Prognostic significance of the preoperative C-reactive protein-to-albumin ratio in patients with colorectal cancer
Hiroshi Tamagawa1, Toru Aoyama1, Masakatsu Numata1, Yukio Maezawa1, Keisuke Kazama1, Yosuke Astumi1, Kentaro Hara1, Kazuki Kano1, Norio Yukawa1, Hiroyuki Saeki2, Tenii Godai3, Takashi Oshima1, Motohiko Goda1, Yasushi Rino1, Munetaka Masuda1
1 Department of Surgery, Yokohama City University, Yokohama, Japan
2 Department of Surgery, Yokohama Minamikyousai Hospital, Yokohama, Japan
3 Department of Surgery, Fujisawa Shonandai Hospital, Fujisawa, Japan
Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama 236-0004
Source of Support: None, Conflict of Interest: None
Background: The aim of the present study was to determine the utility of the C-reactive protein-to-albumin ratio (CAR) for predicting the overall survival (OS) in locally advanced colorectal cancer (CRC) patients.
Patients and Methods: This retrospective multicenter study was performed using data from a prospectively maintained database of pathological Stage II or III patients undergoing CRC surgery at the Yokohama City University, Department of Surgery, and its affiliated institutions between April 2000 and March 2016. The risk factors for the OS were identified.
Results: A CAR of 0.03 was considered to be the optimal cutoff point for classification based on the 1-, 3-, and 5-year survival rates and receiver operating characteristic curve. The OS rates at 3 and 5 years after surgery were 92.4% and 85.7% in the CAR-low group, respectively, and 86.7% and 81.1% in the CAR-high group. A multivariate analysis showed that the CAR was a significant independent risk factor for the OS. When comparing the patients' demographic and clinical characteristics between the CAR ≤0.03 and >0.03 groups, the incidence of patients who received adjuvant chemotherapy and the incidence of postoperative complications were significantly different between the two groups.
Conclusion: The present study showed that the preoperative CAR was a risk factor for the OS in patients who underwent surgery for CRC. To improve the patients' survival, CAR might be a useful tool for devising treatment strategies.