158P - A clinical significance of preoperative C-reactive protein/albumin ratio in patients with extrahepatic bile duct cancer

Background

C-reactive protein/albumin (CRP/Alb) ratio has been identified to be associated with prognosis in pancreatic cancer. However, the role of it in biliary tract cancers has not been examined. The aim of this study is to assess the role of CRP/Alb in curatively resected extrahepatic bile duct cancers (EBDC).

Methods

We retrospectively analyzed 235 patients who underwent curative resection because of EBDC in Seoul National University Bundang Hospital between March 2005 and February 2018. The laboratory data including CRP and albumin levels were obtained by blood tests prior to surgery. The correlations among the preoperative CRP/Alb ratio, clinicopathological factors, and patient outcomes were investigated.

Results

Men were 143 (60.8%) and mean age was 68 years (range 41–85 years). EBDC perihilar bile duct cancer (n = 61) and distal bile duct cancer (n = 174). Median follow-up was 22 months and median recurrence free survival 17 months, respectively. The optimal prognostic cut-off point of the CRP/Alb ratio for tumor recurrence was 0.18. Multivariate logistic regression analysis for overall survival showed age older than 65 (HR 1.937; 95% CI 1.275–2.944; p = 0.002), advanced staging (Reference stage I, stage II - HR 1.963; 95% CI 1.261–3.056; p = 0.004, stage III - HR 2.158; 95% CI 1.155–4.031; p = 0.016), Increased CA 19-9 (HR 1.735; 95% CI 1.069–2.816; p = 0.026), and CRP/Alb ratio ³ 0.18 (HR 1.638; 95% CI 1.102–2.434; p = 0.015). Multivariate logistic regression analysis for recurrence free survival showed advanced staging (Reference stage I, stage II - HR 1.750; 95% CI 1.127–2.717; p = 0.013), venous invasion (HR 1.742; 95% CI 1.097–2.767; p = 0.019), perineural invasion (HR 2.427; 95% CI 1.114–5.287; p = 0.026), and CRP/Alb ratio ³ 0.18 (HR 1.702; 95% CI 1.144–2.531; p = 0.009).

Conclusions

Preoperative CRP/Alb ratio is significantly associated with recurrence and overall in patients with resected EBDC. Further studies are necessary to assess the role of preoperative CRP/Alb ratio in EBDC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Seoul National University Bundang Hospital.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.