C-reactive Protein to Albumin Ratio as a Prognostic Predictor in Larynx Cancer

Abstract

Objective:During the past decade, several inflammation-based prognostic systems have been reported in the field of clinical oncology. Recently, C-reactive protein and albumin ratio (CAR) have showed their impact on a large variety of tumor types. The aim of this study is to evaluate the impact CAR on prognosis and 5-year survival (5yS) in patients operated for larynx cancer.Method:One hundred eighteen patients operated in our center between 2010 and 2015 were eligible for retrospective analysis. We evaluated the impact of the CAR and neutrophil to lymphocyte ratio (NLR) on the 5yS. Univariate and multivariate Cox regression analyses were performed to determine the associations of CAR.Results:The optimal cut-off level of CAR was at 0.993. A low and high CAR was assigned to 40.7% and 59.3% of patients, respectively. The 5yS rates of patients with a high CAR were worse than those in the low group (79.2% vs 73.2% p<0.05). Disease stage (p<0.001) and high level of NLR were also significant predictors of 5yS. CAR at diagnosis was associated with an unfavorable progress. Patients with stage III-IV disease had a significantly higher pretreatment CAR than patients with stage I-II disease [respectively 1.83±0.52 standard deviation (SD) and 0.58±0.38 (SD), p<0.01]. ROC analysis of overall survival of larynx squamous cell carcinoma revealed that CAR had a greater area under curve value (0.786) compared to NLR (0.695) (p<0.01).Conclusion:CAR is an independent prognostic marker in larynx cancer after being adjusted by other accompanying factors and the CAR could be a readily available biomarker in clinical setting.

Keywords

• albumin
• c-reactive protein
• larynx cancer
• prognosis