Prognostic value of the C-reactive protein to albumin ratio in colorectal cancer: An updated systematic review and meta-analysis

Background: The relationship between pretreatment C-reactive protein to albumin ratio (CAR) and colorectal cancer (CRC) prognosis has been extensively studied in various tumors. However, little is known on CAR and its association with prognosis in CRC. This study aims to investigate the prognostic value of pretreatment CAR in CRC. Methods: We conducted a systematic search of MEDLINE, EMBASE, and Cochrane Library databases for eligible studies evaluating the associations of CAR with survival and/or clinicopathology of CRC. Overall survival (OS), disease-free survival (DFS), relapse-free survival (RFS), and clinicopathological features were synthesized and compared. Results: Nine studies including 3431 patients were analyzed in this meta-analysis. Pooled results showed that elevated pretreatment CAR was associated with poor OS (pooled hazards ratio [HR]: 2.18, 95% confidence interval [CI]: 1.70-2.78, P < .001) and DFS/RFS (pooled HR: 2.36, 95% CI: 1.40-3.98, P < .001). Moreover, elevated pretreatment CARs were correlated with male patients, large tumor diameter, late III-IV tumor node metastasis stage tumors, high serum carcinoembryonic antigen and carbohydrate antigen 19-9, and presence of lymphatic invasion and venous invasion. Conclusion: Elevated pretreatment CAR could be an adverse prognostic indicator in patients with CRC.

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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 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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