C-reactive Protein to Albumin Ratio Predicts Survival in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib

Overview

Journal Sci Rep

Specialty Science

Date 2022 May 19

PMID 35589772

Authors

Toshifumi Tada

Takashi Kumada

Atsushi Hiraoka

Masashi Hirooka

Kazuya Kariyama

Joji Tani

Masanori Atsukawa

Koichi Takaguchi

Ei Itobayashi

Shinya Fukunishi

Kunihiko Tsuji

Toru Ishikawa

Kazuto Tajiri

Hironori Ochi

Satoshi Yasuda

Hidenori Toyoda

Takeshi Hatanaka

Satoru Kakizaki

Noritomo Shimada

Kazuhito Kawata

Takaaki Tanaka

Hideko Ohama

Kazuhiro Nouso

Asahiro Morishita

Akemi Tsutsui

Takuya Nagano

Norio Itokawa

Tomomi Okubo

Taeang Arai

Michitaka Imai

Atsushi Naganuma

Tomoko Aoki

Yohei Koizumi

Shinichiro Nakamura

Kouji Joko

Yoichi Hiasa

Masatoshi Kudo

Affiliations

Soon will be listed here.

Abstract

We investigated the impact of C-reactive protein to albumin ratio (CAR) on predicting outcomes in 522 patients with unresectable hepatocellular carcinoma (HCC) treated with lenvatinib. We determined the optimal CAR cutoff value with time-dependent receiver operating characteristic curve analysis. Additionally, we clarified the relationship between CAR and liver function or HCC progression. Median overall survival was 20.0 (95% confidence interval (CI), 17.2-22.6) months. The optimal CAR cutoff value was determined to be 0.108. Multivariate analysis showed that high CAR (≥ 0.108) (hazard ratio (HR), 1.915; 95% CI, 1.495-2.452), Eastern Cooperative Oncology Group performance status ≥ 1 (HR, 1.429), and α-fetoprotein ≥ 400 ng/mL (HR, 1.604) were independently associated with overall survival. Cumulative overall survival differed significantly between patients with low versus high CAR (p < 0.001). Median progression-free survival was 7.5 (95% CI, 6.7-8.1) months. Multivariate analysis showed that age, CAR ≥ 0.108 (HR, 1.644; 95% CI, 1.324-2.043), and non-hepatitis B, non-hepatitis C etiology (HR, 0.726) were independently associated with progression-free survival. Cumulative progression-free survival differed significantly between patients with low versus high CAR (p < 0.001). CAR values were significantly higher as Japan Integrated Staging score increased (p < 0.001). In conclusion, CAR can predict outcomes in patients with unresectable HCC treated with lenvatinib.

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