C-Reactive Protein to Albumin Ratio: A Reliable Marker in Gastric Cancer Surgery

Abstract

We aim to evaluate the association between elevated postoperative C-reactive protein to albumin ratio (CAR) and major complications in gastric cancer patients. A retrospective review was made of 177 patients who underwent a curative resection due to gastric cancer between 2013 and 2018. The cut-off level for CAR on postoperative 3rd day was determined based on a receiver operating characteristic (ROC) curve analysis. The ROC curve analysis determined an optimal cut-off level of 5 g/dl (AUC, 0.680; p = 0.001). The rate of postoperative complications was higher in patients with a CRP value of ≥5 g/dl (61.02%) (p < 0.001). Major complications occurred in 23 patients (38.98%) with a CAR of ≥ 5 g/dl on postoperative day 3 (p < 0.001). In addition, CAR was found to be higher in patients with longer operation durations and length of hospital stay (p = 0.046 and p < 0.001, respectively). Postoperative complications can be prevented in a timely manner, morbidity rates can be reduced, and thereby, patient quality of life can be improved by determining CAR in the early period.