Prognostic and clinicopathological value of fibrinogen-to-albumin ratio in colorectal cancer: a meta-analysis.

BACKGROUND

The fibrinogen-to-albumin ratio (FAR) has been extensively studied for its potential to predict the prognosis of patients with colorectal cancer (CRC). However, findings have been inconsistent. Therefore, this meta-analysis aims to examine the prognostic value of FAR in CRC.

METHODS

A comprehensive search of PubMed, Web of Science, Cochrane Library, and Embase was conducted up to January 14, 2025. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the value of FAR for estimating overall survival (OS) and progression-free survival (PFS) in patients with CRC. Additionally, the relationship between FAR and CRC clinicopathological characteristics was explored using pooled odds ratios (ORs) with corresponding 95% CIs.

RESULTS

This meta-analysis included 10 studies comprising 4,704 patients. The findings indicated that elevated FAR was significantly associated with worse OS (HR = 1.59, 95% CI = 1.38-1.83,  < 0.001) and PFS (HR = 1.65, 95% CI = 1.44-1.90,  < 0.001) among patients with CRC. Subgroup analyses confirmed that high FAR consistently predicted unfavorable OS and PFS, regardless of study design, histology, treatment, FAR threshold, threshold determination method, or type of survival analysis (all  < 0.05). Moreover, elevated FAR was significantly associated with age ≥60 years (OR = 1.56, 95% CI = 1.31-1.85,  < 0.001), male sex (OR = 1.20, 95% CI = 1.01-1.43,  = 0.042), and poor tumor differentiation (OR = 1.63, 95% CI = 1.26-2.10,  < 0.001).

CONCLUSIONS

Elevated FAR is strongly associated with poor OS and PFS in patients with CRC, as well as with older age and poor tumor differentiation, suggesting its potential as a prognostic marker.