Published online Aug 7, 2018. doi: 10.3748/wjg.v24.i29.3281
Peer-review started: April 20, 2018
First decision: June 6, 2018
Revised: June 16, 2018
Accepted: June 27, 2018
Article in press: June 27, 2018
Published online: August 7, 2018
To investigate the prognostic role of fibrinogen-to-albumin ratio (FAR) on patients with gallbladder cancer (GBC) in this study.
One hundred and fifty-four GBC patients were retrospectively 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.
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 CA199 (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 (CI): 1.532-3.581, P < 0.001], TNM stage (P = 0.035), albumin level (HR = 0.595, 95%CI: 0.385-0.921, P = 0.020) and FAR (HR: 2.813, 95%CI: 1.765-4.484, P < 0.001) were independent prognostic factors in GBC patients.
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, cost-effective and noninvasive.
Core tip: The vital prognostic significance of fibrinogen and serum albumin has been confirmed in diverse malignancies, presenting host hemostasis and nutrition, respectively. Moreover, elevated plasma fibrinogen and reduced serum albumin levels are significantly related to shortened survival of cancer patients. It is reported that fibrinogen-to-albumin ratio (FAR) is more potent in predicting cancer patient prognosis than elevated fibrinogen or reduced serum albumin level alone. Nevertheless, there has been no study on the prognostic role of FAR in gallbladder cancer (GBC). Herein, we defined an elevated preoperative FAR, featured by noninvasiveness, cost-effectiveness and easily-accessible, which was a potential prognostic indicator for GBC.