China: C-reactive protein/albumin ratio (CAR) is linked to poor survival in surgically treated gastrointestinal stromal tumors (GISTs) patients, suggests a recent study in the journal Cancer Management and Research.
In recent years the role of albumin and C-reactive protein (CRP) in the interaction network between systemic inflammatory response and cancer has attracted increased attention. It has been known that systemic inflammation and malnutrition may promote tumor progression. CAR is linked to the poor long-term survival of several malignant tumors.
Against the above background, Xianglong Cao, Department of Gastrointestinal Surgery, Beijing Hospital, Beijing, China, and colleagues aimed to explore the predictive value of CAR in gastrointestinal stromal tumors.
For this purpose, the researchers conducted a retrospective study on 325 patients with primary GIST surgically treated with curative intent from 2009 to 2018. Using X-tile software, the cut-off point of CAR was set. Kaplan–Meier method and multivariate Cox regression model were used to study the prognostic value of CAR.
The time-dependent receiver operating characteristic curve (tROC) was drawn, and the prognostic accuracy of CAR, Glasgow prognostic score (GPS), and National Institute of Health (NIH) risk classification was compared by the area under the curve (AUC).
Key findings of the study include:
The best cut-off point of CAR was 0.55. Increased CAR was associated with the location of the lower digestive tract, larger tumor size, higher mitotic index, higher NIH risk classification, lower ALB, higher CRP, and higher GPS.
Multivariable analysis revealed that CAR (hazard ratio [HR] 2.598) was an independent predictor of overall survival.
The AUC of CAR was lower than that of NIH risk classification at 2 years (0.601 vs. 0.775) and 5 years (0.629 vs 0.735).
The AUC of NIH risk classification significantly increased (2-year OS 0.801; 5-year OS 0.777) when combined with CAR.
"CAR is a new independent predictor of poor survival in patients with GIST. CAR combined with NIH risk classification can effectively improve the performance of prognosis prediction," concluded the authors.
Reference:
The study titled, "Preoperative C-Reactive Protein/Albumin Ratio is a Prognostic Indicator for Survival in Surgically Treated Gastrointestinal Stromal Tumors: A Retrospective Cohort Study," is published in the journal Cancer Management and Research.
DOI: https://www.dovepress.com/preoperative-c-reactive-proteinalbumin-ratio-is-a-prognostic-indicator-peer-reviewed-fulltext-article-CMAR#