A retrospective study on the prognostic value of preoperative C-reactive protein to albumin ratio in patients with oral cavity squamous cell carcinoma
Background Although the C-reactive protein-to-albumin ratio (CAR) can predict poor outcomes in assorted cancers, its prognostic value in oral cavity squamous cell carcinoma (OSCC) remains unclear. We explored the value of preoperative CAR in predicting clinical outcomes in OSCC patients treated with...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
PeerJ Inc.
2020-06-01
|
Series: | PeerJ |
Subjects: | |
Online Access: | https://peerj.com/articles/9361.pdf |
id |
doaj-0a3a3aa6d2bd474b99ee080197f70b55 |
---|---|
record_format |
Article |
spelling |
doaj-0a3a3aa6d2bd474b99ee080197f70b552020-11-25T03:08:05ZengPeerJ Inc.PeerJ2167-83592020-06-018e936110.7717/peerj.9361A retrospective study on the prognostic value of preoperative C-reactive protein to albumin ratio in patients with oral cavity squamous cell carcinomaKu-Hao Fang0Chia-Hsuan Lai1Cheng-Ming Hsu2Ethan Huang3Ming-Shao Tsai4Geng-He Chang5Yi-Chan Lee6Yao-Te Tsai7Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, TaiwanDepartment of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, TaiwanBackground Although the C-reactive protein-to-albumin ratio (CAR) can predict poor outcomes in assorted cancers, its prognostic value in oral cavity squamous cell carcinoma (OSCC) remains unclear. We explored the value of preoperative CAR in predicting clinical outcomes in OSCC patients treated with radical surgery. Methods All the recommended cutoff values were defined analyzing receiver operating characteristic curves or overall survival (OS). Dichotomization was performed on the basis of optimal CAR cutoff, and we compared the clinicopathological features between groups. Kaplan–Meier analysis was also performed to compare OS curves between the two groups. Univariate and multivariate analyses using the Cox proportional hazards model were conducted to find the clinical characteristics that were most closely correlated with disease free survival (DFS) and overall survival (OS). A nomogram incorporated CAR and several clinicopathological factors was established to predict prognosis and its accuracy was evaluated using concordance index (c-index). Results In this retrospective study, a total of 326 patients with newly diagnosis of OSCC and received primary surgery between 2008 and 2017 were enrolled. Through the executed ROC curve analyses, the optimal CAR cutoff derived was 0.195 (area under the curve = 0.718, p < 0.001), with this cutoff exhibiting a discrimination ability superior to that of other inflammation-based prognostic scores after comparing the area under curves. Multivariate analysis demonstrated that CAR (≥0.195/<0.195) was associated with OS (hazard ratio 3.614; 95% CI [1.629–8.018]; p = 0.002) and DFS (hazard ratio 1.917; 95% CI [1.051–3.863]; p = 0.029). Kaplan–Meier analysis and log rank test revealed a significant difference in DFS and OS curves between patients with low CAR (<0.195) and those with high CAR (≥0.195; both p < 0.001). The c-index of the nomogram based on TNM system alone was 0.684 and could be increased to 0.801 if CAR and other clinicopathological factors were included. Conclusions Preoperative CAR could constitute an independent prognostic indicator for OS and DFS prediction in OSCC patients treated with curative surgery. The established nomogram that incorporated CAR and prognostic factors might increase the accuracy of prognostic prediction for patients with OSCC.https://peerj.com/articles/9361.pdfC-reactive protein-to-albumin ratioOral cavity squamous cell carcinomaInflammation-based prognostic indexPrognostic predictorNomogram |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ku-Hao Fang Chia-Hsuan Lai Cheng-Ming Hsu Ethan Huang Ming-Shao Tsai Geng-He Chang Yi-Chan Lee Yao-Te Tsai |
spellingShingle |
Ku-Hao Fang Chia-Hsuan Lai Cheng-Ming Hsu Ethan Huang Ming-Shao Tsai Geng-He Chang Yi-Chan Lee Yao-Te Tsai A retrospective study on the prognostic value of preoperative C-reactive protein to albumin ratio in patients with oral cavity squamous cell carcinoma PeerJ C-reactive protein-to-albumin ratio Oral cavity squamous cell carcinoma Inflammation-based prognostic index Prognostic predictor Nomogram |
author_facet |
Ku-Hao Fang Chia-Hsuan Lai Cheng-Ming Hsu Ethan Huang Ming-Shao Tsai Geng-He Chang Yi-Chan Lee Yao-Te Tsai |
author_sort |
Ku-Hao Fang |
title |
A retrospective study on the prognostic value of preoperative C-reactive protein to albumin ratio in patients with oral cavity squamous cell carcinoma |
title_short |
