ArticleOncoTargets and therapy2025
Prognostic Impact of Pre-Treatment CRP/Albumin Ratio in Patients with Advanced-Stage Epithelial Ovarian Cancer.
Article in OncoTargets and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Systemic inflammation has emerged as a key determinant of prognosis in epithelial ovarian cancer (EOC). The pre-treatment C-reactive protein/albumin (CRP/Alb) ratio integrates host inflammatory and nutritional status, but its prognostic role in advanced-stage EOC remains incompletely defined. Methods: We retrospectively analyzed 256 patients with FIGO stage III-IV high-grade serous ovarian cancer treated at a tertiary oncology center between 2010 and 2024. All patients underwent primary or interval cytoreductive surgery followed by standard platinum-based chemotherapy. Pre-treatment CRP and albumin values obtained within 14 days before therapy were used to calculate the CRP/Alb ratio. Patients were stratified according to the predefined median cut-off (2.32). Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. Cox regression models were applied for univariate and multivariate analyses. Results: Median follow-up was 81.4 months. The median OS for the entire cohort was 58.1 months. Patients with a CRP/Alb ratio <2.32 had significantly longer OS (74.6 vs 45.6 months; p = 0.003) and PFS (24.8 vs 17.1 months; p = 0.026) compared to those with higher ratios. In multivariate analysis, a CRP/Alb ratio ≥2.32 remained an independent predictor of worse OS (HR = 1.88; 95% CI: 1.12-3.18; p = 0.018), along with age ≥65 years (HR = 2.34; p < 0.001) and ECOG performance status 2-3 (HR = 1.60; p = 0.006). Individual CRP or albumin levels did not retain prognostic significance. Conclusion: The pre-treatment CRP/Alb ratio is a simple, accessible, and independent prognostic biomarker in advanced-stage EOC. Its integration into routine risk assessment may enhance individualized prognostication and help identify high-risk patients who could benefit from closer monitoring and tailored supportive care. Prospective multicenter validation is warranted.
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