| Summary: | Zhiyao Fan,1–4,* Kun Fan,1–4,* Yitao Gong,1–4,* Qiuyi Huang,1–4 Chao Yang,1–4 He Cheng,1–4 Kaizhou Jin,1–4 Quanxing Ni,1–4 Xianjun Yu,1–4 Guopei Luo,1–4 Chen Liu1–4 1Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China; 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China; 3Shanghai Pancreatic Cancer Institute, Shanghai, People’s Republic of China; 4Pancreatic Cancer Institute, Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guopei Luo; Chen LiuDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, 270 Dong An Road, Shanghai 200032, People’s Republic of ChinaTel +86-21-6403-1446Fax +86-21-6403-1446Email luoguopei@fudanpci.org; liuchen@fudanpci.orgPurpose: The CRP/albumin (Alb) ratio, a recently reported predictor, has shown value for prognosis in various human cancers. This study aimed to determine the prognostic value of baseline CRP/Alb and to explore the relevance between postchemotherapy CRP/Alb and the efficacy of chemotherapy in advanced pancreatic cancer patients.Patients and methods: Five hundred and ninety-five patients diagnosed with locally advanced or metastatic adenocarcinoma of the pancreas were enrolled. Cut-off Finder was used to calculate the best cut‑off value for baseline CRP/Alb. The primary endpoint was overall survival, which was analyzed by Kaplan-Meier survival curves with 95% confidence intervals. The log rank test and Cox proportional hazard model were used to evaluate the univariate and multivariate analyses.Results: The optimal cut-off value for baseline CRP/Alb was determined to be 0.18. Both the baseline CRP/Alb (CRP/Alb≥0.18 vs. CRP/Alb<0.18, hazard ratio [HR] = 2.506; p<0.001) and postchemotherapy CRP/Alb (CRP/Alb≥0.18 vs. CRP/Alb<0.18, HR = 1.854; p =0.002) were significant predictors of overall survival according to multivariate analysis and were independent of other factors. Patients with a baseline and postchemotherapy CRP/Alb ≥0.18 had the worst prognosis.Conclusion: CRP/Alb is a strong and useful indicator of prognosis for advanced pancreatic cancer. Both baseline and postchemotherapy CRP/Alb can be used in predicting the survival of patients and monitoring the effectiveness of chemotherapy in clinical practice.Keywords: CRP/Alb ratio, pancreatic cancer, prognosis, chemotherapy
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