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Prognostic significance of C-reactive protein to albumin ratio in colorectal cancer patients: a meta-analysis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Inconsistent results on the prognostic significance of C-reactive protein to albumin ratio (CAR) in colorectal cancer patients have been reported. This meta-analysis sought to assess the prognostic value of pretreatment CAR for survival outcomes in colorectal cancer patients.

Methods

We conducted a systematic literature search of PubMed and Embase databases until February 16, 2019. Observational studies investigating the prognostic role of pretreatment CAR for survival outcome in patients with colorectal cancer were included. Outcome measures included overall survival (OS), disease-free survival (DFS), or progression-free survival (PFS). Pooled hazard ratio (HR) with 95% confidence interval (CI) was utilized to summarize the prognostic significance of CAR for patient survival.

Results

Nine retrospective studies involving 2492 colorectal cancer patients were identified. A fixed-effect model meta-analysis showed that high pretreatment CAR was an independent predictor of poor OS (HR 2.25; 95% CI 1.84–2.76) and DFS (HR 2.49; 95% CI 1.43–4.33). On the other hand, no significant association was observed between high CAR and PFS (HR 1.71; 95% CI 0.44–6.60). The predictive values of OS with high pretreatment CAR caused no significant changes in different sample sizes, countries, cut-off values of CAR, treatment methods, and study quality of subgroups.

Conclusion

This meta-analysis suggests that CAR may be a powerful prognostic indicator for colorectal cancer prognosis. High pretreatment CAR is associated with poor OS and DFS in patients with colorectal cancer.

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Funding

This work was supported by (1) Jiangsu Provincial Key Research and Development Special Fund (BE2015666), (2) Jiangsu Innovative Team Leading Talent Fund (CXTDC2016006, QNRC2016446), (3) Natural Science Foundation of Jiangsu (BK20171304), (4) Jiangsu Six High Peak Talent Fund (WSW-205), and (5) Jiangsu 333 Talent Fund (BRA2016140).

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Authors and Affiliations

  1. Cancer Institute, the Affiliated People’s Hospital, Jiangsu University, Zhenjiang, 212002, Jiangsu, China

    Yu Fan, Shouyan Xiang, Zhe Dai & Chen Zou

  2. Department of Digestive Disease,The first people’s Hospital of Suqian City, Suqian, 223800, Jiangsu, China

    Xiaoyan Wang

  3. Department of Digestive Disease, Central Hospital of Shanghai Qingpu District, No. 1158 East Road, Qingpu District, Shanghai, 201700, People’s Republic of China

    Zhenjun Gao

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  1. Yu Fan
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  2. Shouyan Xiang
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  3. Zhe Dai
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  4. Chen Zou
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  5. Xiaoyan Wang
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Correspondence to Zhenjun Gao.

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Fan, Y., Xiang, S., Dai, Z. et al. Prognostic significance of C-reactive protein to albumin ratio in colorectal cancer patients: a meta-analysis. Int J Colorectal Dis 34, 1105–1111 (2019). https://doi.org/10.1007/s00384-019-03299-x

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