Published online Sep 15, 2023. doi: 10.4251/wjgo.v15.i9.1662
Peer-review started: May 31, 2023
First decision: July 23, 2023
Revised: August 4, 2023
Accepted: August 18, 2023
Article in press: August 18, 2023
Published online: September 15, 2023
Fibrinogen-to-albumin ratio (FAR) has been found to be of prognostic significance for several types of malignant tumors. However, less is known about the association between FAR and survival outcomes in hepatocellular carcinoma (HCC) patients.
To explore the association between FAR and prognosis and survival in patients with HCC.
A total of 366 histologically confirmed HCC patients diagnosed between 2013 and 2018 in a provincial cancer hospital in southwestern China were retrospectively selected. Relevant data were extracted from the hospital information system. The optimal cutoff for baseline serum FAR measured upon disease diagnosis was established using the receiver operating characteristic (ROC) curve. Univariate and multivariate Cox proportional hazards models were used to determine the crude and adjusted associations between FAR and the overall survival (OS) of the HCC patients while controlling for various covariates. The restricted cubic spline (RCS) was applied to estimate the dose-response trend in the FAR-OS association.
The optimal cutoff value for baseline FAR determined by the ROC was 0.081. Multivariate Cox proportional hazards model revealed that a lower baseline serum FAR level was associated with an adjusted hazard ratio of 2.43 (95% confidence interval: 1.87–3.15) in the OS of HCC patients, with identifiable dose-response trend in the RCS. Subgroup analysis showed that this FAR-OS association was more prominent in HCC patients with a lower baseline serum aspartate aminotransferase or carbohydrate antigen 125 level.
Serum FAR is a prominent prognostic indicator for HCC. Intervention measures aimed at reducing FAR might result in survival benefit for HCC patients.
Core Tip: It is important to explore the affecting factors of survival for hepatocellular carcinoma (HCC) patients. A receiver operating characteristic curve was used to establish the optimal cutoff value for baseline serum fibrinogen-to-albumin ratio (FAR) in disease diagnosis. Univariate and multivariate Cox proportional risk models were employed to determine the correlation between FAR and overall survival (OS) in HCC patients. Restricted cubic spline was used to estimate dose-response trends in FAR-OS associations. Serum FAR is an important prognostic index of HCC. Effective FAR reduction may benefit HCC patient survival.