• Yiyue Ren, Xiaoxiao Fan, Guoqiao Chen, Daizhan Zhou, Hui Lin, and Xiujun Cai.
• Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine and Innovation Center for Minimally Invasive Technique and Device, Zhejiang University, Hangzhou, China.
• Med Clin (Barc). 2019 Sep 13; 153 (5): 183-190.

Background & ObjectivesRecent studies have shown that the C-reactive protein-to-albumin ratio (CAR) can predict the mortality in patients with hepatocellular carcinoma (HCC). The aim of the present study was to investigate the utility of preoperative CAR for predicting postoperative overall and tumor free survival among HCC patients after radical surgery.MethodsPreoperative neutrophil-to-lymphocyte ratio (NLR), clinicopathological parameters, laboratory data and patient demographics of 187 patients with HCC receiving initial radical liver resection from Sir Run Run Shaw hospital were evaluated. Multivariate analyses were performed to identify clinical characteristics associated with overall survival (OS) and tumor free survival (TFS). Subsequently, the prognostic value of CAR was evaluated using the area under the curve (AUC) compared with other systemic inflammation-based prognostic scores.ResultsMultivariate analysis revealed that the tumor number [hazard ratio (HR)=2.668; p=0.018] was independently associated with OS. While, the CRP/Alb ratio [HR=0.477; p=0.006] and the tumor number [HR=2.458; p=0.006] were significantly associated with TFS. The AUC values of the CRP/Alb ratio (6 months: 0.868; 12 months: 0.787; 36 months: 0.680) were higher than those of the GPS, mGPS and NLR at all time points in OS.ConclusionPreoperative CRP/Alb ratio is an independent prognostic marker with tumor free survival in patients with HCC after curative resection and the prognostic ability was comparable to other applied inflammation-based prognostic scores in both overall and tumor-free survival, especially at the early stage.Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

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