Prognostic and clinicopathological value of fibrinogen-to-albumin ratio in patients with esophageal cancer: a meta-analysis.

BACKGROUND

Fibrinogen-to-albumin ratio (FAR) has been widely examined for its prognostic value in esophageal cancer (EC), although findings across studies have been inconsistent. This meta-analysis aimed to assess the predictive role of FAR in EC.

METHODS

A comprehensive search was conducted across Web of Science, Embase, PubMed, and Cochrane Library. The prognostic value of FAR in EC was assessed by pooling hazard ratios (HRs) and 95% confidence intervals (CIs). Additionally, the correlation between FAR and clinicopathological features of EC was evaluated using pooled odds ratios (ORs) and 95%CIs.

RESULTS

A total of six studies involving 2,616 patients were included. The analysis revealed that a high FAR was significantly associated with poor overall survival (OS) in EC (HR = 1.98, 95%CI = 1.48-2.65, p < 0.001). Furthermore, elevated FAR correlated significantly with male sex (OR = 1.38, 95%CI = 1.09-1.74, p = 0.007), T3-T4 stages (OR = 2.36, 95%CI = 1.93-2.87, p < 0.001), N1-N3 stages (OR = 1.58, 95%CI = 1.32-1.91, p < 0.001), TNM III-IV stages (OR = 2.68, 95%CI = 1.52-4.73, p = 0.001), and tumor length > 3 cm (OR = 2.36, 95%CI = 1.15-4.87, p = 0.020). However, FAR showed no significant association with age (OR = 0.87, 95%CI = 0.48-1.60, p = 0.660), tumor location (OR = 0.98, 95%CI = 0.77-1.25, p = 0.886), or tumor differentiation (OR = 1.09, 95%CI = 0.76-1.56, p = 0.634).

CONCLUSION

This meta-analysis highlights that an elevated FAR is a strong prognostic indicator of poor OS in patients with EC. Moreover, high FAR is significantly associated with clinical features indicative of tumor progression and metastasis.

© 2025. The Author(s).