Clinical Implication of Pre-operative C-reactive Protein-Albumin Ratio as a Prognostic Factor of Patients With Pancreatic Ductal Adenocarcinoma: A Single-institutional Retrospective Study.

Abstract

BACKGROUND:

The C-reactive protein (CRP)-to-serum albumin ratio is associated with a poor prognosis in patients with several cancers. The purpose of this study was to clarify the relationship between the preoperative CRP/Alb ratio and overall survival of pancreatic ductal adenocarcinoma (PDAC) in patients who received radical surgery and S-1 adjuvant chemotherapy.

PATIENTS AND METHODS:

We included 117 patients who underwent radical surgery with S-1 adjuvant chemotherapy. We constructed receiver operating characteristic curve (ROC curve) of the CRP/Alb ratio to determine the cut-off value. We analyzed the relationship among the CRP/Alb ratio, clinicopathological status, and survival.

RESULTS:

The optimal cut-off value of the CRP/Alb ratio was 0.036. All patients were divided into a high-ratio group (CRP/Alb ratio ≥0.036) and low-ratio group (CRP/Alb ratio <0.036). The 5-year overall survival (OS) rates in the high- and low-ratio groups were 22.5% and 36.4%, respectively (p=0.0089). The 5-year disease-free survival (DFS) rates in the high- and low-ratio groups were 12.5% and 22.1%, respectively (p=0.0097). The univariate and multivariate analyses of the OS showed that the pathological N factor and CRP/Alb ratio were independent factors of the survival. The univariate and multivariate analyses of the RFS showed that the pathological N factor, resection margin, and CRP/Alb ratio were independent factors of the survival.

CONCLUSION:

The preoperative CRP/Alb ratio is a strong prognostic factor for PDAC patients with undergo curative resection with S-1 adjuvant chemotherapy.

• Authors: Masaaki Murakawa, Naoto Yamamoto, Yuto Kamioka, Mariko Kamiya, Satoshi Kobayashi, Makoto Ueno, Manabu Morimoto, Yosuke Atsumi, Toru Aoyama, Hiroshi Tamagawa, Norio Yukawa, Yasushi Rino, Munetaka Masuda, Soichiro Morinaga
• Journal: In vivo (Athens, Greece) (In Vivo) 2020 Jan-Feb Vol. 34 Issue 1 Pg. 347-353 ISSN: 1791-7549 [Electronic] Greece
• PMID: 31882498 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Chemical References

• Biomarkers, Tumor
• Serum Albumin
• C-Reactive Protein

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biomarkers, Tumor (analysis)
• C-Reactive Protein (analysis)
• Carcinoma, Pancreatic Ductal (metabolism, mortality, pathology, therapy)
• Chemotherapy, Adjuvant (mortality)
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Pancreatectomy (mortality)
• Pancreatic Neoplasms (metabolism, mortality, pathology, therapy)
• Prognosis
• ROC Curve
• Retrospective Studies
• Serum Albumin (analysis)
• Survival Rate