C-Reactive Protein-to-Albumin Ratio to Predict Tolerability of S-1 as an Adjuvant Chemotherapy in Pancreatic Cancer

• Published in: Cancers 2024-02, Vol.16 (5), p.922
• Main Authors: Funamizu, Naotake, Sakamoto, Akimasa, Hikida, Takahiro, Ito, Chihiro, Shine, Mikiya, Nishi, Yusuke, Uraoka, Mio, Nagaoka, Tomoyuki, Honjo, Masahiko, Tamura, Kei, Sakamoto, Katsunori, Ogawa, Kohei, Takada, Yasutsugu
• Format: Article
• Language: English
• Subjects: Adjuvant treatment; Albumin; Body mass index; C-reactive protein; Cancer; Cancer therapies; Chemotherapy; Enzymes; Hospitals; Medical prognosis; Multivariate analysis; Nutritional status; Oral administration; Pancreatic cancer; Patient compliance; Patients; Potassium; Statistical analysis; Surgeons; Surgery; Survival; Toxicity
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers16050922

Adjuvant chemotherapy (AC) with S-1 after radical surgery for resectable pancreatic cancer (PC) has shown a significant survival advantage over surgery alone. Consequently, ensuring that patients receive a consistent, uninterrupted S-1 regimen is of paramount importance. This study aimed to investigate whether the C-reactive protein-to-albumin ratio (CAR) could predict S-1 AC completion in PC patients without dropout due to adverse events (AEs). We retrospectively enrolled 95 patients who underwent radical pancreatectomy and S-1 AC for PC between January 2010 and December 2022. A statistical analysis was conducted to explore the correlation of predictive markers with S-1 completion, defined as continuous oral administration for 6 months. Among the 95 enrolled patients, 66 (69.5%) completed S-1, and 29 (30.5%) failed. Receiver operating characteristic curve analysis revealed 0.05 as the optimal CAR threshold to predict S-1 completion. Univariate and multivariate analyses further validated that a CAR ≥ 0.05 was independently correlated with S-1 completion ( < 0.001 and = 0.006, respectively). Furthermore, a significant association was established between a higher CAR at initiation of oral administration and acceptable recurrence-free and overall survival ( = 0.003 and < 0.001, respectively). CAR ≥ 0.05 serves as a predictive marker for difficulty in completing S-1 treatment as AC for PC due to AEs.