CRP to Albumin Ratio as a Prognostic Nutrition-Based Biomarker for Patients With Gastric Cancer: A Narrative Review.

Gastric cancer stands as a significant global health challenge, ranking among the top malignancies worldwide in terms of prevalence and mortality. Despite advances in treatment modalities, including surgical intervention and chemotherapy, its prognosis remains largely unfavorable, with late-stage diagnoses contributing to high mortality rates. In recent years, attention has turned to inflammation-based prognostic markers, notably the CRP to albumin ratio (CAR), as potential indicators of disease progression and patient outcomes postoperatively. The CAR index is observed to have the potential as an independent predictor of survival outcomes, including overall survival (OS), disease-free survival, recurrence-free survival, and cancer-specific survival, but with inconsistent data. Discrepancies in defining optimal CAR cutoff values have been observed, and there are no standardized criteria. CAR is also integrated into the bibliography with other prognostic factors for the development of novel prognostic indices that offer avenues for refining risk stratification and enhancing patient care in gastric cancer management. In this narrative review, we study the utility of the CAR index for the OS of gastric cancer patients after a curative or palliative gastrectomy.