Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 25;7(4):273-283.
doi: 10.23922/jarc.2023-016. eCollection 2023.

Prognostic Value of C-reactive Protein-to-albumin Ratio after Curative Resection in Patients with Colorectal Cancer

Koki Tamai  1 , Hajime Hirose  1 , Shu Okamura  1 , Yo Akazawa  1 , Masahiro Koh  1 , Koji Hayashi  1 , Yoshiteru Katsura  1 , Natsumi Tanaka  1 , Chikara Ebisui  1 , Masahiko Yano  1
Affiliations

Prognostic Value of C-reactive Protein-to-albumin Ratio after Curative Resection in Patients with Colorectal Cancer

Koki Tamai et al. J Anus Rectum Colon. .

Abstract

Objectives: The current retrospective study aimed to evaluate the association between combined preoperative and postoperative C-reactive protein-to-albumin ratio, which is correlated with prognosis in different types of malignancies, and prognosis after curative resection in patients with colorectal cancer.

Methods: This study enrolled 263 patients who underwent curative resection for stage II/III colorectal cancer. C-reactive protein-to-albumin ratio was calculated within 30 days before and 7 days after surgery. Receiver operating characteristic curve analyses were performed to determine the optimal cutoff values of preoperative and postoperative C-reactive protein-to-albumin ratio. The correlations between combined preoperative and postoperative C-reactive protein-to-albumin ratio and prognosis were analyzed.

Results: The cutoff values of preoperative and postoperative C-reactive protein-to-albumin ratio were 0.223 and 0.813, respectively; higher ratios were significantly associated with poor overall survival, based on the Kaplan-Meier curves (p < 0.001, p = 0.003, respectively). Further, preoperative and postoperative C-reactive protein-to-albumin ratios were correlated with poor progression-free survival (p < 0.001, p = 0.064, respectively). In the multivariate analysis, combined preoperative and postoperative C-reactive protein-to-albumin ratio was an independent predictor of overall survival and progression-free survival (p = 0.012, p = 0.044, respectively). Compared with low preoperative and postoperative C-reactive protein-to-albumin ratio, high ratios of that were significantly associated with poor overall survival (hazard ratio = 3.897, p = 0.006) and progression-free survival (hazard ratio = 2.130, p = 0.029).

Conclusions: Combined preoperative and postoperative C-reactive protein-to-albumin ratio, useful for prognostic prediction, can be a promising prognostic marker after curative resection in patients with colorectal cancer.

Keywords: C-reactive protein; albumin; colorectal cancer; prognosis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest There are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Correlation between preoperative and postoperative CAR. CAR C-reactive protein-to-albumin ratio
Figure 2.
Figure 2.
Receiver operating characteristics curves of preoperative (a) and postoperative (b) CAR of overall survival in patients with colorectal cancer after curative resection. CAR C-reactive protein-to-albumin ratio
Figure 3.
Figure 3.
Overall survival (a) and progression-free survival (b) according to preoperative CAR and overall survival (c) and progression-free survival (d) according to postoperative CAR. CAR C-reactive protein-to-albumin ratio
Figure 4.
Figure 4.
Overall survival (a) and progression-free survival (b) according to combined preoperative and postoperative CAR (*, p = 0.006; **, p = 0.013; ***, p < 0.001; ****, p = 0.041). CAR C-reactive protein-to-albumin ratio
See this image and copyright information in PMC

References

    1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a Cancer Journal for Clinicians. 2021 May; 71(3): 209-49. - PubMed
    1. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002 Dec; 420(6917): 860-7. - PMC - PubMed
    1. Diakos CI, Charles KA, McMillan DC, et al. Cancer-related inflammation and treatment effectiveness. Lancet Oncol. 2014 Oct; 15(11): e493-503. - PubMed
    1. Dupré A, Malik HZ. Inflammation and cancer: what a surgical oncologist should know. European Journal of Surgical Oncology. 2018 May; 44(5): 566-70. - PubMed
    1. Ni HH, Lu Z, Huang X, et al. Combining pre- and postoperative lymphocyte-C-reactive protein ratios can better predict hepatocellular carcinoma prognosis after partial hepatectomy. Journal of Inflammation Research. 2022 Apr; 15: 2229-41. - PMC - PubMed