• Masashi Utsumi, Masaru Inagaki, Koji Kitada, Naoyuki Tokunaga, Midori Kondo, Kosuke Yunoki, Yuya Sakurai, Ryosuke Hamano, Hideaki Miyasou, Yousuke Tsunemitsu, and Shinya Otsuka.
• Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan.
• Medicine (Baltimore). 2023 Jun 2; 102 (22): e33656e33656.

BackgroundThe preoperative C-reactive protein-to-albumin ratio is a novel inflammation-based prognostic marker in various cancers. However, its prognostic role in biliary tract cancer is unknown. We conducted a systematic review and meta-analysis to evaluate the prognostic value of preoperative C-reactive protein-to-albumin ratio in biliary tract cancer.MethodsA systematic search of the literature for studies evaluating the prognostic value of C-reactive protein-to-albumin ratio in patients undergoing surgery for biliary tract cancer was conducted, and a random effects meta-analysis of overall survival and recurrence-free survival was performed.ResultsNine studies with 1292 participants were included. The preoperative C-reactive protein-to-albumin ratio negatively correlated with overall survival (hazard ratio, 2.44 [95% confidence interval: 1.98-2.90]; P < .001) and recurrence-free survival (hazard ratio, 2.73 [95% confidence interval: 2.01-3.70]; P < .001). Subgroup analysis showed that an elevated preoperative C-reactive protein-to-albumin ratio predicted poor overall survival, regardless of the cutoff value, sample size, histological type, and treatment.ConclusionAn elevated preoperative C-reactive protein-to-albumin ratio is significantly associated with poor prognosis in patients undergoing surgery for biliary tract cancer. The C-reactive protein-to-albumin ratio may be an independent prognostic biomarker for overall survival and recurrence-free survival in patients undergoing surgery for biliary tract cancer.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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