Potential prognostic factors for predicting the chemotherapeutic outcomes and prognosis of patients with metastatic colorectal cancer

Abstract

Objectives: The purpose of this study was to explore whether pretreatment potential prognostic factors are related to chemotherapeutic outcomes and the prognosis of inpatients with metastatic colorectal cancer (mCRC) undergoing chemotherapy.

Materials and methods: Data from 71 patients with mCRC were analyzed retrospectively. The relationship between the potential prognostic factors before first-line chemotherapy and the clinicopathological characteristics and chemotherapy response of the patients was calculated using Fisher's exact test and the chi-square test. The prognostic factors were analyzed using univariate and multivariate analyses. We analyzed the subgroups using the Mann-Whitney U test.

Results: Four factors were eventually used as prognostic factors, namely the albumin-to-globulin ratio (AGR), the fibrinogen-to-albumin ratio (FAR), the prealbumin-to-globulin ratio (PGR), and the fibrinogen-to-prealbumin ratio (FPR); the cutoff values of the four potential prognostic factors were 1.40, 10.63, 5.44, and 18.49, respectively. The high AGR and PGR groups had a higher response rate than that of the low groups. Patients in the low FAR and FPR groups showed a higher objective response rate than the high FAR and FPR groups. Patients with low FPR were associated with a higher disease control rate than patients with high FPR. Higher progression-free survival (PFS) was observed in the high AGR and PGR and low FAR and FPR groups. The AGR, FAR, PGR, and FPR were considered reliable prognostic factors for PFS in a univariate analysis.

Conclusions: The prechemotherapy AGR, FAR, PGR, and FPR were good prognostic factors to predict the chemotherapy response and PFS in patients with mCRC.

Keywords: FAR; PGR; chemotherapy response; colorectal cancer; prealbumin; prealbumin to globulin.

Figure 1

Receiver operating characteristic curve analysis of the albumin‐to‐globulin ratio (AGR), the lymphocyte‐to‐monocyte ratio (LMR), and the prealbumin‐to‐globulin ratio (PGR) (A), and the neutrophil‐to‐lymphocyte ratio (NLR), the fibrinogen‐to‐albumin ratio (FAR), the platelet‐to‐lymphocyte ratio (PLR), and the fibrinogen‐to‐prealbumin ratio (FPR) (B) in patients with metastatic colorectal cancer

Figure 2

Kaplan‐Meier survival curve analysis of the relationship between the pretreatment albumin‐to‐globulin ratio (AGR) (A), the fibrinogen‐to‐albumin ratio (FAR) (B), the prealbumin‐to‐globulin ratio (PGR) (C), and the fibrinogen‐to‐prealbumin ratio (FPR) (D), and progression‐free survival (PFS)

Figure 3

Pearson's correlation analysis for the linear relationship between the albumin‐to‐globulin ratio (AGR) (A), the fibrinogen‐to‐albumin ratio (FAR) (B), the prealbumin‐to‐globulin ratio (PGR) (C), and the fibrinogen‐to‐prealbumin ratio (FPR) (D), and progression‐free survival (PFS)