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Original Research

High C-reactive protein/albumin ratio predicts unfavorable distant metastasis-free survival in nasopharyngeal carcinoma: a propensity score-matched analysis

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Pages 371-381 | Published online: 21 Feb 2018

Figures & data

Table 1 Clinical and laboratory characteristics of the patients in the training set and validation set

Table 2 Associations between CAR and clinicopathological features before and after propensity score matching

Figure 1 Hazard ratios (HRs) for distant metastasis-free survival (DMFS) for various cutoff points of the C-reactive protein/albumin (CRP/ALB) ratio (CAR) in patients with nasopharyngeal carcinoma.

Notes: The value of X-axis represented all the possible values of CAR in our patient population. The Y-axis represents HRs. From the left to right of the X-axis, all the possible CAR values were tested as a cutoff for discrimination of DMFS and the corresponding HR and its 95% confidence interval (CI) were calculated and plotted (two dashed lines represent upper and lower limits of 95% CIs, respectively, and the solid line between the two dashed lines represents HR). The vertical line designates the optimal cutoff point with the most significant split (log-rank test). The plots were generated using Cutoff Finder.

Figure 1 Hazard ratios (HRs) for distant metastasis-free survival (DMFS) for various cutoff points of the C-reactive protein/albumin (CRP/ALB) ratio (CAR) in patients with nasopharyngeal carcinoma.Notes: The value of X-axis represented all the possible values of CAR in our patient population. The Y-axis represents HRs. From the left to right of the X-axis, all the possible CAR values were tested as a cutoff for discrimination of DMFS and the corresponding HR and its 95% confidence interval (CI) were calculated and plotted (two dashed lines represent upper and lower limits of 95% CIs, respectively, and the solid line between the two dashed lines represents HR). The vertical line designates the optimal cutoff point with the most significant split (log-rank test). The plots were generated using Cutoff Finder.

Table 3 Univariate and multivariate analyses of associations between CAR and DMFS before propensity score matching in the training cohort

Figure 2 Prognostic value of the C-reactive protein/albumin ratio (CAR) for distant metastasis-free survival (DMFS) in the training cohort before matching (A), the validation cohort (B) and training cohort after 1:1 ratio matching (C).

Figure 2 Prognostic value of the C-reactive protein/albumin ratio (CAR) for distant metastasis-free survival (DMFS) in the training cohort before matching (A), the validation cohort (B) and training cohort after 1:1 ratio matching (C).

Figure 3 Forest plot of subgroup analysis showing hazard ratios (HRs) and 95% CI (bars) for DMFS in 1,168 patients with nasopharyngeal carcinoma who underwent definitive radiotherapy.

Note: Subgroups were defined by factors showing significant associations with the C-reactive protein/albumin ratio (CAR) and DMFS.

Abbreviations: 3DCRT, three-dimensional conformal radiation therapy; ALB, albumin; ALP, alkaline phosphatase; ALT, alanine transaminase; AST, aspartate transaminase; CAR, CRP/ALB ratio; CI, confidence interval; CRP, C-reactive protein; CRT, conventional radiotherapy; chemo-radiotherapy, chemotherapy plus radiotherapy; DMFS, distant metastasis-free survival; EBV-DNA, Epstein–Barr virus DNA; GLB, globulin; HGB, hemoglobin; IMRT, intensity-modulated radiation therapy; LDH, lactate dehydrogenase; RT, radiotherapy; WBC, white blood cell.

Figure 3 Forest plot of subgroup analysis showing hazard ratios (HRs) and 95% CI (bars) for DMFS in 1,168 patients with nasopharyngeal carcinoma who underwent definitive radiotherapy.Note: Subgroups were defined by factors showing significant associations with the C-reactive protein/albumin ratio (CAR) and DMFS.Abbreviations: 3DCRT, three-dimensional conformal radiation therapy; ALB, albumin; ALP, alkaline phosphatase; ALT, alanine transaminase; AST, aspartate transaminase; CAR, CRP/ALB ratio; CI, confidence interval; CRP, C-reactive protein; CRT, conventional radiotherapy; chemo-radiotherapy, chemotherapy plus radiotherapy; DMFS, distant metastasis-free survival; EBV-DNA, Epstein–Barr virus DNA; GLB, globulin; HGB, hemoglobin; IMRT, intensity-modulated radiation therapy; LDH, lactate dehydrogenase; RT, radiotherapy; WBC, white blood cell.

Table 4 Univariate and multivariate analyses of associations between CAR and DMFS after 1:1 ratio propensity score matching in the training cohort