title: Clinical Burden of C-Reactive Protein/Albumin Ratio Before Curative Surgery for Patients with Gastric Cancer.
abstract: To assess the relationship of C-reactive protein/albumin ratio (CAR) to outcomes and surgical site infection (SSI) in gastric cancer (GC) treated with curative intent, we retrospectively assessed 384 patients with GC for CAR, SSIs, disease-free survival (DFS), overall survival (OS) and other factors. We found SSIs in 42 patients (10.9%). Pathological T-stage, TNM classification, body mass index, duration of surgery, blood loss and preoperative CAR were significantly associated with SSIs; in multivariate analyses, CAR [hazard ratio (HR)=2.98, p=0.003] and duration of surgery (HR=2.34, p=0.029) independently predicted SSI. Age, sex, T-and N-stages, tumor size and serum carcinoembryonic antigen (CEA) were associated with high CAR, and high CAR, CEA and CA19-9 combined was associated with shorter OS (p=0.0001) and DFS (p=0.0001). Multivariate analyses also linked high CAR to early recurrence (HR=2.21, p=0.011) and poor prognosis (HR=1.82, p=0.038). We show, for the first time to our knowledge, that a high CAR predicts SSI, early recurrence and poor prognosis in patients with GC treated with curative intent.
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan ytoi0725@clin.medic.mie-u.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Toiyama
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Tadanobu
authors.initials: T
authors.lastname: Shimura
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Yasuda
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujikawa
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Okita
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ohi
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Yoshiyama
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Jyunichiro
authors.initials: J
authors.lastname: Hiro
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Araki
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Mohri
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000601:surgery*
chemical_list: D000418:Albumins; D002097:C-Reactive Protein
keywords: CRP/albumin ratio; Gastric cancer; recurrence. prognosis; surgical site infection