The C-reactive Protein to Albumin Ratio Predicts Long-Term Outcomes in Patients with Pancreatic Cancer After Pancreatic Resection

Background The C-reactive protein to albumin (CRP/Alb) ratio, a novel inflammation-based prognostic score, is associated with outcomes in septic patients. The prognostic value of CRP/Alb ratio has not been established in cancer patients. The aim of this study is to evaluate the significance of CRP/Alb ratio in therapeutic outcome after pancreatic resection for pancreatic cancer. Methods The study comprised 113 patients who had undergone pancreatic resection for pancreatic cancer between April 2001 and December 2011. We retrospectively investigated the relation between CRP/Alb ratio and disease-free as well as overall survival. Results The optimal cut-off level of the CRP/Alb ratio was 0.03. For disease-free survival, preoperative biliary drainage ( p = 0.011), advanced tumor-node-metastasis (TNM) classification ( p = 0.002), and higher CRP/Alb ratio ( p = 0.049) by univariate analysis, and advanced TNM classification ( p = 0.003) by multivariate analysis, were independent and significant predictors of cancer recurrence. For overall survival, preoperative biliary drainage ( p = 0.012), advanced TNM classification ( p = 0.001), and higher CRP/Alb ratio ( p = 0.023) by univariate analysis, and advanced TNM classification ( p = 0.003) and higher CRP/Alb ratio ( p = 0.035) by multivariate analysis, were independent and significant predictors of poor patient outcome. Conclusions The CRP/Alb ratio may be an independent and significant indicator of poor long-term outcomes in patients with pancreatic cancer after pancreatic resection.