The Prognostic Role of Glasgow Prognostic Score and C-reactive Protein to Albumin Ratio for Sarcoma: A System Review and Meta-Analysis

Backgrounds. Both pretreatment serum CRP (C-reactive protein) level and ALB (albumin) level have been found to be predictive of survival for multiple malignancies including sarcoma. Since both of the GPS (Glasgow prognostic score) and CAR (C-reactive protein to albumin ratio) are based on the combination of CRP and ALB, we conducted a meta-analysis to evaluate the prognostic role of these two parameters for sarcoma patients. Methods. A detailed literature search was conducted in MEDLINE, Embase, and Cochrane Library for relevant research publications written in English. Patients’ clinical characteristics, outcomes of overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were extracted. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were combined to evaluate the prognostic role of GPS or CAR. Results. Twelve articles containing 2695 patients were identified as eligible studies. The results showed that an elevated GPS was significantly correlated with poor OS (HR=2.42; 95% CI: 1.98-2.94; p<0.001; fixed-effects model), DSS (HR=2.28; 95% CI: 1.75-2.97; p<0.001; fixed-effects model), and DFS (HR=2.05; 95% CI: 1.62-2.60; p<0.001; fixed-effects model). A higher CAR also was shown to be significantly correlated with poor OS (HR=2.23; 95% CI: 1.70-2.92; p<0.001; fixed-effects model) and DFS (HR=1.81; 95% CI: 1.7-2.58; p=0.001; fixed-effects model). Conclusion. An elevated GPS is predictive of poor survival in patients with sarcomas and is promising to be used as a factor for risk stratification. A higher CAR value is also predictive of poor survival; however, the optimal CAR cut-off value is still to be determined.

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Prognostic role of pretreatment C-reactive protein to albumin ratio in metastatic colorectal cancer: A systematic review and meta-analysis

10.37766/inplasy2021.2.0013 ◽

2021 ◽

Author(s):

Yan Pan ◽

Lin Wang ◽

Yinmei Lou

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Metastatic Colorectal Cancer ◽

Meta Analysis ◽

C Reactive Protein ◽

Prognostic Role ◽

Albumin Ratio ◽

Reactive Protein

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Prognostic Role of the Pretreatment C-Reactive Protein/Albumin Ratio in Solid Cancers: A Meta-Analysis

Scientific Reports ◽

10.1038/srep41298 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 15

Author(s):

Nan Li ◽

Guang-Wei Tian ◽

Ying Wang ◽

Hui Zhang ◽

Zi-hui Wang ◽

...

Keyword(s):

Meta Analysis ◽

C Reactive Protein ◽

Prognostic Role ◽

Albumin Ratio ◽

Reactive Protein

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Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.737155 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yingji Fang ◽

Tingting Zheng ◽

Chengling Zhang

Keyword(s):

Meta Analysis ◽

Disease Free Survival ◽

Cochrane Library ◽

Gynecological Cancers ◽

C Reactive Protein ◽

Prognostic Role ◽

Albumin Ratio ◽

Reactive Protein ◽

Gynecology And Obstetrics

BackgroundMany studies have investigated the prognostic role of the C-reactive protein/albumin ratio (CRP/Alb ratio) in patients with gynecological cancers; however, there is lack of consensus owing to conflicting results across studies. We performed a meta-analysis to determine the prognostic role of the CRP/Alb ratio in gynecological cancers.MethodsWe searched the PubMed, Embase, the Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang electronic databases since inception to April 2021. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were used to estimate the prognostic effect of the CRP/Alb ratio in gynecological cancers. Pooled odds ratios (ORs) and 95% CIs were used to investigate the association between the CRP/Alb ratio and clinicopathological features.ResultsThe meta-analysis included seven studies with 1,847 patients. The pooled results showed that a high pretreatment CRP/Alb ratio was associated with poor overall survival (HR, 1.84; 95% CI, 1.41–2.40; p < 0.001) and progression-/disease-free survival (HR, 2.58; 95% CI, 1.42–4.68; p = 0.002). Additionally, a high CRP/Alb ratio was significantly associated with stages III–IV disease (the International Federation of Gynecology and Obstetrics classification) (OR, 2.98; 95% CI, 1.45–6.14; p = 0.003). However, we observed a non-significant correlation between the CRP/Alb ratio and lymph node metastasis, tumor size, and histopathological grade.ConclusionsThe CRP/Alb ratio is a convenient and accurate predictor of survival outcomes in gynecological cancers. A high CRP/Alb ratio also predicts tumor progression.

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Prognostic Value of C-Reactive Protein, Glasgow Prognostic Score, and C-Reactive Protein-to-Albumin Ratio in Colorectal Cancer

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2021.637650 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jiahui Zhou ◽

Wene Wei ◽

Hu Hou ◽

Shufang Ning ◽

Jilin Li ◽

...

