Prognostic prediction of colorectal cancer using the C-reactive protein to albumin ratio: the importance of inflammatory biomarkers and their association with long-term outcomes.

ing cause of death in Korea [1]. The standard therapy recommended for high-risk stage II and III patients is oxaliplatin-based adjuvant chemotherapy combined with fluoropyrimidine. This treatment regimen has significantly enhanced both overall survival and disease-free survival rates. However, outcomes can vary greatly among patients with the same disease stage [2]. Most patients who experience recurrence ultimately succumb to distant metastases [2, 3]. Therefore, considerable efforts have been made to investigate risk factors linked to distant metastasis in colorectal cancer, as well as to develop strategies for its prevention and management to improve oncological outcomes. Systemic inflammation has been identified as a key factor affecting the prognosis of colorectal cancer, prompting extensive research into various biomarkers [4–7]. Inflammatory indicators, such as the Glasgow Prognostic Score, neutrophil to lymphocyte ratio, and lymphocyte to monocyte ratio, have been extensively studied [6, 7]. More recently, the C-reactive protein to albumin ratio (CAR) has been reported to be a useful predictor of the prognosis of CRC. Kataoka et al. [8] found a distinct association between CAR on postoperative day (POD) 7 and prognosis. They proposed that CAR on POD 7 plays a significant role in the metastatic process of cancer. Even when patients undergo scheduled adjuvant chemoPrognostic prediction of colorectal cancer using the C-reactive protein to albumin ratio: the importance of inflammatory biomarkers and their association with long-term outcomes