Correlation of Preoperative Fibrinogen/Albumin Ratio and Postoperative C-reactive Protein/Albumin Ratio with Early Complications After Radical Resection of Rectal Cancer

Abstract

Abstract Background: Inflammatory response, nutritional status, and coagulation system function are closely related to tumor initiation, proliferation, metastasis, and poor prognosis. The purpose of this study was to explore the correlation between preoperative fibrinogen/albumin ratio (FAR) and postoperative C-reactive protein/albumin ratio (CAR) and early complications after radical resection of rectal cancer. Meanwhile, the predictive value of FAR and CAR for early complications after radical resection of rectal cancer was compared.Methods: The clinical data of 810 patients undergoing radical rectal cancer surgery who were admitted to the General Surgery Department of Taizhou Hospital, Zhejiang Province, from January 2017 to December 2021 were retrospectively analyzed, and to identify early complications after radical rectal cancer surgery, univariate and multivariate analyses were used. In predicting early complications after radical rectal cancer surgery, the receiver operating characteristic curve was used to analyze and evaluate the accuracy of preoperative FAR and postoperative CAR. The relationship between different levels of preoperative FAR and the incidence of early postoperative complications and median postoperative hospital stay in patients with rectal cancer were analyzed and compared.Results: Early postoperative complications occurred in 223 (27.5%) of 810 patients enrolled. In univariate analysis, the correlations between early postoperative complications after radical rectectomy and age, diabetes, preoperative albumin, preoperative hemoglobin, carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), preoperative fibrinogen, postoperative C-reactive protein, preoperative FAR value after radical rectal cancer surgery, postoperative CAR value, surgical route, surgical method, surgical time, intraoperative blood loss, and tumor pathological staging were statistically significant (P < 0.05). In multivariate analysis, tumor pathological stage [OR (95% CI): 0.572 (0.331–0.989), P = 0.046], preoperative FAR value [OR (95% CI): 0.035 (0.018–0.069), P < 0.001], and postoperative CAR value [OR (95% CI): 0.163 (0.057–0.464), P = 0.001] were independent predictors of early complications after radical resection of rectal cancer. Multivariate analysis identified that tumor pathological stage [OR (95% CI): 0.572 (0.331–0.989), P = 0.046], preoperative FAR value [OR (95% CI): 0.035 (0.018–0.069), P < 0.001], and postoperative CAR value [OR (95% CI): 0.163 (0.057–0.464), P = 0.001] were independent predictors for early postoperative complications.Conclusions: In patients with radical rectal cancer, both preoperative FAR value and postoperative CAR value are independent predictors of early postoperative complications, but FAR is more suggestive of the occurrence of complications than CAR.