# The Clinical Impact of Change in the C-Reactive Protein/Albumin Ratio in Gastric Cancer Patients Who Receive Curative Treatment

## TL;DR

This study shows that changes in the C-reactive protein/albumin ratio can predict survival outcomes in gastric cancer patients after curative treatment.

## Contribution

The study identifies change in CAR as a novel prognostic marker for gastric cancer patients post-surgery.

## Key findings

- Patients with a high-change in CAR had significantly lower 3- and 5-year overall survival rates compared to those with low-change in CAR.
- Change in CAR was a significant prognostic factor for both overall survival and recurrence-free survival in gastric cancer patients.
- The study found no significant differences in clinicopathological parameters like age, sex, T factor, or N factor between the high- and low-change CAR groups.

## Abstract

Recently, change in the C-reactive protein/albumin ratio (CAR) has become a promising prognostic marker in some malignancies. The aim of the present study was to evaluate the clinical impact of change in the CAR in gastric cancer patients who received curative resection.

The present study included 458 patients who underwent curative treatment for gastric cancer between 2013 and 2017. The prognosis and clinicopathological parameters were compared between patients who showed a high-change in CAR and those who showed a low-change in CAR.

The OS stratified by each clinical factor was compared using a log-rank test, and a significant difference was observed using a 0.05 change in CAR. When the patient background factors were compared between the high-change (change in CAR ≥ 0.05) and low-change (change in CAR < 0.05) groups, the median age, sex ratio, T factor, and N factor were similar. In the low-change group, the OS rates at 3 and 5 years after surgery were 94.1% and 87.6%, respectively, which amounted to a significant difference from the low-change group, with rates of 83.6 and 77.5% in the high-change group. In the low-change group, the RFS rates at 3 and 5 years after surgery were 90.1% and 85.1%, respectively, while those in the high-change group 77.6 and 75.2%. The univariate and multivariate analyses of factors associated with OS and RFS showed that the change in CAR was a significant prognostic factor.

The change in CAR is a significant risk factor and promising prognostic factor for gastric cancer patients.