Effect of preoperative C-reactive protein/albumin ratio on postoperative survial in gastric adenocarcinomas
Abstract
Background and Aim: Since the survival time is still low in end-stage gastric cancers, additional treatment and prognostic factors are being investigated. This study aimed to evaluate significance of preoperatively measured C-reactive protein (CRP)/ Albumin ratio in gastric adenocarcinomas and effect on postoperative survival.
Patients and Methods: A total of 258 patients underwent elective gastric adenocarcinoma surgery were investigated retrospectively. Disease-free, overall survival were evaluated according to the last CT, MRI and PET/CT scans performed during their follow-up. Demographic data, operation reports, pathology reports and imaging results of thepatients were collected. The preoperative values of CRP and albumin were recorded and CRP/ Albumin ratio was calculated . After exclusion criteria, a total of 208 patients were included in the study.
Results: There was a significant relationship between the preoperatively measured CRP/Albumin ratio and postoperative survival time. The predictive power of the CRP/Albumin ratio on the exitus was 4.7%. The predictive power of CRP/Albumin ratio on the exitus increased up to 42.5% together with the other parameters affecting survival.
Conclusion: High CRP/Albumin ratio measured preoperatively was associated with the low survival in the postoperative period in the patients with gastric adenocarcinomas who underwent curative surgery. Considering the fact that elevation of CRP may not be kept down due to the tumoral tissue, fixing albumin level by the healing of nutritional status of the patients in the preoperative period is the most important way to manage this rate.
References
- H. Sung et al., “Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries,” CA Cancer J Clin, vol. 71, no. 3, pp. 209–249, May 2021, doi: 10.3322/CAAC.21660.
- B. J. Dicken, D. L. Bigam, C. Cass, J. R. Mackey, A. A. Joy, and S. M. Hamilton, “Gastric Adenocarcinoma: Review and Considerations for Future Directions,” Ann Surg, vol. 241, no. 1, p. 27, Jan. 2005, doi: 10.1097/01.SLA.0000149300.28588.23.
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- H. Shimada et al., “High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer,” Gastric Cancer, vol. 13, no. 3, pp. 170–176, Aug. 2010, doi: 10.1007/S10120-010-0554-3.
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- Y. Yu, W. Wu, Y. Dong, and J. Li, “C-Reactive Protein-to-Albumin Ratio Predicts Sepsis and Prognosis in Patients with Severe Burn Injury,” Mediators Inflamm, vol. 2021, 2021, doi: 10.1155/2021/6621101.
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- Q. Yu et al., “Clinical significance and prognostic value of C-reactive protein/albumin ratio in gastric cancer,” Ann Surg Treat Res, vol. 100, no. 6, pp. 338–346, Jun. 2021, doi: 10.4174/ASTR.2021.100.6.338.
- X. Liu et al., “Preoperative C-Reactive Protein/Albumin Ratio Predicts Prognosis of Patients after Curative Resection for Gastric Cancer,” Transl Oncol, vol. 8, no. 4, pp. 339–345, Aug. 2015, doi: 10.1016/J.TRANON.2015.06.006.
- J. Qi, P. Zhang, Y. Wang, H. Chen, and Y. Li, “Does Total Gastrectomy Provide Better Outcomes than Distal Subtotal Gastrectomy for Distal Gastric Cancer? A Systematic Review and Meta-Analysis,” 2016, doi: 10.1371/journal.pone.0165179.
- F. Bozzetti, E. Marubini, G. Bonfanti, R. Miceli, C. Piano, and L. Gennari, “Subtotal versus total gastrectomy for gastric cancer: five-year survival rates in a multicenter randomized Italian trial. Italian Gastrointestinal Tumor Study Group,” Ann Surg, vol. 230, no. 2, pp. 170–178, Aug. 1999, doi: 10.1097/00000658-199908000-00006.
- H. Saito et al., “Prognostic Significance of the Preoperative Ratio of C-Reactive Protein to Albumin and Neutrophil–Lymphocyte Ratio in Gastric Cancer Patients,” World J Surg, vol. 42, no. 6, pp. 1819–1825, Jun. 2018, doi: 10.1007/S00268-017-4400-1/TABLES/2.
- M. Mao et al., “C-reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer,” Oncol Lett, vol. 14, no. 6, pp. 7417–7424, Dec. 2017, doi: 10.3892/OL.2017.7179/HTML.
- S. Lee, J. W. Choe, H. K. Kim, and J. Sung, “High-Sensitivity C-Reactive Protein and Cancer,” J Epidemiol, vol. 21, no. 3, pp. 161–168, May 2011, doi: 10.2188/JEA.JE20100128.
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Abstract
Giriş ve Amaç: Son evre mide kanserlerinde sağ kalım süresi hala düşük olduğundan, ek tedavi ve prognostik faktörler araştırılmaktadır. Bu çalışmada, mide adenokarsinomlarında ameliyat öncesi ölçülen C-reaktif protein (CRP)/Albumin oranının önemi ve ameliyat sonrası sağ kalım üzerindeki etkisinin değerlendirilmesi amaçlanmıştır.
Hastalar ve Yöntemler: Elektif mide adenokarsinom ameliyatı geçiren toplam 258 hasta retrospektif olarak incelendi. Hastalıksız, genel sağ kalım, takipleri sırasında yapılan son BT, MRI ve PET/BT taramalarına göre değerlendirildi. Hastaların demografik verileri, ameliyat raporları, patoloji raporları ve görüntüleme sonuçları toplandı. Ameliyat öncesi CRP ve albümin değerleri kaydedildi ve CRP/Albumin oranı hesaplandı. Dışlama kriterlerinden sonra, toplam 208 hasta çalışmaya dahil edildi.
