Table 1.
Characteristics of studies included in the meta-analysis
| Author [Ref.] | Year | Country | Cancer category | Case no. | Cancer stage | Design type | Primary treatment option | Optimal cut-off for AFR/FPR | No. > against No. < (cut-off) | Prognostic outcomes | Hazard ratio (95% CI) | Data origin | Follow-up period (months) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Chen et al. [22] | 2019 | China | Colorectal cancer | 430 | Metastatic | Prospective | Mixed modality but targeted therapy | 9.9 by X-tile (AFR) | NR | OS, PFS | OS(U),1.73 (1.35–2.21), Cohort 1 | Crude | More than 36 |
| PFS(U),1.85 (1.29–2.65), Cohort 1 | Crude | ||||||||||||
| Chen et al. [22] | 2019 | China | Colorectal cancer | 77 | Metastatic | Prospective | Radiochemotherapy | 9.9 by X-tile (AFR) | NR | OS, PFS | OS(U), 1.75 (0.93–3.31), Cohort 2 | Crude | More than 36 |
| PFS(U),1.43 (0.84–2.42), Cohort 2 | Crude | ||||||||||||
| Yu et al. [23] | 2019 | China | Ovarian cancer | 313 | Advanced | Retrospective | Surgery plus chemotherapy | 7.78 by ROC (AFR) | 162/151 | OS, PFS | OS(U), 2.50 (1.44–4.09) | Crude | At least 12 |
| OS(M),2.19 (1.18–3.67) | Crude | ||||||||||||
| PFS(U),1.56 (1.21–2.05) | Crude | ||||||||||||
| PFS(M),1.38 (1.04–1.82) | Crude | ||||||||||||
| Zhang et al. [24] | 2019 | China | Colorectal cancer | 71 | Metastatic | Retrospective | Chemotherapy | 10.63 by ROC (AFR) | 23/48 | PFS | PFS(U),1.91 (1.14–3.20) | Crude | Median 6.67 (1.86-27.17) |
| Li et al. [25] | 2019 | China | Ovarian cancer | 186 | I–IV (FIGO) | Retrospective | Surgical resection | Score = 0 (AFR) | 148/38 | OS | OS(U),1.92 (1.56–2.23), Subgroup 1 | Crude | Median 45.5 (2.0-45.5) |
| OS(M),1.05 (1.02–1.63), Subgroup 1 | Crude | ||||||||||||
| OS(U),2.53 (1.36–4.71), Subgroup 2 | Crude | ||||||||||||
| OS(M),2.13 (1.14–3.26),Subgroup 2 | Crude | ||||||||||||
| Ying et al. [26] | 2019 | China | NSCLC | 270 | III–IV (TNM) | Retrospective | Chemotherapy | 8.02 by ROC (AFR) | 119/151 | OS, PFS | OS(U),1.93 (1.28–2.98) | Crude | Up to 60 |
| OS(M),1.79 (1.11–2.59) | Crude | ||||||||||||
| PFS (U), 2.07 (1.32–3.12) | Crude | ||||||||||||
| PFS (M),1.80 (1.09-2.78) | Crude | ||||||||||||
| Du [27] | 2019 | China | Gallbladder cancer | 220 | Metastatic | Retrospective | Chemotherapy mainly | 15.45 by X-tile (AFR) | NR | OS | OS(U),1.97 (0.96–3.67) | Crude | More than 36 |
| OS(M),0.89 (0.46–1.73) | Crude | ||||||||||||
| Wang [28] | 2019 | China | CRLM | 452 | Metastatic | Retrospective | Surgical resection | 13.16 by X-tile (AFR) | 260/192 | OS, DFS | OS(U),1.71 (1.30–2.25) | Crude | Median 28 |
| OS(M),1.63 (1.16–2.30) | Crude | ||||||||||||
| DFS(U),1.60 (1.28–2.00) | Crude | ||||||||||||
| DFS(M),1.45 (1.14–1.88) | Crude | ||||||||||||
