• Hiroshi Tamagawa, Toru Aoyama, Ayako Tamagawa, Keisuke Komori, Yukio Maezawa, Kazuki Kano, Masaaki Murakawa, Yosuke Atsumi, Kentaro Hara, Keisuke Kazama, Masakatsu Numata, Takashi Oshima, Norio Yukawa, Munetaka Masuda, and Yasushi Rino.
• Department of Surgery, Yokohama City University, Yokohama, Japan rinta77-nosuke@amber.plala.or.jp t-aoyama@lilac.plala.or.jp.
• Anticancer Res. 2020 Apr 1; 40 (4): 2365-2371.

BackgroundSeveral immune-inflammatory markers are associated with cancer progression. The purpose of the present study was to clarify the influence of the preoperative C-reactive protein-to-albumin ratio (CRP/ALB ratio) on survival of patients with esophageal cancer and recurrence after curative resection.Patients And MethodsThe preoperative CRP/ALB ratio was evaluated in 122 patients who underwent radical resection for esophageal cancer from 2005 to 2018. The correlations between the CRP/ALB ratio and cancer-specific overall (OS), recurrence-free (RFS) survival and the clinicopathological status were analyzed.ResultsThe optimal cut-off value of the CRP/ALB ratio determined using receiver operating characteristic curve analysis was 0.04. Patients were divided into two groups based on this cut-off value: the low CRP/ALB group (n=59) and the high CRP/ALB group (n=50). The OS rate at 5 years after surgery was significantly lower in the group with high CRP/ALB at 40.5% whilst it was 63.5% in the low CRP/ALB group (p=0.005). The corresponding RFS rates at 5 years after surgery were 32.5% and 48.3%, respectively, which was a statistically significant difference (p=0.007). A multivariate analysis showed that a high CRP/ALB ratio was a significant independent risk factor for poorer cancer-specific OS and RFS.ConclusionThe preoperative CRP/ALB ratio was a strong prognostic marker for patients with esophageal cancer. The surgical strategy, including procedure and perioperative care should be carefully planned for patients with a high CRP/ALB ratio.Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

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