Prognostic significance of the fibrinogen-to-albumin ratio in gallbladder cancer patients

AIM To investigate the prognostic role of fibrinogen-toalbumin ratio(FAR) on patients with gallbladder cancer(Gbc) in this study.METHODS One hundred and fifty-four Gbc patients were retro-spectively analyzed, who received potentially curative cholecystectomy in our institute from March 2005 to December 2017. Receiver operating characteristic curve(ROc curve) was used to determine the optimal cut-offs for these biomarkers. In addition, Kaplan-Meier survival analysis as well as multivariate analysis were applied for prognostic analyses.RESULTS ROc curve revealed that the optimal cut-off value for FAR was 0.08. FAR was significantly correlated with age(P = 0.045), jaundice(P < 0.001), differentiation(P = 0.002), resection margin status(P < 0.001), T stage(P < 0.001), TNM stage(P < 0.001), and c A199(P < 0.001) as well as albumin levels(P < 0.001). Multivariate analysis indicated that the resection margin status [hazard ratio(HR): 2.343, 95% confidence interval(c I): 1.532-3.581, P < 0.001], TNM stage(P = 0.035), albumin level(HR = 0.595, 95%c I: 0.385-0.921, P = 0.020) and FAR(HR: 2.813, 95%c I: 1.765-4.484, P < 0.001) were independent prognostic factors in Gbc patients.CONCLUSION An elevated preoperative FAR was significantly correlated with unfavorable overall survival in Gbc patients, while an elevated preoperative albumin level was a protective prognostic factor for patients with Gbc. The preoperative FAR could be used to predict the prognosis of Gbc patients, which was easily accessible, costeffective and noninvasive.

Prognostic value of the preoperative fibrinogen-to-albumin ratio in pancreatic ductal adenocarcinoma patients undergoing R0 resection

BACKGROUND Inflammation plays an important role in tumor progression,and growing evidence has confirmed that the fibrinogen-to-albumin ratio(FAR)is an important prognostic factor for overall survival in malignant tumors.AIM To investigate the prognostic significance of FAR in patients undergoing radical R0 resection of pancreatic ductal adenocarcinoma(PDAC).METHODS We retrospectively analyzed the data of 282 patients with PDAC who underwent radical R0 resection at The Cancer Hospital of the Chinese Academy of Medical Sciences from January 2010 to December 2019.The surv_cutpoint function of the R package survminer via RStudio software(version 1.3.1073,http://www.rstudio.org)was used to determine the optimal cut-off values of biological markers,such as preoperative FAR.The Kaplan-Meier method and log-rank tests were used for univariate survival analysis,and a Cox regression model was used for multivariate survival analysis for PDAC patients who underwent radical R0 resection.RESULTS The optimal cut-off value of FAR was 0.08 by the surv_cutpoint function.Higher preoperative FAR was significantly correlated with clinical symptoms(P=0.001),tumor location(P<0.001),surgical approaches(P<0.001),preoperative plasma fibrinogen concentration(P<0.001),and preoperative plasma albumin level(P<0.001).Multivariate analysis showed that degree of tumor differentiation(P<0.001),number of metastatic lymph nodes[hazard ratio(HR):0.678,95%confidence interval(CI):0.509-0.904,P=0.008],adjuvant therapy(HR:1.604,95%CI:1.214-2.118,P=0.001),preoperative cancer antigen 19-9 level(HR:1.740,95%CI:1.288-2.352,P<0.001),and preoperative FAR(HR:2.258,95%CI:1.720-2.963,P<0.001)were independent risk factors for poor prognosis in patients with PDAC who underwent radical R0 resection.CONCLUSION The increase in preoperative FAR was significantly related to poor prognosis in patients undergoing radical R0 resection for PDAC.Preoperative FAR can be used clinically to predict the prognosis of PDAC patients undergoing radical R0 resection.

Fibrinogen-to-albumin ratio predicts overall survival of hepatocellular carcinoma

BACKGROUND Fibrinogen-to-albumin ratio(FAR)has been found to be of prognostic significance for several types of malignant tumors.However,less is known about the association between FAR and survival outcomes in hepatocellular carcinoma(HCC)patients.AIM To explore the association between FAR and prognosis and survival in patients with HCC.METHODS A total of 366 histologically confirmed HCC patients diagnosed between 2013 and 2018 in a provincial cancer hospital in southwestern China were retrospectively selected.Relevant data were extracted from the hospital information system.The optimal cutoff for baseline serum FAR measured upon disease diagnosis was established using the receiver operating characteristic(ROC)curve.Univariate and multivariate Cox proportional hazards models were used to determine the crude and adjusted associations between FAR and the overall survival(OS)of the HCC patients while controlling for various covariates.The restricted cubic spline(RCS)was applied to estimate the dose-response trend in the FAR-OS association.RESULTS The optimal cutoff value for baseline FAR determined by the ROC was 0.081.Multivariate Cox proportional hazards model revealed that a lower baseline serum FAR level was associated with an adjusted hazard ratio of 2.43(95%confidence interval:1.87–3.15)in the OS of HCC patients,with identifiable dose-response trend in the RCS.Subgroup analysis showed that this FAR-OS association was more prominent in HCC patients with a lower baseline serum aspartate aminotransferase or carbohydrate antigen 125 level.CONCLUSION Serum FAR is a prominent prognostic indicator for HCC.Intervention measures aimed at reducing FAR might result in survival benefit for HCC patients.