Preoperative fibrinogen-to-albumin ratio, a potential prognostic factor for patients with stage IB-IIA cervical cancer

BMC Cancer. 2020 Jul 25;20(1):691. doi: 10.1186/s12885-020-07191-8.

Abstract

Background: Previous studies have shown that fibrinogen-to-albumin ratio (FAR) is a novel prognostic immune biomarker in various diseases. In this study, we investigated the role of FAR in the prognosis of patients with stage IB-IIA cervical cancer (CC).

Methods: A total of 278 eligible participants with newly diagnosed CC (stage IB-IIA) who had undergone radical hysterectomy followed by adjuvant chemotherapy were enrolled in this study. Demographics, clinicopathological variables, and laboratory tests were obtained from the medical records. Risk factors for overall survival (OS) and recurrence-free survival (RFS) were evaluated by univariate and multivariate Cox proportional regression analyses. The association between OS, RFS, and FAR was assessed by the Kaplan-Meier method using log-rank test.

Results: FAR was associated with age, International Federation of Gynecology and Obstetrics (FIGO) stage, depth of the invasion, and C-reactive protein (CRP) level (P < 0.05). Preoperative FAR was an effective predictor for OS in CC patients with a cut-off value of 7.75 and an area under the curve (AUC) of 0.707 (P < 0.001). The univariate and multivariate Cox analyses indicated that FIGO stage and FAR were two independent risk factors for both OS and RFS (P < 0.05). Kaplan-Meier analysis confirmed that patients with high FAR levels showed significantly lower RFS (P = 0.004) and OS (P = 0.003) than those with low FAR levels.

Conclusions: This study indicated that elevated preoperative FAR might be a novel prognostic factor for CC patients with stage IB-IIA.

Keywords: Biomarker; Cervical cancer; Fibrinogen-to-albumin ratio; Prognosis.

MeSH terms

  • Age Factors
  • C-Reactive Protein / analysis
  • Carcinoma, Squamous Cell / blood*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Disease-Free Survival
  • Female
  • Fibrinogen / analysis*
  • Humans
  • Hysterectomy
  • Kaplan-Meier Estimate
  • Lymph Node Excision
  • Middle Aged
  • Neoplasm Invasiveness
  • Prognosis
  • Proportional Hazards Models
  • Regression Analysis
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin / analysis*
  • Uterine Cervical Neoplasms / blood*
  • Uterine Cervical Neoplasms / mortality*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / therapy

Substances

  • Serum Albumin
  • Fibrinogen
  • C-Reactive Protein