Preoperative High C-Reactive Protein to Albumin Ratio Predicts Short- and Long-Term Postoperative Outcomes in Elderly Gastric Cancer Patients

• Published in: Cancers Vol. 16; no. 3; p. 616
• Main Authors: Takemoto, Yuki, Tanabe, Kazuaki, Chikuie, Emi, Saeki, Yoshihiro, Ota, Hiroshi, Karakuchi, Nozomi, Kohata, Akihiro, Ohdan, Hideki
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 31-01-2024
• Subjects: Age; Aged patients; Albumin; Antigens; Blood transfusion; Blood transfusions; C-reactive protein; Cancer; Cancer patients; Comorbidity; Complications; Development and progression; Gastrectomy; Gastric cancer; Gastrointestinal surgery; Inflammation; Lymphocytes; Multivariate analysis; Neutrophils; Nutritional status; Oncology, Experimental; Patient outcomes; Patients; Peripheral blood; Postoperative; Prognosis; Proteins; Regression analysis; Risk factors; Stomach cancer; Surgical outcomes; Japan; C-reactive protein to albumin ratio; elderly patients; complication; nutrition; gastric cancer; prognostic factor; inflammation
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers16030616

Individualized preoperative assessment of the general condition of elderly patients with gastric cancer is necessary for appropriate surgical treatment planning. This study investigated the efficacy of preoperative markers that could be easily calculated from preoperative peripheral blood to predict the short- and long-term postoperative outcomes of gastrectomy. In total, 571 patients who underwent R0 surgical resection for gastric cancer were enrolled. In the elderly patient group (≥65 years old), univariate analyses revealed that the incidence of postoperative complications was associated with poor performance status (
= 0.012), more comorbidities (
= 0.020), high C-reactive protein to albumin ratio (CAR,
= 0.003), total gastrectomy (
= 0.003), open approach (
= 0.034), blood transfusion (
= 0.002), and advanced cancer (
= 0.003). Multivariate analysis showed that a high CAR was associated with a high incidence of postoperative complications (
= 0.046). High CAR was also associated with poor OS (
= 0.015) and RFS (
= 0.035). However, these trends were not observed among younger patients (<65 years old). Preoperative CAR may play a significant role in predicting short- and long-term surgical outcomes, particularly in elderly patients with gastric cancer.