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The CRP/Albumin Ratio Predicts Survival And Monitors Chemotherapeutic Effectiveness In Patients With Advanced Pancreatic Cancer

Authors Fan Z, Fan K, Gong Y, Huang Q, Yang C, Cheng H, Jin K, Ni Q, Yu X, Luo G, Liu C

Received 6 April 2019

Accepted for publication 14 August 2019

Published 30 September 2019 Volume 2019:11 Pages 8781—8788

DOI https://doi.org/10.2147/CMAR.S211363

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Nicola Ludin

Peer reviewer comments 3

Editor who approved publication: Dr Teng


Zhiyao Fan,1–4,* Kun Fan,1–4,* Yitao Gong,1–4,* Qiuyi Huang,1–4 Chao Yang,1–4 He Cheng,1–4 Kaizhou Jin,1–4 Quanxing Ni,1–4 Xianjun Yu,1–4 Guopei Luo,1–4 Chen Liu1–4

1Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China; 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China; 3Shanghai Pancreatic Cancer Institute, Shanghai, People’s Republic of China; 4Pancreatic Cancer Institute, Fudan University, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Guopei Luo; Chen Liu
Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, 270 Dong An Road, Shanghai 200032, People’s Republic of China
Tel +86-21-6403-1446
Fax +86-21-6403-1446
Email luoguopei@fudanpci.org; liuchen@fudanpci.org

Purpose: The CRP/albumin (Alb) ratio, a recently reported predictor, has shown value for prognosis in various human cancers. This study aimed to determine the prognostic value of baseline CRP/Alb and to explore the relevance between postchemotherapy CRP/Alb and the efficacy of chemotherapy in advanced pancreatic cancer patients.
Patients and methods: Five hundred and ninety-five patients diagnosed with locally advanced or metastatic adenocarcinoma of the pancreas were enrolled. Cut-off Finder was used to calculate the best cut‑off value for baseline CRP/Alb. The primary endpoint was overall survival, which was analyzed by Kaplan-Meier survival curves with 95% confidence intervals. The log rank test and Cox proportional hazard model were used to evaluate the univariate and multivariate analyses.
Results: The optimal cut-off value for baseline CRP/Alb was determined to be 0.18. Both the baseline CRP/Alb (CRP/Alb≥0.18 vs. CRP/Alb<0.18, hazard ratio [HR] = 2.506; p<0.001) and postchemotherapy CRP/Alb (CRP/Alb≥0.18 vs. CRP/Alb<0.18, HR = 1.854; p =0.002) were significant predictors of overall survival according to multivariate analysis and were independent of other factors. Patients with a baseline and postchemotherapy CRP/Alb ≥0.18 had the worst prognosis.
Conclusion: CRP/Alb is a strong and useful indicator of prognosis for advanced pancreatic cancer. Both baseline and postchemotherapy CRP/Alb can be used in predicting the survival of patients and monitoring the effectiveness of chemotherapy in clinical practice.

Keywords: CRP/Alb ratio, pancreatic cancer, prognosis, chemotherapy

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