The significant impact of fibrinogen to C-reactive protein–albumin ratio (F-CAR) on the long-term outcomes after pancreatic resection for pancreatic cancer

Abstract

Abstract Objectives: We aimed to evaluate the prognostic value of a novel biomarker we developed, namely the fibrinogen-C-reactive protein (CRP)-albumin ratio (F-CAR), in patients with pancreatic cancer who underwent pancreatic resection. Method: 163 patients who underwent pancreatic resection for pancreatic cancer were analyzed retrospectively. The relationship between F-CAR and the long-term outcomes in patients after pancreatectomy was investigated. The F-CAR was calculated from preoperative serum fibrinogen, albumin, and CRP levels. Results: Multivariate analysis revealed that several factors, including age (p < 0.01), high serum carbohydrate antigen 19-9 (CA 19-9) level (p < 0.01), high serum carcinoembryonic antigen (CEA) level (p = 0.049), pT3 or pT4 (UICC) (p < 0.01), pN1 or pN2, (p < 0.01), and high F-CAR (hazard ratio (HR) 1.51, 95% confidence interval (CI) 1.03-2.22, p = 0.04) were independent and significant predictors of disease-free survival. Moreover, factors such as age (p = 0.02), high serum CEA level (p < 0.01), preoperative biliary drainage (p = 0.02), preoperative chemotherapy (p = 0.04), lymph node metastasis (p < 0.01), adjuvant chemotherapy (p = 0.046) and high F-CAR (HR 1.55, 95% CI 1.03-2.35, p = 0.04) were found to be independent and significant predictors of overall survival. Conclusions: F-CAR is a useful prognostic factor for disease-free survival and overall survival after pancreatic resection in pancreatic cancer patients.