0.0001). Nevertheless, the data were not confirmed in the multivariate analysis. Conclusions: Elevated preoperative FAR is a potential predictor of malignancy as well as advanced grade in patients with bladder cancer. Further data are required to suggest a promising role of the fibrinogen-to-albumin ratio as a diagnostic biomarker for bladder tumors.
“…In recent years, there have been continuous studies to explore the relationship between FAR and the clinical outcome of human solid tumors ( 29 , 35 , 36 , 39 ). FAR is expected to be a simple, inexpensive, and readily available biomarker for predicting clinical prognosis in patients with solid tumors.…”
BackgroundRecent studies have shown that the fibrinogen to albumin ratio (FAR) is closely related to the prognosis of various cancers. The aim of this systematic review and meta-analysis was to investigate the prognostic value of FAR in malignancies based on the available evidence.MethodTo systematically search the Cochrane Library, Embase, PubMed, Google Scholar, Baidu scholars, CNKI and VIP databases for relevant studies published before April 1, 2022, and to evaluate the fibrinogen-to-albumin ratio (FAR) and survival of patients with malignant tumors through a meta-analysis relationship between the results. Results. This meta-analysis included 19 eligible studies involving 5926 cancer patients. We found that high FAR was associated with poor overall survival (HR=2.25, 95%CI 1.86-2.74, p<0.001), recurrence-free survival (HR=2.29, 95%CI 1.91-2.76, P<0.001), progression-free survival (HR: 2.10, 95%CI 1.58-2.79, p<0.001), disease-free survival (HR=1.52, 95%CI 1.17-1.96, p=0.001), and time to recurrence (HR: 1.555, 95%CI 1.031-2.346, P=0.035) was significantly correlated.ConclusionsHigh FAR is significantly associated with poor clinical outcomes in cancer, suggesting that it may be an important predictor of prognosis in patients with malignancies.
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