C-reactive protein/albumin ratio is a poor prognostic factor of esophagogastric junction and upper gastric cancer.

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/Alb0.1, n=20). The 5-year recurrence-free survival and overall survival (OS) rates were significantly lower in the patients with the CRP/Alb ratio0.1 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 ratio0.1 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.