| Chen et al. [29] | 2018 | China | NSCLC | 529 | I–III (AJCC) | Retrospective | Surgical resection | 9.67 by ROC (AFR) | 392/137 | OS, DFS | OS(U),4.22 (2.83–6.29) | Crude | Median 35.0 (1–78.5) |
| OS(M),1.95 (1.21–3.16) | Crude | ||||||||||||
| DFS(U),2.73 (2.06–3.62) | Crude | ||||||||||||
| DFS(M),1.78 (1.27–2.51) | Crude | ||||||||||||
| Gao et al. [30] | 2018 | China | ESCC | 153 | 0–III (AJCC) | Prospective | Surgical resection | 9.3 by ROC (AFR) | 128/25 | OS | OS(U),1.95 (1.18–3.25) | Crude | More than 36 |
| OS(M),2.38 (1.15–4.93) | Crude | ||||||||||||
| Li et al. [31] | 2018 | China | Lung cancer | 412 | I–IV | Prospective | Multiple modality | 7.8 by ROC (AFR) | NR | OS | OS(U),1.97 (1.36–2.85) | Crude | More than 36 |
| OS(M),1.79 (1.23–2.61) | Crude | ||||||||||||
| Sun et al. [32] | 2018 | China | Colorectal cancer | 702 | I–III (AJCC) | Prospective | Surgical resection | 9.2 by X-tile (AFR) | 562/118 | OS | OS(U),1.88 (1.25–2.84) | Crude | More than 36 |
| OS(M),1.41 (0.90–2.20) | Crude | ||||||||||||
| Liang et al. [33] | 2018 | China | Soft tissue sarcoma | 310 | IA–IV (AJCC) | Retrospective | Surgical resection | 13.77 by ROC (AFR) | 176/134 | OS, DFS | OS(U),3.15 (2.07–4.79) | Crude | Median 91.5 |
| OS(M),1.91 (1.16–3.13) | Crude | ||||||||||||
| DFS(U),1.96 (1.41–2.72) | Crude | ||||||||||||
| Xu et al. [34] | 2018 | China | HCC | 151 | 0-C (BCLC) | Retrospective | Surgical resection | 16.1 by ROC (AFR) | 50/101 | OS, DFS | OS(U),2.15 (1.35–3.40) | Crude | Median 33.8 (1–86) |
| OS(M),2.02 (1.27–3.21) | Crude | ||||||||||||
| DFS(U),1.70 (1.14–2.54) | Crude | ||||||||||||
| DFS(M),1.56 (1.03–2.35) | Crude | ||||||||||||
| Sun et al. [35] | 2018 | China | ESCC | 373 | I–III (AJCC) | Retrospective | Surgical resection | Score = 0 (AFR) | 154/219 | OS, DFS | OS(U),1.69 (1.27–2.24) | Crude | Median 51.9 |
| OS(M),1.37 (1.01–1.88) | Crude | ||||||||||||
| DFS(U),1.68 (1.28–2.20) | Crude | ||||||||||||
| DFS(M),1.39 (1.04–1.88) | Crude | ||||||||||||
| Xu et al. [36] | 2018 | China | Gallbladder cancer | 154 | 0–IVB (AJCC) | Retrospective | Surgical resection | 12.5 by ROC (AFR) | 71/83 | OS | OS(U),4.63 (2.99–7.17) | Crude | Median 17 |
| OS(M),2.81 (1.77–4.48) | Crude | ||||||||||||
| Zou et al. [37] | 2018 | China | Leukemia | 191 | A–C (Binet stage) | Retrospective | Untreated | 9.7 by X-tile (AFR) | 171/20 | OS | OS(U),3.65 (1.67–7.99) | Crude | Median 51 (1–270) |
| OS(M),3.47 (1.54–7.82) | Crude | ||||||||||||
| PFS (U),1.24 (0.72–2.13) | Crude | ||||||||||||
| Zhang et al. [38] | 2017 | China | Gastric cancer | 360 | II–III (AJCC) | Retrospective | Surgical resection | 8.9 by X-tile (AFR) | 290/70 | OS | OS(U),2.34 (1.59–3.45) | Crude | More than 36 |
| OS(M),1.54 (1.01–2.34) | Crude | ||||||||||||
