• Kensuke Kudou, Hiroshi Saeki, Yuichiro Nakashima, Tomohiro Kamori, Tetsuro Kawazoe, Yasuhiro Haruta, Yoshiaki Fujimoto, Hiroya Matsuoka, Shun Sasaki, Tomoko Jogo, Kosuke Hirose, Qingjiang Hu, Yasuo Tsuda, Koichi Kimura, Koji Ando, Eiji Oki, Tetsuo Ikeda, and Yoshihiko Maehara.
• Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
• J. Gastroenterol. Hepatol. 2019 Feb 1; 34 (2): 355-363.

Background And AimThe C-reactive protein (CRP)/albumin (Alb) ratio has been reported as a novel prognostic marker in several cancers. The objective of this study was to investigate the prognostic value of the CRP/Alb ratio in patients who underwent surgery for adenocarcinoma of the esophagogastric junction (AEG) and upper gastric cancer (UGC).MethodsData for 144 patients who underwent surgery for AEG and UGC were reviewed. The CRP/Alb ratio, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, Glasgow Prognostic Score, and controlling nutritional status score were calculated, and the relationship between these biomarkers and postoperative prognosis was analyzed.ResultsThe optimal cutoff value of the CRP/Alb ratio was determined to be 0.1. According to the cutoff value of CRP/Alb ratio, patients were divided into two groups (CRP/Alb < 0.1, n = 124; CRP/Alb ≥ 0.1, n = 20). The 5-year recurrence-free survival and overall survival (OS) rates were significantly lower in the patients with the CRP/Alb ratio ≥ 0.1 than in those with the CRP/Alb ratio < 0.1 (recurrence-free survival: 44.9% vs 77.9%, P = 0.0011; OS: 43.4% vs 82.0%, P < 0.0001). In the multivariate analyses, the N-stage, and CRP/Alb ratio ≥ 0.1 were identified as independent predictive factors for OS in patients with AEG and UGC (P = 0.0061 and P = 0.0439, respectively).ConclusionsThe CRP/Alb ratio was strongly associated with poor prognosis in patients who underwent surgery for AEG and UGC.© 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

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