The Prognostic Value Of Preoperative Fibrinogen To Albumin Ratio In Patients With Resectable Gastrointestinal Stromal Tumor

Objective:To evaluate the prognostic significance of FAR in gastrointestinal stromal tumor(GIST)patients.Methods:A total of 218 patients with GIST who underwent radical surgery in the Second Affiliated Hospital of Nanchang University from January 2015 to January 2018 were included in this retrospective study.Preoperative FAR values,NLR values(Neutrophil to lymphocyte ratio),PLR values(platelet to lymphocyte ratio)and SII values(Systemic immune inflammatory index)of these patients were collected and calculated.The optimal critical points for FAR,NLR,PLR,and SII were determined by Receiver operating characteristic(ROC)curves with the 5-years recurrence-free survival as an endpoint.The Kaplan–Meier curves and multivariate Cox regression model were used to evaluate prognostic factors.Results:The optimal critical points was 0.09 for the FAR by the ROC analysis,so patients were divided into high FAR group(FAR≥0.09)and low FAR group(FAR < 0.09).In addition,FAR performs better in evaluating RFS than NLR,PLR,and SII.In the Kaplan-Meier analysis,The RFS in low FAR group was significantly longer than that in high FAR group(p < 0.001).Many important factors are closely associated with FAR,included tumor size,mitotic index,modified NIH risk category,surgical procedure,NLR,and SII.Multivariate analysis showed that mitotic index(P=0.011),modified NIH risk category(P<0.001),FAR(P=0.043),and NLR(P=0.033)were independent prognostic factors of RFS in patients with gastrointestinal stromal tumors.In addition,in the high-risk subgroup analysis,patients with low FAR had longer RFS than patients with high FAR(P =0.024).Conclusion:1.The preoperative FAR was a simple and effective biomarker to predict the recurrence-free survival of GIST patients after radical resection.2.The preoperative FAR has reference value for more accurate classification of recurrence risk in GIST patients.