Abstract
BackgroundIn recent years, many studies have explored the potential prognostic utility of C-reactive protein/albumin ratio (CAR) in patients with gastric cancer (GC), however, the results remain conflicting. We thus performed a meta-analysis to determine the association of CAR and prognosis of GC.MethodsThis meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. PubMed, Web of science, Embase, and Cochrane Library were searched. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and cancer-specific survival (CSS) of included studies were pooled to estimate the prognostic value of CAR.ResultsEight studies with a total of 3,216 patients were included in this meta-analysis. High CAR was significantly associated with poor OS (HR = 1.59, 95%CI = 1.36–1.85, p<0.001) and worse CSS (HR = 1.65, 95%CI = 1.21–2.25, p = 0.002). In addition, high CAR was significantly associated with male sex (OR = 1.80, 95%CI = 1.31–2.47, p<0.001), advanced tumor stage (OR = 2.14, 95%CI = 1.48–3.09, p<0.001), and tumor size ≥3cm (OR = 2.69, 95%CI = 1.84–3.93, p<0.001).ConclusionElevated pretreatment CAR is a prognostic marker of poor OS and CSS in patients with GC. Furthermore, high CAR levels are associated with clinicopathological features reflecting tumor progression.
Highlights
Gastric cancer (GC) is the fourth most commonly diagnosed cancer and the second leading cause of cancer-related death around the world [1]
High C-reactive protein/ albumin ratio (CAR) was significantly associated with poor overall survival (OS) (HR = 1.59, 95%confidence intervals (CIs) = 1.36–1.85, p
Elevated pretreatment CAR is a prognostic marker of poor OS and CSS in patients with GC
Summary
Gastric cancer (GC) is the fourth most commonly diagnosed cancer and the second leading cause of cancer-related death around the world [1]. Surgery is the only chance for curative treatment; and implementation of a multidisciplinary approach is mandatory and improves survival outcomes [4]. Recent progress of treatment of GC improved the survival outcomes of patients. Recent research points to CAR-T immunotherapy as a promising treatment for GC [7]. Prognostic markers including platelet count, CA 19–9, CEA, and neutrophil-to-lymphocyte ratio (NLR) are reported to be highly associated with prognosis of GC [8]. Because of poor prognosis of patients with late-stage, it is important to identify simple and useful biomarkers to help prognostic assessment and therapeutic modalities selection. Many studies have explored the potential prognostic utility of C-reactive protein/ albumin ratio (CAR) in patients with gastric cancer (GC), the results remain conflicting. We performed a meta-analysis to determine the association of CAR and prognosis of GC
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