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Albumin-fibrinogen ratio and fibrinogen-prealbumin ratio as promising prognostic markers for cancers: an updated meta-analysis.

ABSTRACT: OBJECTIVE:Provide an updated and comprehensive evaluation of the prognostic value of the albumin-fibrinogen ratio (AFR) and the fibrinogen-prealbumin ratio (FPR) for patients with cancer. MATERIALS AND METHODS:Four databases (PubMed, Web of Science, Cochrane Library, and WanFang) were searched. The primary endpoints were overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS). Pooled data were synthesized using StataMP 14 and expressed as hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS:This update examined 19 studies (7282 cases) that assessed the correlation of AFR with cancer prognosis. Pooled univariate and multivariate analyses indicated significant correlations of low AFR with poor OS (HR 2.18, 95%CI 1.87-2.55 and HR 1.75, 95%CI 1.54-2.00, respectively), poor DFS (HR 1.89, 95%CI 1.54-2.32 and HR 1.51, 95%CI 1.29-1.76, respectively), and poor PFS (HR 1.68, 95%CI 1.42-1.99 and HR 1.48, 95%CI 1.16-1.88, respectively). Pooled univariate and multivariate analyses of 6 studies (2232 cases) indicated high FPR significantly correlated with poor OS (HR 2.37, 95%CI 2.03-2.77 and HR 1.97, 95%CI 1.41-2.77, respectively). One study reported that high FPR correlated with poor DFS (univariate analysis: HR 2.20, 95%CI 1.35-3.57; multivariate analysis: HR 1.77, 95%CI 1.04-2.99) and one study reported a correlation of high FPR with poor PFS in univariate analysis alone (HR 1.79, 95%CI 1.11-2.88). CONCLUSION:A low AFR and a high FPR correlated with increased risk of cancer mortality and recurrence. AFR and FPR may be promising prognostic markers for cancers.

SUBMITTER: Sun DW

PROVIDER: S-EPMC6958612 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Albumin-fibrinogen ratio and fibrinogen-prealbumin ratio as promising prognostic markers for cancers: an updated meta-analysis.

Sun Da-Wei DW An Lin L Lv Guo-Yue GY Lv Guo-Yue GY

World journal of surgical oncology 20200113 1

<h4>Objective</h4>Provide an updated and comprehensive evaluation of the prognostic value of the albumin-fibrinogen ratio (AFR) and the fibrinogen-prealbumin ratio (FPR) for patients with cancer.<h4>Materials and methods</h4>Four databases (PubMed, Web of Science, Cochrane Library, and WanFang) were searched. The primary endpoints were overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS). Pooled data were synthesized using StataMP 14 and expressed as hazard rat ...[more]

PMID: 31931816

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Project description:With COVID-19 still hovering around and threatening the lives of many at-risk patients, an effective, quick, and inexpensive prognostic method is required. Few studies have shown fibrinogen to albumin ratio (FAR) and C-reactive protein to albumin ratio (CAR) to be promising as prognostic markers for COVID-19 disease. However, their implications remain unclear. This meta-analysis aimed to elucidate the prognostic role of FAR and CAR in COVID-19 disease. A systematic literature search was undertaken using PubMed and Embase till April 2022. Inverse variance standardised mean difference (SMD) was calculated to report the overall effect size using random effect models. The generic inverse variance random-effects method was used to pool the area under the curve (AUC) values. All statistical analyses were performed on Revman and MedCalc Software. A total of 23 studies were included. COVID-19 non-survivors had a higher CAR on admission compared with survivors (SMD = 1.79 [1.04, 2.55]; p < 0.00001; I2 = 97%) and patients with a severe COVID-19 infection had a higher CAR on admission than non-severe patients (SMD = 1.21 [0.54, 1.89]; p = 0.0004; I2 = 97%). Similarly, higher mean FAR values on admission were significantly associated with COVID-19 mortality (SMD = 0.55 [0.32, 0.78]; p < 0.00001; I2 = 82%). However, no significant association was found between mean FAR on admission and COVID-19 severity (SMD = 0.54 [-0.09, 1.18]; p = 0.09; I2 = 91%). The pooled AUC values found that CAR had a good discriminatory-power to predict COVID-19 severity (AUC = 0.81 [0.75, 0.86]; p < 0.00001; I2 = 80%) and mortality (AUC = 0.81 [0.74, 0.87]; p < 0.00001; I2 = 86%). FAR had a fair discriminatory-power to predict COVID-19 severity (AUC = 0.73 [0.64, 0.82]; p < 0.00001; I2 = 89%). Overall, CAR was a good predictor of both severity and mortality associated with COVID-19 infection. Similarly, FAR was a satisfactory predictor of COVID-19 mortality but not severity.

Project description:Background: Both nutritional status and coagulation function are closely associated with prognosis in patients with bladder cancer (BC). This study aimed to investigate the prognostic value of albumin-to-fibrinogen ratio (AFR) for BC patients underwent radical cystectomy (RC) or transurethral resection of bladder tumor (TURBT), and develop predictive nomograms based on AFR. Methods: We retrospectively collected medical records of 358 BC patients who underwent RC or TURBT between January 2012 and December 2018. The whole cohort was divided into the training (215 patients, 60.06%) and validation cohorts (143 patients, 39.94%) based on surgery dates. The training cohort was applied to select characteristics and construct nomograms, while the validation cohort was used to verify the nomograms independently. Endpoints of the current study included overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS). Prognostic values of AFR and other characteristics were evaluated using univariate and multivariate Cox regression analyses and compared using the concordance-index (C-index). Nomograms for OS, DSS and DFS were constructed based on both-directional stepwise Cox proportional hazards regression analysis and evaluated by the receiver operating characteristic (ROC) curve, the C-index and calibration plot. Results: In whole cohort, 86 patients (24.02%) were classified into low AFR group and had worse OS (hazard ratio [HR]: 4.079, 95% confidence interval [CI]: 2.085-7.982, P < 0.001), DSS (HR: 3.012, 95% CI: 1.302-6.966, P = 0.010) and DFS (HR: 1.863, 95% CI: 1.204-2.883, P = 0.005) compared to BC patients in high AFR group. Meanwhile, the AFR processed better prognostic power than albumin and fibrinogen, individually. Multivariate Cox analysis indicated that AFR was an independent prognostic factor for OS (HR: 2.601, 95% CI: 1.057-6.395, P = 0.037) and DFS (HR: 1.971, 95% CI: 1.049-3.703, P = 0.035). Novel nomograms, incorporating AFR, tumor grade and tumor multifocality, were constructed and successfully validated for predictions of OS, DSS and DFS in BC. Conclusions: Preoperative AFR was identified as an independent prognostic predictor for OS and DFS of BC patients underwent surgery. The nomograms incorporating AFR provided accurate predictions for OS, DSS and DFS, which could help urologists in better clinical decision-making.

Dataset Information

Albumin-fibrinogen ratio and fibrinogen-prealbumin ratio as promising prognostic markers for cancers: an updated meta-analysis.

Publications

Albumin-fibrinogen ratio and fibrinogen-prealbumin ratio as promising prognostic markers for cancers: an updated meta-analysis.

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