Impact of the Preoperative C-reactive Protein to Albumin Ratio on the Long-Term Outcomes of Hepatic Resection for Intrahepatic Cholangiocarcinoma

Asian Pac J Cancer Prev. 2020 Aug 1;21(8):2373-2379. doi: 10.31557/APJCP.2020.21.8.2373.

Abstract

Objective: The present study aimed to investigate the impact of preoperative C-reactive protein to albumin (CRP/Alb) ratio on the long-term outcomes of patients with intrahepatic cholangiocarcinoma (ICC).

Methods: 82 patients who underwent hepatic resection for mass-forming type of ICC were evaluated. The relationship between preoperative CRP/Alb ratio and survival outcomes was investigated.

Results: The optimal cutoff value of CRP/Alb ratio for assessing overall survival (OS) was determined as 0.089. Univariate analysis for recurrence-free survival (RFS) showed that CRP/Alb ratio >0.089, carbohydrate antigen 19-9 (CA 19-9) >37 U/mL, lymph node metastasis, vascular invasion, and multiple tumors were significantly associated with postoperative recurrence. On multivariate analysis, the independent prognostic factors identified were CRP/Alb ratio >0.089 (p < 0.001), lymph node metastasis (p = 0.006), and multiple tumors (p < 0.001). Univariate analysis for OS showed that CRP/Alb ratio >0.089, CA 19-9 >37 U/mL, lymph node metastasis, vascular invasion, multiple tumors, and positive surgical margin were significantly associated with overall death. On multivariate analysis, the independent prognostic factors identified were CRP/Alb ratio >0.089 (p < 0.001), lymph node metastasis (p = 0.01), and multiple tumors (p = 0.005).

Conclusion: Preoperative CRP/Alb ratio may predict poor long-term outcomes after hepatic resection in patients with ICC.<br />.

Keywords: CRP/Alb ratio; Hepatic resection; Intrahepatic cholangiocarcinoma; Prognostic factor.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Duct Neoplasms / blood
  • Bile Duct Neoplasms / mortality*
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / surgery
  • Biomarkers, Tumor / blood*
  • C-Reactive Protein / analysis*
  • Cholangiocarcinoma / blood
  • Cholangiocarcinoma / mortality*
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / surgery
  • Female
  • Follow-Up Studies
  • Hepatectomy / mortality*
  • Humans
  • Male
  • Middle Aged
  • Preoperative Care*
  • Prognosis
  • Retrospective Studies
  • Serum Albumin / analysis*
  • Survival Rate

Substances

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