C-reactive protein-to-albumin ratio predicts outcome of neoadjuvant chemotherapy for colorectal liver metastases: A multicenter prediction model

作者：Tao Zheng, Zheng Yuanyuan, Zhenyuan Zhou, Rong Ye, Hangdong Jia, Weijie Chen, Ming Zheng, Yizhen Chen · 发表于：Surgery · 年份：2025 · DOI：10.1016/j.surg.2025.109334 · 被引用次数：10 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Hepatocellular Carcinoma Treatment and Prognosis、Colorectal Cancer Surgical Treatments

BACKGROUND: Neoadjuvant chemotherapy for patients with colorectal liver metastasis often results in varying outcomes. This study aimed to develop a clinical prediction model incorporating the C-reactive protein-to-albumin ratio to determine neoadjuvant chemotherapy efficacy in patients with colorectal liver metastasis METHODS: This retrospective study included 1,335 patients with colorectal liver metastasis who received neoadjuvant chemotherapy. Patients were classified into high and low C-reactive protein-to-albumin ratio groups on the basis of an optimal cutoff value. Multivariate regression and Cox proportional hazards models were used to examine associations between clinical factors and progression-free survival. A prediction model was constructed and validated both internally and externally. RESULTS: The optimal C-reactive protein-to-albumin ratio cutoff value was 0.234. Patients with a high C-reactive protein-to-albumin ratio had a greater risk of 3-year disease progression and shorter 5-year survival (both P < .05). The final model incorporated C-reactive protein-to-albumin ratio value, clinical risk score, and tumor differentiation. It demonstrated excellent performance in predicting progression-free survival (C-index = 0.69) and OS (C-index = 0.72), outperforming the clinical risk score alone in both internal and external validations. CONCLUSION: The C-reactive protein-to-albumin ratio is an effective independent predictor for patients with colorectal liver metastasi...