Preoperative circulating fibrinogen to albumin ratio in predicting 5-year prognosis of oral cancer radical surgery

Hong Zhu, Wei Zhang, Pu Ye,  Meng Wu

Abstract:

Accurate prediction of oral cancer (OC) prognosis before surgery is the key to treatment. The prognosis of OC is mainly based on the Tumor-Node-Metastasis (TNM) staging system, but TNM staging cannot accurately predict clinical prognosis. Current research results show that systemic inflammatory and nutritional markers can influence the postoperative prognosis and outcome of malignant tumors. The objectives of this research are to explore the preoperative blood fibrinogen and albumin in OC patients and to determine the predictive validity of the fibrinogen to albumin ratio (FAR) over 5 years of follow-up. This retrospective cohort study queried The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University database and identified 157 cases of OC operations performed between 2014 and 2016. Survival curves were presented by the Kaplan-Meier method. Univariate and multivariate analyses were used to assess clinical value for patients with radical surgery. The FAR revealed a good prediction for 5-year cancer-specific survival (CSS). The optimal cut-off value for FAR was 0.072. Multivariate logistic regression analyses revealed that FAR was an independent risk factor for survival. Increased FAR (>0.072) is negatively associated with the CSS of patients (log-rank test, p<0.01). The preoperative FAR may provide a significant predictor of cancer-specific survival in oral cancer patients undergoing radical surgery.