Prognostic role of pre-treatment C-reactive protein/albumin ratio in esophageal cancer: a meta-analysis

Abstract

BackgroundIn recent years, the role of pre-treatment C-reactive protein/albumin ratio (CAR) in prognosis of esophageal cancer (EC) has been investigated by several studies. This meta-analysis aimed to provide a more accurate and objective assessment of the prognostic value of pre-treatment CAR in EC.MethodsStudies assessing the role of pre-treatment CAR in prognosis of EC were searched from PubMed, Embase and the Cochrane Library (last update by April 16, 2019). The hazard ratios (HRs) of CAR and the corresponding 95% CIs for overall survival (OS) or cancer-specific survival (CSS) in EC were extracted for pooled analysis.ResultsA total of eight observational studies including 2255 patients were collected. The pooled analysis showed that high CAR was related to worse OS in EC (pooled HR = 1.81; 95% CI = 1.40–2.35; P < 0.001). Subgroup analyses showed that the negative correlation between the CAR and OS was consistently demonstrated in subgroups stratified by country, pathological type, and cut-off value (P < 0.05). However, there was no relation between CAR and OS in subgroup of patients receiving neoadjuvant chemotherapy at a proportion of 100% (HR = 1.15, 95% CI = 0.56–2.69; P = 0.715). In addition, high CAR was also related to worse CSS in EC (pooled HR = 2.61; 95% CI = 1.67–4.06; P < 0.001).ConclusionsHigh pre-treatment CAR was an adverse prognostic factor for EC patients. More large-sample clinical trials are still needed to verify the prognostic value of pre-treatment CAR in EC.

Predictive impact of C-reactive protein to albumin ratio for recurrent or metastatic head and neck squamous cell carcinoma receiving nivolumab

“…There is no consensus about the CAR cutoff for ICI-treated patients. Although the importance of CAR as a prognostic factor has already been reported in other squamous cell carcinoma (SCC) such as anal squamous cell carcinoma 24 and esophageal cancer 25 , the proposed cutoff values vary in the several literatures. The major possible reasons would be the differences in the calculating method or patient background such as disease stage or cancer type and indeed, a positive correlation between disease stage and CAR has been reported in SCC 22 , 24 .…”

Biomarkers for Malignant Pleural Mesothelioma—A Novel View on Inflammation

“…Since systemic inflammatory parameters can indicate inflammatory and infectious processes in the patient's body as well as malignancy, they are highly unspecific for diagnostic or screening purposes. However, after exclusion of acute inflammation or infection, some of the established and widely available inflammatory markers have been identified as prognostic or predictive markers in various solid tumors [94][95][96][97][98][99] including MPM [100][101][102].…”

<p>Prognostic Significance of Inflammatory Biomarkers in Patients with Breast Cancer Skeletal Metastases</p>

“…Duan et al 6 summarized that preoperative elevated NLR was associated with poor prognosis in breast cancer. Mandaliya et al 7 suggested that LMR was a prognostic biomarker in stage IV non-small cell lung cancer, and the prognostic role of CAR in esophageal cancer was demonstrated by Liu et al 8 …”

“…Duan et al 6 summarized that preoperative elevated NLR was associated with poor prognosis in breast cancer. Mandaliya et al 7 suggested that LMR was a prognostic biomarker in stage IV nonsmall cell lung cancer, and the prognostic role of CAR in esophageal cancer was demonstrated by Liu et al 8 Thio et al 9 have investigated inflammatory biomarkers in patients with skeletal metastases from several malignancies and found that NLR can serve as an independent prognostic factor. However, on account of breast cancer patients with skeletal metastases, the prognostic significance of inflammatory biomarkers has not been entirely clear.…”