SUN-LB282: The Value of the C-Reactive Protein-To-Albumin Ratio for Predicting Survival After Surgery for Patients with Primary Hepatocellular Carcinoma

Abstract We investigated the impact of C-reactive protein to albumin ratio (CAR) on predicting outcomes in 522 patients with unresectable hepatocellular carcinoma (HCC) treated with lenvatinib. We determined the optimal CAR cutoff value with time-dependent receiver operating characteristic curve analysis. Additionally, we clarified the relationship between CAR and liver function or HCC progression. Median overall survival was 20.0 (95% confidence interval (CI), 17.2–22.6) months. The optimal CAR cutoff value was determined to be 0.108. Multivariate analysis showed that high CAR (≥0.108) (hazard ratio (HR), 1.915; 95% CI, 1.495–2.452), Eastern Cooperative Oncology Group performance status ≥1 (HR, 1.429), and α-fetoprotein ≥400 ng/mL (HR, 1.604) were independently associated with overall survival. Cumulative overall survival differed significantly between patients with low versus high CAR (p<0.001). Median progression-free survival was 7.5 (95% CI, 6.7–8.1) months. Multivariate analysis showed that age, CAR ≥0.108 (HR, 1.644; 95% CI, 1.324–2.043), and non-hepatitis B, non-hepatitis C etiology (HR, 0.726) were independently associated with progression-free survival. Cumulative progression-free survival differed significantly between patients with low versus high CAR (p<0.001). CAR values were significantly higher as Japan Integrated Staging score increased (p<0.001). In conclusion, CAR can predict outcomes in patients with unresectable HCC treated with lenvatinib.

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Clinical Significance of C-Reactive Protein to Albumin Ratio in Patients with Hepatocellular Carcinoma: A Meta-Analysis

Disease Markers ◽

10.1155/2020/4867974 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Nanping Lin ◽

Jingrong Li ◽

Qiao Ke ◽

Lei Wang ◽

Yingping Cao ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Meta Analysis ◽

Prognostic Significance ◽

Clinicopathological Characteristics ◽

Included Study ◽

Current Data ◽

Cochrane Library ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein

Aim. To evaluate the prognostic significance of C-reactive protein to albumin ratio (CAR) for clinical outcomes in hepatocellular carcinoma (HCC) patients. Material and Methods. Eligible studies were searched by PubMed, MedLine, the Cochrane Library, from January 1, 2000, to June 30, 2019, investigating the prognostic value of CAR in patients with HCC. Primary endpoint was OS. Hazard ratio (HR) with 95% confidence interval (CI) was used to determine the effect size. Results. 7 records including 2208 patients published since 2014 were enrolled into our meta-analysis. Clinicopathological characteristics were also correlated with the level of CAR. The pooled HR for the OS rate between low and high CAR groups was 2.13 (95% CI 1.70~2.68, P<0.00001) using a random model, but sensitivity analysis showed that the pooled HR for the OS rates did not change substantially after removal of any included study. As for patients receiving surgery, the pooled HR for the OS rate between low and high CAR groups was 2.04 (95% CI 1.59~2.61, P<0.00001). Subgroup analysis showed that CAR could be a prognostic biomarker for HCC patients regardless of regions (China, HR=1.75, 95% CI 1.51~2.02; Japan, HR=3.36, 95% CI 2.07~5.45; Korea, HR=2.26, 95% CI 1.47~4.47; respectively), the cut-off value (<0.1, HR=2.84, 95% CI 1.90~4.24; >0.1, HR=1.99, 95% CI 1.52~2.61; respectively), and sample size (<200, HR=2.85, 95% CI 2.01~4.03; >200, HR=1.75, 95% CI 1.52~2.02; respectively). Conclusion. With the current data, we clearly concluded that CAR was closely correlated with prognosis of patients with HCC. Multicenter, prospective randomized trials are warranted to confirm the conclusion.

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