The impact of C-reactive protein to albumin ratio on survivals in patients with esophageal cancer.

Abstract

22 Background: C-reactive protein to albumin (CRP/Alb) ratio is a novel inflammation-based prognostic score. It was originally reported as a prognostic score in septic patients, however, recent reports show CRP/Alb can be a prognostic score in some cancer patients. There are a few reports about CRP/Alb in patients with esophageal cancer. The usefulness of CRP/Alb in patients with esophageal cancer is still unclear. Methods: The aim of this study is to ensure the evidence of CRP/Alb in patients with esophageal cancer as a prognostic score. One hundred and sixty patients with esophageal cancer were reviewed in the current study. CRP/Alb was calculated before the treatment: In neoadjuvant chemotherapy (NAC) patients, CRP/Alb was calculated before NAC, in non-NAC patients, CRP/Alb was calculated before surgery. CRP/Alb was divided into high group and low group, using cut off value 0.035. The number of 0.035 was determined, referred from other reports of CRP/Alb. Results: The distributions of postoperative pathologic stages 0, 1, 2, 3, and 4 were respectively 4, 51, 33, 56, and 16. The number of high CRP/Alb group was 58 (36.3%). That of low CRP/Alb group was 102 (63.7%). In the survival analysis, the patients with high CRP/Alb showed a significantly shorter overall survival. In the multivariate analysis with pathological stage, neoadjuvant treatment, field of lymph node dissection, and CRP/Alb as covariates, CRP/Alb was detected as a significantly independent prognostic score (hazard ratio 2.602; P < 0.001). Conclusions: In this study, CRP/Alb was thought to be a prognostic score with statistical significance in esophageal cancer. Therefore, further investigation of reducing preoperative inflammation and increasing preoperative nutrition in esophageal cancer is needed.