Details

Autor(en) / Beteiligte

• Matsumoto, T.
• Itoh, S.
• Yoshizumi, T.
• Kurihara, T.
• Yoshiya, S.
• Mano, Y.
• Takeishi, K.
• Harada, N.
• Ikegami, T.
• Soejima, Y.
• Baba, H.
• Mori, M.

Titel

C‐reactive protein : albumin ratio in patients with resectable intrahepatic cholangiocarcinoma

Ist Teil von

• BJS open, 2020-12, Vol.4 (6), p.1146-1152

Ort / Verlag

Chichester, UK: John Wiley & Sons, Ltd

Erscheinungsjahr

2020

Quelle

Wiley-Blackwell subscription journals

Beschreibungen/Notizen

• Background The C‐reactive protein : albumin ratio (CAR) has been reported as a novel prognostic marker in several cancers. The aim of this study was to investigate the prognostic value of CAR in patients with intrahepatic cholangiocarcinoma (ICC). Methods This was a single‐centre retrospective study of patients who underwent surgery for ICC in a university hospital in Japan between 1998 and 2018. CAR, Glasgow Prognostic Score (GPS) and modified GPS (mGPS) were calculated. Their correlation with recurrence‐free survival (RFS) and overall survival (OS) was analysed with Cox proportional hazards models. Results Seventy‐two patients were included in the study. Patients were divided into two groups according to the optimal CAR cut‐off value of 0·02. CAR above 0·02 was associated with higher carbohydrate antigen 19‐9 levels (20·5 versus 66·1 units/ml for CAR of 0·02 or less; P = 0·002), larger tumour size (3·2 versus 4·4 cm respectively; P = 0·031) and a higher rate of microvascular invasion (9 of 28 versus 25 of 44; P = 0·041). RFS and OS were shorter in patients with CAR above 0·02: hazard ratio (HR) 4·31 (95 per cent c.i. 2·02 to 10·63) and HR 4·80 (1·85 to 16·40) respectively. In multivariable analysis CAR above 0·02 was an independent prognostic factor of RFS (HR 3·29 (1·33 to 8·12); P < 0·001), but not OS. Conclusions CAR was associated with prognosis in patients who had hepatic resection for ICC. Antecedentes La relación proteína C reactiva/albumina (C‐reactive protein/albumin ratio, CAR) ha sido descrita como un marcador pronóstico novedoso en varios tipos de cáncer. El objetivo de este estudio fue investigar el valor pronóstico de CAR en pacientes con colangiocarcinoma intrahepático (intrahepatic cholangiocarcinoma, ICC). Métodos Se trata de un estudio retrospectivo y unicéntrico de pacientes sometidos a cirugía por ICC en un hospital universitario de Japón entre 1998 y 2018. Se calcularon CAR, puntuación pronóstica de Glasgow (Glasgow prognostic score, GPS), y GPS modificada (mGPS). Se analizó su correlación con la supervivencia libre de recidiva (recurrence‐free survival, RFS) y con la supervivencia global (overall survival, OS) mediante modelos de riesgos proporcionales de Cox. Resultados Se incluyeron un total de 72 pacientes. El valor de corte óptimo de CAR fue de 0,02. Los pacientes se dividieron en dos grupos de acuerdo a este valor de corte. La presencia de CAR > 0,02 se asoció con niveles más elevados de antígeno carbohidrato 19‐9 (20,5 U/ml versus 66,1 U/ml; P = 0,002), mayor tamaño tumoral (3,2 cm versus 4,4 cm; P = 0,031) y una tasa más elevada de invasión microvascular (32,1% versus 56,8%; P = 0,041). La RFS y OS fueron más cortas en pacientes con CAR > 0,02 (cociente de riesgos instantáneos, hazard ratio, HR 4,305; i.c. del 95% 2,016‐10,63 y HR 4,803; i.c. del 95% 1,846‐16,40, respectivamente). En los análisis multivariables, CAR de > 0,02 fue un factor pronóstico independiente para RFS (HR 3,286; i.c. del 95% 1,330‐8,118; P < 0,001), pero no para la OS. Conclusión CAR se asoció con el pronóstico en pacientes sometidos a resección hepática por ICC. This study showed that a high C‐reactive protein : albumin ratio (CAR) is an independent predictor of poor recurrence‐free survival in patients with intrahepatic cholangiocarcinoma (ICC). The results also suggest that patients with ICC with a high CAR had a more aggressive tumour behaviour, including a larger tumour size, higher frequency of microvascular invasion and higher serum CA19‐9 concentration, than those with a low preoperative CAR. High CAR associated with poorer survival=E2=80=99