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. 2021 Jul 20;19(1):218.
doi: 10.1186/s12957-021-02330-2.

Fibrinogen/albumin ratio index is an independent predictor of recurrence-free survival in patients with intrahepatic cholangiocarcinoma following surgical resection

Hu Liu #  1   2 , Guoteng Qiu #  1   2 , Fengjuan Hu  3 , Hong Wu  4   5
Affiliations

Fibrinogen/albumin ratio index is an independent predictor of recurrence-free survival in patients with intrahepatic cholangiocarcinoma following surgical resection

Hu Liu et al. World J Surg Oncol. .

Abstract

Background: Systemic inflammation and nutritional status are associated with tumor development and progression. This study investigated the prognostic value of fibrinogen/albumin ratio index (FARI) in predicting recurrence-free survival (RFS) in patients with intrahepatic cholangiocarcinoma (ICC) undergoing hepatectomy.

Methods: A retrospective cohort was conducted including patients who received curative hepatectomy for ICC at our hospital between May 2010 and December 2016. We collected the preoperative hematologic parameters and clinical data of all patients. Time-dependent receiver operating characteristic curve was used to identify the optimal cutoff value of FARI. The association between FARI-high and FARI-low group was investigated by using the Kaplan-Meier method. A nomogram based on the results of univariate and multivariate analysis was established.

Results: A total of 394 patients with ICC who underwent hepatectomy at our hospital were enrolled. K-M analysis revealed that increased FARI was related to reduced RFS (P < 0.001). The multivariate analysis indicated that tumor number, tumor-node-metastasis stage, lymph node metastasis, cirrhosis, serum carbohydrate antigen 19-9, and FARI were independent predictors of RFS, and the ROC curve analysis showed that the optimal cutoff value for FARI was 0.084 based on the Youden index. The nomogram for FARI showed satisfactory accuracy in predicting RFS for ICC patients undergoing hepatectomy (C index = 0.663; AIC = 3081.07).

Conclusion: Preoperative FARI is an independent predictor of RFS in patients undergoing hepatectomy for ICC, and the nomogram can be useful for clinical decision-making in the postoperative management of these patients.

Keywords: Albumin; Fibrinogen; Fibrinogen-to-albumin ratio; Intrahepatic cholangiocarcinoma; Prognosis; Surgery.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Scores for different parameters used to predict RFS in patients with ICC. Violin plots showing the distribution of FARI (A), GLR (B), NLR (C), and AAPR score (D) in non-relapsed and relapsed groups at the end of follow-up. Solid lines represent the median value; dotted lines represent quartiles. *P < 0.05, **P < 0.01, ***P < 0.001
Fig. 2
Fig. 2
Survival analysis of patients with ICC according to different variables. Kaplan–Meier survival curves of RFS in groups defined by cutoff values of FARI (A), GLR (B), NLR (C), and AAPR score (D)
Fig. 3
Fig. 3
Nomogram for predicting the probability of 1- and 3-year RFS in ICC patients undergoing hepatectomy
See this image and copyright information in PMC

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