Sonuçlar: Ameliyat öncesi ölçülen CRP/Albumin oranı ile ameliyat sonrası sağ kalım süresi arasında anlamlı bir ilişki vardı. CRP/Albumin oranının ölümü belirmedeki öngörü gücü %4.7 idi. CRP/Albumin oranının ölümü öngörü gücü, sağkalımı etkileyen diğer parametrelerle birlikte %42.5'e kadar yükseldi.
Sonuç: Ameliyat öncesi ölçülen yüksek CRP/Albumin oranı, küratif cerrahi geçiren gastrik adenokarsinomlu hastalarda postoperatif dönemde düşük sağkalımla ilişkiliydi. CRP yüksekliğinin tümör dokusu nedeniyle düşük tutulamayabileceği gerçeği göz önüne alındığında, ameliyat öncesi dönemde hastaların beslenme durumunun iyileşmesiyle albumin düzeyinin sabitlenmesi bu oranı yönetmenin en önemli yoludur.
References
- H. Sung et al., “Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries,” CA Cancer J Clin, vol. 71, no. 3, pp. 209–249, May 2021, doi: 10.3322/CAAC.21660.
- B. J. Dicken, D. L. Bigam, C. Cass, J. R. Mackey, A. A. Joy, and S. M. Hamilton, “Gastric Adenocarcinoma: Review and Considerations for Future Directions,” Ann Surg, vol. 241, no. 1, p. 27, Jan. 2005, doi: 10.1097/01.SLA.0000149300.28588.23.
- I. H. Kim, “Current status of adjuvant chemotherapy for gastric cancer,” World J Gastrointest Oncol, vol. 11, no. 9, p. 679, Sep. 2019, doi: 10.4251/WJGO.V11.I9.679.
- H. Shimada et al., “High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer,” Gastric Cancer, vol. 13, no. 3, pp. 170–176, Aug. 2010, doi: 10.1007/S10120-010-0554-3.
- M. W. Kattan, M. S. Karpeh, M. Mazumdar, and M. F. Brennan, “Postoperative nomogram for disease-specific survival after an R0 resection for gastric carcinoma,” J Clin Oncol, vol. 21, no. 19, pp. 3647–3650, Oct. 2003, doi: 10.1200/JCO.2003.01.240.
- V. E. Strong et al., “Comparison of gastric cancer survival following R0 resection in the United States and Korea using an internationally validated nomogram,” Ann Surg, vol. 251, no. 4, pp. 640–646, Apr. 2010, doi: 10.1097/SLA.0B013E3181D3D29B.
- Y. Yu, W. Wu, Y. Dong, and J. Li, “C-Reactive Protein-to-Albumin Ratio Predicts Sepsis and Prognosis in Patients with Severe Burn Injury,” Mediators Inflamm, vol. 2021, 2021, doi: 10.1155/2021/6621101.
- Y. J. Fu, K. Z. Li, J. H. Bai, and Z. Q. Liang, “C-reactive protein/albumin ratio is a prognostic indicator in Asians with pancreatic cancers: A meta-analysis,” Medicine, vol. 98, no. 48, Nov. 2019, doi: 10.1097/MD.0000000000018219.
- Q. Yu et al., “Clinical significance and prognostic value of C-reactive protein/albumin ratio in gastric cancer,” Ann Surg Treat Res, vol. 100, no. 6, pp. 338–346, Jun. 2021, doi: 10.4174/ASTR.2021.100.6.338.
- X. Liu et al., “Preoperative C-Reactive Protein/Albumin Ratio Predicts Prognosis of Patients after Curative Resection for Gastric Cancer,” Transl Oncol, vol. 8, no. 4, pp. 339–345, Aug. 2015, doi: 10.1016/J.TRANON.2015.06.006.
- J. Qi, P. Zhang, Y. Wang, H. Chen, and Y. Li, “Does Total Gastrectomy Provide Better Outcomes than Distal Subtotal Gastrectomy for Distal Gastric Cancer? A Systematic Review and Meta-Analysis,” 2016, doi: 10.1371/journal.pone.0165179.
- F. Bozzetti, E. Marubini, G. Bonfanti, R. Miceli, C. Piano, and L. Gennari, “Subtotal versus total gastrectomy for gastric cancer: five-year survival rates in a multicenter randomized Italian trial. Italian Gastrointestinal Tumor Study Group,” Ann Surg, vol. 230, no. 2, pp. 170–178, Aug. 1999, doi: 10.1097/00000658-199908000-00006.
- H. Saito et al., “Prognostic Significance of the Preoperative Ratio of C-Reactive Protein to Albumin and Neutrophil–Lymphocyte Ratio in Gastric Cancer Patients,” World J Surg, vol. 42, no. 6, pp. 1819–1825, Jun. 2018, doi: 10.1007/S00268-017-4400-1/TABLES/2.
- M. Mao et al., “C-reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer,” Oncol Lett, vol. 14, no. 6, pp. 7417–7424, Dec. 2017, doi: 10.3892/OL.2017.7179/HTML.
- S. Lee, J. W. Choe, H. K. Kim, and J. Sung, “High-Sensitivity C-Reactive Protein and Cancer,” J Epidemiol, vol. 21, no. 3, pp. 161–168, May 2011, doi: 10.2188/JEA.JE20100128.
- D. Gupta and C. G. Lis, “Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literature,” Nutr J, vol. 9, no. 1, pp. 1–16, Dec. 2010, doi: 10.1186/1475-2891-9-69/TABLES/5.
Details
| Primary Language | English |
|---|---|
| Subjects | Oncologic Surgery, General Surgery |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | December 9, 2024 |
| Submission Date | July 26, 2024 |
| Acceptance Date | July 30, 2024 |
| Published in Issue | Year 2024Volume: 63 Issue: 4 |