A retrospective study on the prognostic value of preoperative C-reactive protein to albumin ratio in patients with oral cavity squamous cell carcinoma |
title_full |
A retrospective study on the prognostic value of preoperative C-reactive protein to albumin ratio in patients with oral cavity squamous cell carcinoma |
title_fullStr |
A retrospective study on the prognostic value of preoperative C-reactive protein to albumin ratio in patients with oral cavity squamous cell carcinoma |
title_full_unstemmed |
A retrospective study on the prognostic value of preoperative C-reactive protein to albumin ratio in patients with oral cavity squamous cell carcinoma |
title_sort |
retrospective study on the prognostic value of preoperative c-reactive protein to albumin ratio in patients with oral cavity squamous cell carcinoma |
publisher |
PeerJ Inc. |
series |
PeerJ |
issn |
2167-8359 |
publishDate |
2020-06-01 |
description |
Background Although the C-reactive protein-to-albumin ratio (CAR) can predict poor outcomes in assorted cancers, its prognostic value in oral cavity squamous cell carcinoma (OSCC) remains unclear. We explored the value of preoperative CAR in predicting clinical outcomes in OSCC patients treated with radical surgery. Methods All the recommended cutoff values were defined analyzing receiver operating characteristic curves or overall survival (OS). Dichotomization was performed on the basis of optimal CAR cutoff, and we compared the clinicopathological features between groups. Kaplan–Meier analysis was also performed to compare OS curves between the two groups. Univariate and multivariate analyses using the Cox proportional hazards model were conducted to find the clinical characteristics that were most closely correlated with disease free survival (DFS) and overall survival (OS). A nomogram incorporated CAR and several clinicopathological factors was established to predict prognosis and its accuracy was evaluated using concordance index (c-index). Results In this retrospective study, a total of 326 patients with newly diagnosis of OSCC and received primary surgery between 2008 and 2017 were enrolled. Through the executed ROC curve analyses, the optimal CAR cutoff derived was 0.195 (area under the curve = 0.718, p < 0.001), with this cutoff exhibiting a discrimination ability superior to that of other inflammation-based prognostic scores after comparing the area under curves. Multivariate analysis demonstrated that CAR (≥0.195/<0.195) was associated with OS (hazard ratio 3.614; 95% CI [1.629–8.018]; p = 0.002) and DFS (hazard ratio 1.917; 95% CI [1.051–3.863]; p = 0.029). Kaplan–Meier analysis and log rank test revealed a significant difference in DFS and OS curves between patients with low CAR (<0.195) and those with high CAR (≥0.195; both p < 0.001). The c-index of the nomogram based on TNM system alone was 0.684 and could be increased to 0.801 if CAR and other clinicopathological factors were included. Conclusions Preoperative CAR could constitute an independent prognostic indicator for OS and DFS prediction in OSCC patients treated with curative surgery. The established nomogram that incorporated CAR and prognostic factors might increase the accuracy of prognostic prediction for patients with OSCC. |
topic |
C-reactive protein-to-albumin ratio Oral cavity squamous cell carcinoma Inflammation-based prognostic index Prognostic predictor Nomogram |
url |
https://peerj.com/articles/9361.pdf |
work_keys_str_mv |
AT kuhaofang aretrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT chiahsuanlai aretrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT chengminghsu aretrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT ethanhuang aretrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT mingshaotsai aretrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT genghechang aretrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT yichanlee aretrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT yaotetsai aretrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT kuhaofang retrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT chiahsuanlai retrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT chengminghsu retrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT ethanhuang retrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT mingshaotsai retrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT genghechang retrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT yichanlee retrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma AT yaotetsai retrospectivestudyontheprognosticvalueofpreoperativecreactiveproteintoalbuminratioinpatientswithoralcavitysquamouscellcarcinoma |
_version_ |
1724667518135566336 |