Prognostic Value of the Preoperative Lymphocyte-to-C-Reactive Protein Ratio and Albumin-to-Globulin Ratio in Patients with Osteosarcoma
Open Access
- 1 December 2020
- journal article
- research article
- Published by Informa UK Limited in OncoTargets and Therapy
- Vol. ume 13, 12673-12681
- https://doi.org/10.2147/ott.s287192
Abstract
Purpose: Growing evidence indicates that preoperative biomarkers could be identified as independent prognostic factors in various cancers. The purpose of this study was to assess prognostic value of the preoperative lymphocyte-to-C-reactive protein ratio (LCR), albumin-to-globulin ratio (AGR), lymphocyte–monocyte ratio (LMR), and C-reactive protein to albumin ratio (CAR) in patients with osteosarcoma. Methods: A total of 137 osteosarcoma patients treated at our hospital between 2011 and 2019 were enrolled in the study. Patient demographics, clinical characteristics, and laboratory data were collected and analyzed. The optimal cutoff values of LCR, AGR, LMR, and CAR were assessed with receiver operating characteristic (ROC) analysis. Kaplan–Meier analysis was performed to estimate overall survival (OS). Univariate and multivariate Cox regression models were employed to determine the independent prognostic factors. The hazard ratios (HR) and 95% confidence intervals (95% CI) were calculated to evaluate relative risk. Results: The optimal cutoff values of LCR, AGR, LMR, and CAR were 0.14, 1.79, 3.05 and 0.24, respectively. According to the univariate analysis, OS was remarkably associated with neoadjuvant chemotherapy (P < 0.001), pathological fracture (P < 0.001), local recurrence (P = 0.020), metastasis (P < 0.001), LCR (P = 0.035), AGR (P = 0.028), LMR (P = 0.010), and CAR (P = 0.004). In multivariate analyses, pathological fracture (P = 0.025), metastasis (P < 0.001), LCR (P = 0.012), and AGR (P = 0.001) were identified as independent risk predictors for OS. Conclusion: The present study provides new evidence that the preoperative LCR and AGR could serve as independent prognostic factors for patients with osteosarcoma. These findings will help physicians to stratify patients for appropriate treatment protocols and facilitate decision-making so as to improve the patients’ survival condition.Keywords
This publication has 49 references indexed in Scilit:
- Nutritional status, acute phase response and depression in metastatic lung cancer patients: correlations and association prognosisSupportive Care in Cancer, 2011
- Preoperative elevation of serum C-reactive protein as an independent prognostic indicator for gastric cancerSurgery Today, 2011
- Hallmarks of Cancer: The Next GenerationCell, 2011
- Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literatureNutrition Journal, 2010
- Immunity, Inflammation, and CancerCell, 2010
- Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instabilityCarcinogenesis: Integrative Cancer Research, 2009
- Neutrophil/lymphocyte ratio and its association with survival after complete resection in non–small cell lung cancerThe Journal of Thoracic and Cardiovascular Surgery, 2008
- Cancer-related inflammationNature, 2008
- A systematic review of the association between circulating concentrations of C reactive protein and cancerJournal of Epidemiology and Community Health, 2007
- New Guidelines to Evaluate the Response to Treatment in Solid TumorsJNCI Journal of the National Cancer Institute, 2000