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Meta-Analysis
. 2025 May 16;23(1):196.
doi: 10.1186/s12957-025-03832-z.

Prognostic and clinicopathological value of fibrinogen-to-albumin ratio in non-small cell lung cancer: a meta-analysis

Ling Tong #  1 , Hui Hu #  2 , Jiashan Li  3 , Lihai Pan  4
Affiliations
Meta-Analysis

Prognostic and clinicopathological value of fibrinogen-to-albumin ratio in non-small cell lung cancer: a meta-analysis

Ling Tong et al. World J Surg Oncol. .

Abstract

Background: The fibrinogen-to-albumin ratio (FAR) has been explored for its role in predicting non-small cell lung cancer (NSCLC) prognosis, but findings remain inconsistent. This study aimed to determine the exact impact of FAR on predicting NSCLC prognosis through a meta-analysis.

Methods: This study conducted a comprehensive search of PubMed, Web of Science, Embase, Cochrane Library, and CNKI up to April 2, 2025, and determined pooled hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate the prognostic value of FAR in NSCLC.

Results: This meta-analysis included seven studies with a total of 2,655 cases. The pooled analysis revealed that an elevated FAR significantly predicted poor overall survival (OS) (HR = 1.82, 95% CI = 1.56-2.14, p < 0.001) and poor progression-free survival (PFS) (HR = 1.50, 95% CI = 1.29-1.74, p < 0.001) in patients with NSCLC, which was strongly associated with male sex (OR = 1.53, 95% CI = 1.12-2.08, p = 0.008) and tumor size ≥ 5 cm (OR = 1.52, 95% CI = 1.08-2.14, p = 0.017). However, FAR showed no significant correlation with smoking history (OR = 1.44, 95% CI = 0.80-2.59, p = 0.218) or Eastern Cooperative Oncology Group performance status (OR = 1.60, 95% CI = 0.74-3.45, p = 0.230).

Conclusion: This meta-analysis suggests that elevated FAR is a strong predictor of OS and PFS in patients with Chinese NSCLC and correlates with larger tumor size.

Keywords: Evidence-based medicine; Fibrinogen-to-albumin ratio; Meta-analysis; Non-small cell lung cancer; Prognosis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the literature retrieval and selection for this study
Fig. 2
Fig. 2
Forest plots of the prognostic value of FAR for OS in patients with NSCLC
Fig. 3
Fig. 3
Forest plots of the prognostic value of FAR for PFS in patients with NSCLC
Fig. 4
Fig. 4
The correlation between FAR and clinicopathological factors of NSCLC. (A) Gender (male vs. female); (B) Smoking history (yes vs. no); (C) ECOG PS (≥ 1 vs. 0); and (D) Tumor size (cm) (≥ 5 vs. < 5)
Fig. 5
Fig. 5
Sensitivity analysis. (A) OS and (B) PFS
Fig. 6
Fig. 6
Publication bias by Begg’s test and Egger’s test. (A) Begg’s test for OS, p = 0.133; (B) Egger’s test for OS, p = 0.140; (C) Begg’s test for PFS, p = 0.221; and (D) Egger’s test for PFS, p = 0.183
See this image and copyright information in PMC

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