| Hwang et al. [39] | 2017 | Korea | Breast cancer | 793 | I–III (AJCC) | Retrospective | Surgical resection | 14.08 by ROC (AFR) | 538/255 | OS | OS(U),2.72 (1.66–4.47) | Crude | Median 44.0 (0–197) |
| OS(M),2.62 (1.46–4.72) | Crude | ||||||||||||
| Tan et al. [40] | 2017 | China | ESCC | 1135 | T1-4aN0-3 (AJCC) | Retrospective | Surgical resection | 12.5 by X-tile (AFR) | 625/510 | OS | OS(U),1.38 (1.22–1.56) | Curve | More than 60 |
| OS(M),1.33 (1.09–1.69) | Crude | ||||||||||||
| Zhang et al. [41] | 2019 | China | HCC | 230 | A–C (BCLC) | Prospective | Surgical resection | 15.6 by X-tile (FPR) | NR | OS, DFS | OS(U),5.07 (2.55–10.06) | Crude | More than 36 |
| OS(M),4.16 (2.06–8.39) | Crude | ||||||||||||
| DFS(U),2.20 (1.36–3.57) | Crude | ||||||||||||
| DFS(M),1.77 (1.04–2.99) | Crude | ||||||||||||
| Li [42] | 2019 | China | NSCLC | 360 | IIB–IV (AJCC) | Retrospective | Chemotherapy | 21.24 by ROC (FPR) | 151/209 | OS | OS(U),2.09 (1.66–2.62) | Data | 3–45 |
| OS(M),1.22 (1.04–1.43) | Crude | ||||||||||||
| Du et al. [27] | 2019 | China | Gallbladder cancer | 220 | Metastatic | Retrospective | Chemotherapy mainly | 31.84 by X-tile (FPR) | NR | OS | OS(U),1.93 (1.26–2.97) | Crude | More than 36 |
| OS(M),1.57 (1.00–2.46) | Crude | ||||||||||||
| Sun et al. [32] | 2018 | China | Colorectal cancer | 555 | I–III (AJCC) | Prospective | Surgical resection | 18.3 by X-tile (FPR) | 230/325 | OS | OS(U),2.40 (1.57–3.67) | Crude | More than 36 |
| OS(M),1.94 (1.24–3.05) | Crude | ||||||||||||
| Zhang et al. [38] | 2017 | China | Gastric cancer | 360 | II–III (AJCC) | Retrospective | Surgical resection | 12.1 by X-tile (FPR) | 246/114 | OS | OS(U),3.37 (2.02–5.64) | Crude | More than 36 |
| OS(M),2.33 (1.37–3.94) | Crude | ||||||||||||
| Chen et al. [22] | 2019 | China | Colorectal cancer | 430 | Metastatic | Prospective | Mixed modality but targeted therapy | 22.8 by X-tile (FPR) | NR | OS | OS(U),2.33 (1.42–3.82), Cohort 1 | Crude | More than 36 |
| OS(M),1.90 (1.10–3.28), Cohort 1 | Crude | ||||||||||||
| Chen et al. [22] | 2019 | China | Colorectal cancer | 77 | Metastatic | Prospective | Radiochemotherapy | 22.8 by X-tile (FPR) | NR | OS | OS(U),4.47 (1.65–12.14), Cohort 2 | Crude | More than 36 |
| OS(M),4.21 (1.16–15.27), Cohort 2 | Crude | ||||||||||||
| Zhang et al [24] | 2019 | China | Colorectal cancer | 71 | Metastatic | Retrospective | Chemotherapy | 18.49 by ROC (FPR) | 23/48 | PFS | PFS(U),1.79 (1.11–2.88) | Crude | Median 6.67 (1.86–27.17) |
NSCLC non-small cell lung cancer, CRLM colorectal liver metastases, ESCC esophageal squamous cell carcinoma, HCC hepatocellular carcinoma, AFR albumin to fibrinogen, FPR fibrinogen to prealbumin ratio, NR not reported, ROC receiver operating characteristic, U univariate, M multivariate