Predictive Value of the New Inflammatory Score Based on C-reactive Protein to Albumin Ratio in Serious Postoperative Complications after Curative Pancreaticoduodenectomy for Pancreatic Adenocarcinoma

Abstract

Introduction: The CRP/Albumin Ratio (CAR) which has been shown to be closely related to the results in septic patients has been found to be also associated with postoperative and long-term outcomes in patients with malignant diagnosis. Although the prognostic value of CAR in many gastrointestinal cancers has been determined, studies on pancreatic cancer are limited. Aim: To evaluate the predictive value of CAR on serious postoperative complications after curative pancreaticoduodenectomy for pancreatic cancer. Materials and Methods: One hundred eighty seven patients that underwent curative resection for pancreatic cancer between January 2010 and January 2020 were included in the study. The optimal cut-off level of the CAR was calculated as 0.22. Patients were divided into two groups as below and above this value. Clinicopathological and postoperative variables were compared between the groups. Results: In univariate and multivariate analysis, modified Glasgow Prognostic Score (mGPS) (OR: 3.67. %95 CI: 2.31~5.82. p=0.028), CAR (OR: 8.02 %95 CI: 3.45~21.62. p>0.001), lymph node status (OR: 1.54. %95 CI: 0.41~3.39. p=0.042) and TNM stage (OR: 3.92. %95 CI: 1.56~10.08. p= 0.005) were found to be independent risk factors for serious postoperative complications. Conclusion: Based on these data, CAR, which can be easily measured from preoperative biochemical results in each patient, may be an independent and significant predictor of postoperative serious complications and poor outcomes after pancreaticoduodenectomy in patients with pancreatic cancer.