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The C-reactive protein to albumin ratio is a prognostic factor for stage I non-small cell lung cancer in elderly patients: JACS1303

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Abstract

Purpose

To establish the prognostic significance of C-reactive protein (CRP) and albumin in octogenarians with non-small cell lung cancer (NSCLC) based on the study of the Japanese Association for Chest Surgery (JACS 1303).

Methods

A total of 618 octogenarians with pathological stage I NSCLC, who underwent pulmonary resection, were included in the analysis. We conducted multivariable Cox regression analysis to evaluate the CRP to albumin ratio (CAR) as a potential prognostic factor. Other clinicopathological factors were also evaluated.

Results

The median age was 82 years. Operations included lobectomy (n = 388; 62.8%) segmentectomy (n = 95; 15%), and wedge resection (n = 135; 22%). Pathological stage IA was diagnosed in 380 (61.5%) patients. The 3-year (OS) and cancer-specific survival (CS) rates were 86.7% and 94.6%, respectively. OS was significantly higher for patients with low CAR (< 0.106) than for those with high CAR (≥ 0.106) (hazard ratio = 3.13, 95% confidence interval: 1.99–4.93, p < 0.0001). Univariate analysis identified sex, poor performance status, smoking status, comorbidity, solid tumor, histology, high Glasgow prognostic scale, and high CAR as significant prognostic factors. Multivariate analysis identified only the CAR as a significant prognostic factor for both OS and CS.

Conclusions

Our analysis of the nationwide data demonstrated that the CAR is a useful prognostic factor for elderly patients with stage I NSCLC.

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Acknowledgements

We thank Shuntaro Sato, Ph.D., Clinical Research Center, Nagasaki University Hospital for statistical advice.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Takuro Miyazaki & Takeshi Nagayasu

  2. Department of Chest Surgery, St. Marianna University School of Medicine, Kawasaki, Japan

    Hisashi Saji

  3. Department of Surgery, Division of General Thoracic Surgery, Faculty of Medicine, Tottori University, Tottori, Japan

    Hiroshige Nakamura & Tomohiro Haruki

  4. Department of Thoracic Surgery, Kurashiki Central Hospital, Okayama, Japan

    Norihito Okumura

  5. Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Masanori Tsuchida

  6. Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Makoto Sonobe

  7. Division of Thoracic Surgery, Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan

    Keiju Aokage

  8. Department of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Masayuki Nakao

  9. Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan

    Morihito Okada

  10. Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan

    Kenji Suzuki

  11. Department of General Thoracic Surgery, Dokkyo Medical University, Shimotsuga, Japan

    Masayuki Chida

  12. Committee for Scientific Affairs, The Japanese Association for Chest Surgery, Kyoto, Japan

    Morihito Okada & Kenji Suzuki

  13. Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan and President, The Japanese Association for Chest Surgery, Kyoto, Japan

    Ichiro Yoshino

Authors
  1. Takuro Miyazaki
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  2. Hisashi Saji
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  14. Ichiro Yoshino
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Consortia

Committee for Scientific Affairs, The Japanese Association for Chest Surgery

Corresponding author

Correspondence to Takuro Miyazaki.

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Conflict of interest

Hisashi Saji received honoraria from MSD, Boehringer Ingelheim, ETHICON, Covidien, Chugai-pharm, Astellas Pharma, FUJIFILM Medical, and Bristol-Myers Squibb. Hiroshige Nakamura received honoraria from Intuitive Surgical Corp, Johnson & Johnson C.C. and research funding from Covidien Japan C.C., Johnson & Johnson C., Co. Morihito Okada received honoraria from Ethicon, Astra Zeneca, Chugai, Covidien, Pfizer, MSD, Daiichi-Sankyo, Bristol-Myers and research funding from Ethicon, Covidien, Daiichi-Sankyo, Chugai, Ono, Lilly, Astra Zeneca, Kirin-Kyowa, and Medi-Physics.

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Miyazaki, T., Saji, H., Nakamura, H. et al. The C-reactive protein to albumin ratio is a prognostic factor for stage I non-small cell lung cancer in elderly patients: JACS1303. Surg Today 52, 1463–1471 (2022). https://doi.org/10.1007/s00595-022-02485-9

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  • DOI: https://doi.org/10.1007/s00595-022-02485-9

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