Prognostic value of C-reactive protein to albumin ratio in metastatic colorectal cancer: A systematic review and meta-analysis.

BACKGROUND: In recent years, several observational studies have investigated the association between C-reactive protein to albumin ratio (CAR) and prognosis of metastatic colorectal cancer (mCRC), and yielded controversial outcomes. METHODS: Eligible studies assessing the relationship of CAR with survival and clinicopathological parameters in mCRC were searched from PubMed, Cochrane library, and Embase databases up to February 3, 2021. Overall survival (OS), progression-free survival, recurrence-free survival, and disease-free survival were synthetically calculated and compared. RESULTS: A total of 6 studies including 771 patients were enrolled in this systematic review. Pooled results indicated that elevated CAR was significantly associated with poorer OS (hazard ratio: 2.393; 95% confidence interval: 1.949-2.938, P < .01) as well as decreased progression-free survival/disease-free survival/recurrence-free survival (hazard ratio: 1.731; 95% confidence interval: 1.261-2.375, P < .01). Additionally, high CAR was significantly consistent with increased modified Glasgow Prognostic Score and neutrophil-lymphocyte ratio. CONCLUSION: High CAR could be a negative prognostic marker for mCRC patients. More large-sample clinical trials are still needed to confirm the prognostic significance of CAR in mCRC.

Effect of bevacizumab combined with first-line chemotherapy on metastatic colorectal cancer.

BACKGROUND: To investigate the effect of bevacizumab combined with chemotherapy on the metastasis response rate, survival time of patients with metastatic colorectal cancer (mCRC), the incidence of complications, and the efficacy and safety of bevacizumab for mCRC were recorded. METHODS: Of 87 patients with mCRC, 42 were treated without bevacizumab (control group, CG) and 45 were treated with bevacizumab (observation group, OG). Baseline characteristics, resectability of metastases, quality of life (QOL), and short- and long-term curative effect were compared to evaluate the safety of the treatment plan in the two groups. RESULTS: After 6 months of treatment, the overall response rate (ORR) and disease control rate (DCR) of the CG were 28.57% and 59.52%, respectively, whereas the ORR and DCR of the OG were notably higher at 48.89% and 86.67%, respectively (P < 0.05). The resectability rate of metastases in the OG increased from 8.89% pretreatment to 40.00% posttreatment, whereas that of metastases in the CG increased from 11.90% pretreatment to 23.81% posttreatment. In the OG, the median survival time was 23.0 (range, 19.7-26.3) months, and the median progression-free survival (PFS) was 11.0 (range, 9.4-12.6) months. These results were all superior to those of the CG, which were 14.0 (range, 12.6-15.4) months and 6.0 (range, 4.9-7.2) months, respectively. CONCLUSION: Bevacizumab combined with first-line chemotherapy can significantly prolong survival and PFS, improve QOL, increase the resectability rate of metastases, and improve survival outcomes of patients with mCRC.