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SYSTEMATIC REVIEW article

Front. Nutr.
Sec. Clinical Nutrition
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1444352
This article is part of the Research Topic Nutrition and Metabolism in Cancer: Role in Prevention and Prognosis View all 12 articles

Preoperative C-reactive protein to albumin ratio may be a good prognostic marker in patients undergoing hepatectomy for hepatocellular carcinoma: a meta-analysis

Provisionally accepted
Shi Wang Shi Wang 1*Shengqian Xu Shengqian Xu 1*Jun Wang Jun Wang 1*Hailin Ye Hailin Ye 1Xiaoya Xu Xiaoya Xu 1Kai Zhang Kai Zhang 2Xiaopeng Fan Xiaopeng Fan 1*
  • 1 Lishui City People's Hospital, Lishui, China
  • 2 Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China

The final, formatted version of the article will be published soon.

    Background: Systemic inflammatory response represented by C-reactive protein to albumin ratio (CAR) was shown to be associated with long-term outcome in patients with hepatocellular carcinoma (HCC). We conducted a meta-analysis to investigate the prognostic value of preoperative CAR in patients undergoing hepatectomy for HCC. Methods: We searched four databases (PubMed, Embase, Scopus and Cochrane Library) from inception to May 10th, 2024. Studies investigating the prognostic value of preoperative CAR in HCC patients after hepatectomy. The primary endpoints were overall survival (OS) and disease-free survival (DFS). Data from individual studies were aggregated to calculate the pooled hazard ratio (HR) using a random-effects model. Results: A total of 11 studies included 4066 patients were finally analyzed in the meta-analysis. Overall, the higher preoperative CAR was associated with poorer OS (HR 1.92, 95% CI 1.67 to 2.22, I2=0%) and DFS (HR 1.79, 95% CI 1.59 to 2.02, I2=0%) rate. Furthermore, subgroup analyses indicated that CAR could be a prognostic biomarker for patients with HCC regardless of regions and cut-off value. Conclusions: Our meta-analysis indicates that higher preoperative CAR level is associated with poorer OS and DFS, it may be a good prognostic marker of survival outcomes after hepatectomy in patients with HCC. However, future prospective trials are necessary to validate the conclusion.

    Keywords: C-reactive protein to albumin ratio, prognostic marker, Hepatocellular Carcinoma, Hepatectomy, Meta-analysis

    Received: 05 Jun 2024; Accepted: 17 Sep 2024.

    Copyright: © 2024 Wang, Xu, Wang, Ye, Xu, Zhang and Fan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Shi Wang, Lishui City People's Hospital, Lishui, China
    Shengqian Xu, Lishui City People's Hospital, Lishui, China
    Jun Wang, Lishui City People's Hospital, Lishui, China
    Xiaopeng Fan, Lishui City People's Hospital, Lishui, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.