Prognostic role of C‐reactive protein to albumin ratio in lung cancer: An updated systematic review and meta‐analysis

Abstract Background C‐reactive protein to albumin ratio (CRP/Alb ratio, CAR) has been suggested as a potential prognostic biomarker in lung cancer. This updated systematic review and meta‐analysis aimed to assess the association between CAR and lung cancer prognosis in current literature. Methods A systematic search of databases was conducted to identify relevant studies published up to April 2023. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the association between CAR and overall survival (OS) and progression‐free survival (PFS) and recurrence‐free survival (RF) in lung cancer patients. Results This meta‐analysis includes 16 studies with a total of 5337 patients, indicating a significant association between higher CAR and poorer OS, PFS, and RFS in lung cancer patients, with a pooled HR of 1.78 (95% CI = 1.60–1.99), 1.57 (95% CI = 1.36–1.80), and 1.97 (95% CI = 1.40–2.77), respectively. Conclusions This updated meta‐analysis provides evidence for the potential prognostic role of CAR in lung cancer, suggesting its utility as an effective and noninvasive biomarker for identifying high‐risk patients and informing treatment decisions in a cost‐effective manner. However, further large‐scale studies will be necessary to establish the optimal cut‐off value for CAR in lung cancer and confirm the present findings.