Prognostic and clinicopathological role of pretreatment fibrinogen-to-albumin ratio (FAR) in patients with gastric cancer: a meta-analysis.

[BACKGROUND] Fibrinogen-to-albumin ratio (FAR) has been previously suggested for its significance in forecasting gastric cancer (GC) prognosis, however, the results remained conflicting. The present work focused on clarifying FAR's accurate effect on forecasting GC prognosis via meta-analysis.

[METHODS] This study thoroughly retrieved PubMed, Web of Science, Embase, Cochrane Library, and CNKI until January 4, 2025, and determined pooled hazard ratios (HRs) and 95% confidence intervals (CIs) to forecast FAR's role in forecasting GC overall survival (OS) and disease-free survival (DFS).

[RESULTS] We retrieved 12 studies recruiting 5665 cases in the present work. From the pooled findings, high FAR exhibited significant relation to unfavorable OS (HR = 1.68, 95%CI = 1.38-2.04, p < 0.001) of patients with GC. But FAR was not apparently linked with DFS of GC (HR = 1.24, 95%CI = 0.69-2.22, p = 0.468). According to our combined findings, elevated FAR exhibited significant connection to age ≥ 60 years (OR = 2.13, 95%CI = 1.72-2.65, p < 0.001), tumor size ≥ 5 cm (OR = 1.91, 95%CI = 1.13-3.24, p = 0.016), and TNM stage of III-IV (OR = 2.5, 95%CI = 2.08-3.23, p < 0.001). Nonetheless, FAR remained insignificantly linked with gender (OR = 1.16, 95%CI = 0.94-1.43, p = 0.162), invasion depth (OR = 2.01, 95%CI = 1.00-4.04, p = 0.050), N stage (OR = 1.30, 95%CI = 0.63-2.67, p = 0.482), tumor differentiation (OR = 1.22, 95%CI = 0.93-1.62, p = 0.153), and vascular invasion (OR = 1.11, 95%CI = 0.68-1.81, p = 0.687) of GC patients.

[CONCLUSION] In the present study, increased FAR dramatically predicted the dismal OS of GC. Moreover, high FAR showed obvious relation to older age, larger tumor size, and advanced stage of GC cases.