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. 2023 Sep 15;15(9):1662-1672.
doi: 10.4251/wjgo.v15.i9.1662.

Fibrinogen-to-albumin ratio predicts overall survival of hepatocellular carcinoma

Hao Sun  1 , Jie Ma  2 , Jian Lu  2 , Zhi-Hong Yao  2 , Hai-Liang Ran  1 , Hai Zhou  2 , Zhong-Qin Yuan  2 , Yun-Chao Huang  2 , Yuan-Yuan Xiao  3
Affiliations

Fibrinogen-to-albumin ratio predicts overall survival of hepatocellular carcinoma

Hao Sun et al. World J Gastrointest Oncol. .

Abstract

Background: Fibrinogen-to-albumin ratio (FAR) has been found to be of prognostic significance for several types of malignant tumors. However, less is known about the association between FAR and survival outcomes in hepatocellular carcinoma (HCC) patients.

Aim: To explore the association between FAR and prognosis and survival in patients with HCC.

Methods: A total of 366 histologically confirmed HCC patients diagnosed between 2013 and 2018 in a provincial cancer hospital in southwestern China were retrospectively selected. Relevant data were extracted from the hospital information system. The optimal cutoff for baseline serum FAR measured upon disease diagnosis was established using the receiver operating characteristic (ROC) curve. Univariate and multivariate Cox proportional hazards models were used to determine the crude and adjusted associations between FAR and the overall survival (OS) of the HCC patients while controlling for various covariates. The restricted cubic spline (RCS) was applied to estimate the dose-response trend in the FAR-OS association.

Results: The optimal cutoff value for baseline FAR determined by the ROC was 0.081. Multivariate Cox proportional hazards model revealed that a lower baseline serum FAR level was associated with an adjusted hazard ratio of 2.43 (95% confidence interval: 1.87-3.15) in the OS of HCC patients, with identifiable dose-response trend in the RCS. Subgroup analysis showed that this FAR-OS association was more prominent in HCC patients with a lower baseline serum aspartate aminotransferase or carbohydrate antigen 125 level.

Conclusion: Serum FAR is a prominent prognostic indicator for HCC. Intervention measures aimed at reducing FAR might result in survival benefit for HCC patients.

Keywords: Cox proportional hazards model; Fibrinogen-to-albumin ratio; Hepatocellular carcinoma; Overall survival; Survival analysis.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curves for hepatocellular carcinoma patients with different baseline fibrinogen-to-albumin ratio levels. FAR: Fibrinogen-to-albumin ratio.
Figure 2
Figure 2
Dose-response association between baseline fibrinogen-to-albumin ratio and the overall survival of hepatocellular carcinoma by using the quartiles.
Figure 3
Figure 3
Dose-response relationship between quantitative baseline fibrinogen-to-albumin ratio and the overall survival of hepatocellular carcinoma patients by using the restricted cubic spline. FAR: Fibrinogen-to-albumin ratio; HR: Hazard ratio.
Figure 4
Figure 4
Subgroup analysis stratified by aspartate aminotransferase, carbohydrate antigen 125 and clinical stage. 95%CI: 95% confidence interval; AST: Aspartate aminotransferase; CA125: Carbohydrate antigen 125; HR: Hazard ratio.
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