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. 2022 Jun 27;14(6):580-593.
doi: 10.4240/wjgs.v14.i6.580.

Prognostic significance of the preoperative hemoglobin to albumin ratio for the short-term survival of gastric cancer patients

Ce-Gui Hu  1 , Bai-E Hu  1 , Jin-Feng Zhu  1 , Zheng-Ming Zhu  1 , Chao Huang  2
Affiliations

Prognostic significance of the preoperative hemoglobin to albumin ratio for the short-term survival of gastric cancer patients

Ce-Gui Hu et al. World J Gastrointest Surg. .

Abstract

Background: Hemoglobin and albumin are associated with the prognosis of gastric cancer (GC) patients. However, the prognostic value of the hemoglobin to albumin ratio (HAR) for the short-term survival of GC patients with D2 radical resection has not been studied.

Aim: To investigate the significance of the HAR in evaluating the short-term survival of GC patients after D2 radical resection and to construct a nomogram to predict the prognosis in GC patients after surgery, thus providing a reference for the development of postoperative individualized treatment and follow-up plans.

Methods: Cox regression and Kaplan-Meier analysis was used for prognostic analysis. Logistic regression was used to analyze the relationships between HAR and the clinicopathological characteristics of the GC patients. A prognostic nomogram model for the short-term survival of GC patients was constructed by R software.

Results: HAR was an independent risk factor for the short-term survival of GC patients. GC patients with a low HAR had a poor prognosis (P < 0.001). Low HAR was markedly related to high stage [odds ratio (OR) = 0.45 for II vs I; OR = 0.48 for III vs I], T classification (OR = 0.52 for T4 vs T1) and large tumor size (OR = 0.51 for ≥ 4 cm vs < 4 cm) (all P < 0.05). The nomogram model was based on HAR, age, CA19-9, CA125 and stage, and the C-index was 0.820.

Conclusion: Preoperative low HAR was associated with short-term survival in GC patients. The prognostic nomogram model can accurately predict the short-term survival of GC patients with D2 radical resection.

Keywords: Gastric cancer; Hemoglobin to albumin ratio; Nomogram; Prognosis; Short-term survival.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Survival curve of gastric cancer patients with low hemoglobin to albumin ratio and high hemoglobin to albumin ratio. HAR: Hemoglobin to albumin ratio; HR: Hazard ratio.
Figure 2
Figure 2
Association between hemoglobin to albumin ratio and clinicopathological characteristics, including grade, stage, T classification, N classification, tumor size, vascular infiltration, nerve infiltration and age. HAR: Hemoglobin to albumin ratio.
Figure 3
Figure 3
Relationships between hemoglobin to albumin ratio and prognostic factors, including stage, T classification, and tumor size, CA125, fibrinogen to lymphocyte ratio, platelet to albumin ratio, platelet to lymphocyte ratio and hemoglobin to fibrinogen ratio. HAR: Hemoglobin to albumin ratio; FLR: Fibrinogen to lymphocyte ratio; HFR: Hemoglobin to fibrinogen ratio; PAR: Platelet to albumin ratio; PLR: Platelet to lymphocyte ratio.
Figure 4
Figure 4
Receiver operating characteristic curve of hemoglobin to albumin ratio or combined factors to predict the short-term survival of gastric cancer patients. HAR: Hemoglobin to albumin ratio; AUC: Area under the curve.
Figure 5
Figure 5
Nomogram of the logistic regression model. HAR: Hemoglobin to albumin ratio.
See this image and copyright information in PMC

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