Keyword(s):

Colorectal Cancer ◽

Multivariate Analysis ◽

Prognostic Factors ◽

Roc Curve ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Stage I ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein

Background: Emerging evidence suggests that inflammatory response biomarkers are predictive factors that can improve the accuracy of colorectal cancer (CRC) prognoses. We aimed to evaluate the prognostic significance of C-reactive protein (CRP), the Glasgow Prognostic Score (GPS), and the CRP-to-albumin ratio (CAR) in CRC.Methods: Overall, 307 stage I–III CRC patients and 72 colorectal liver metastases (CRLM) patients were enrolled between October 2013 and September 2019. We investigated the correlation between the pretreatment CRP, GPS, and CAR and the clinicopathological characteristics. The Cox proportional hazards model was used for univariate or multivariate analysis to assess potential prognostic factors. A receiver operating characteristic (ROC) curve was constructed to evaluate the predictive value of each prognostic score. We established CRC survival nomograms based on the prognostic scores of inflammation.Results: The optimal cutoff levels for the CAR for overall survival (OS) in all CRC patients, stage I–III CRC patients, and CRLM patients were 0.16, 0.14, and 0.25, respectively. Kaplan–Meier analysis and log-rank tests demonstrated that patients with high CRP, CAR, and GPS had poorer OS in CRC, both in the cohorts of stage I–III patients and CRLM patients. In the different cohorts of CRC patients, the area under the ROC curve (AUC) of these three markers were all high. Multivariate analysis indicated that the location of the primary tumor, pathological differentiation, and pretreatment carcinoembryonic antigen (CEA), CRP, GPS, and CAR were independent prognostic factors for OS in stage I–III patients and that CRP, GPS, and CAR were independent prognostic factors for OS in CRLM patients. The predictors in the prediction nomograms included the pretreatment CRP, GPS, and CAR.Conclusions: CRP, GPS, and CAR have independent prognostic values in patients with CRC. Furthermore, the survival nomograms based on CRP, GPS, and CAR can provide more valuable clinical significance.

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Prognostic role of the pretreatment C-reactive protein/albumin ratio in gastric cancer

Medicine ◽

10.1097/md.0000000000019362 ◽

2020 ◽

Vol 99 (10) ◽

pp. e19362

Author(s):

Xuanxuan Yang ◽

Xing Song ◽

Luo Zhang ◽

Changping Wu

Keyword(s):

Gastric Cancer ◽

C Reactive Protein ◽

Prognostic Role ◽

Albumin Ratio ◽

Reactive Protein

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

BMC Cancer ◽

10.1186/s12885-019-6373-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Zhenhua Liu ◽

Hongtai Shi ◽

Longyun Chen

Keyword(s):

Esophageal Cancer ◽

Prognostic Value ◽

Meta Analysis ◽

Pooled Analysis ◽

Cochrane Library ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein ◽

Pre Treatment

Abstract Background In 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. Methods Studies 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. Results A 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). Conclusions High 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.

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Prognostic role of C-reactive protein in prostate cancer: a systematic review and meta-analysis

Asian Journal of Andrology ◽

10.4103/1008-682x.123686 ◽

2014 ◽

Vol 16 (3) ◽

pp. 467 ◽

Cited By ~ 31

Author(s):

Qing Xu ◽

Yi-Jing Chen ◽

Zhu-Qing Liu ◽

Li Chu ◽

Jue-Min Fang ◽

...

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

Meta Analysis ◽

C Reactive Protein ◽

Prognostic Role ◽

Reactive Protein

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Prognostic Role of C-Reactive Protein In Urological Cancers: A Meta-Analysis

Scientific Reports ◽

10.1038/srep12733 ◽

2015 ◽

Vol 5 (1) ◽

Cited By ~ 24

Author(s):

Liang Zhou ◽

Xiang Cai ◽

Qiang Liu ◽

Zhong-Yu Jian ◽

Hong Li ◽

...

Keyword(s):

Meta Analysis ◽

C Reactive Protein ◽

Prognostic Role ◽

Reactive Protein ◽

Urological Cancers

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Prognostic Nutritional Index After Chemoradiotherapy Was the Strongest Prognostic Predictor Among Biological and Conditional Factors in Localized Pancreatic Ductal Adenocarcinoma Patients

Cancers ◽

10.3390/cancers11040514 ◽

2019 ◽

Vol 11 (4) ◽

pp. 514 ◽

Cited By ~ 8

Author(s):

Ichikawa ◽

Mizuno ◽

Hayasaki ◽

Kishiwada ◽

Fujii ◽

...

Keyword(s):

Prognostic Factors ◽

Pancreatic Ductal Adenocarcinoma ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Prognostic Nutritional Index ◽

Ductal Adenocarcinoma ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein ◽

Nutritional Index

Background: In many malignancies, including pancreatic ductal adenocarcinoma (PDAC), host-related inflammatory/immunonutritional markers, such as the prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and C-reactive protein (CRP)/albumin ratio are reported to be prognostic factors. However, the prognostic influence of these factors before and after chemoradiotherapy (CRT) has not been studied in PDAC patients. Methods: Of 261 consecutive PDAC patients who were scheduled for CRT with gemcitabine or S1 plus gemcitabine between February 2005 and December 2015, participants in this study were 176 who completed CRT and had full data available on inflammatory/immunonutritional markers as well as on anatomical and biological factors for the investigation of prognostic/predictive factors. Results: In multivariate analysis, the significant prognostic factors were RECIST classification, cT category, performance status, post-CRT carcinoembryonic antigen, post-CRT C-reactive protein/albumin ratio, post-CRT mGPS, and post-CRT PNI. Post-CRT PNI (cut-off value, 39) was the strongest host-related prognostic factor according to the p-value. In the patients who underwent resection after CRT, median survival time (MST) was significantly shorter in the 12 patients with low PNI (<39) than in the 97 with high PNI (≥39), at 15.5 months versus 27.2 months, respectively (p = 0.0016). In the patients who did not undergo resection, MST was only 8.9 months in those with low PNI and 12.3 months in those with high PNI (p < 0.0001), and thus was similar to that of the resected patients with low PNI. Conclusions: Post-CRT PNI was the strongest prognostic/predictive indicator among the independent biological and conditional prognostic factors in PDAC patients who underwent CRT.

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