Hou YS, Yu ZY, Yang XJ. C-reactive protein/albumin ratio in immunochemotherapy for advanced gastric cancer: Prognostic value, clinical challenges, and future directions. World J Gastrointest Oncol 2026; 18(8): 120245 [DOI: 10.4251/wjgo.v18.i8.120245]
Corresponding Author of This Article
Xiao-Jun Yang, MD, Associate Professor, Chief Physician, Department of Hepatobiliary Surgery, Gansu Provincial Hospital, No. 199 Donggang West Road, Chengguan District, Lanzhou 730000, Gansu Province, China. yangxjmd@aliyun.com
Research Domain of This Article
Oncology
Article-Type of This Article
review-article
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World J Gastrointest Oncol. Aug 15, 2026; 18(8): 120245 Published online Aug 15, 2026. doi: 10.4251/wjgo.v18.i8.120245
C-reactive protein/albumin ratio in immunochemotherapy for advanced gastric cancer: Prognostic value, clinical challenges, and future directions
Yan-Song Hou, Ze-Yuan Yu, Xiao-Jun Yang
Yan-Song Hou, Ze-Yuan Yu, Department of Gastrointestinal Surgery, The Second Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Xiao-Jun Yang, Department of Hepatobiliary Surgery, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Co-corresponding authors: Ze-Yuan Yu and Xiao-Jun Yang.
Author contributions: Hou YS contributed to this paper, the writing, and editing the manuscript; Yu ZY and Yang XJ contributed to manuscript review; and all of the authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Xiao-Jun Yang, MD, Associate Professor, Chief Physician, Department of Hepatobiliary Surgery, Gansu Provincial Hospital, No. 199 Donggang West Road, Chengguan District, Lanzhou 730000, Gansu Province, China. yangxjmd@aliyun.com
Received: February 24, 2026 Revised: March 9, 2026 Accepted: May 6, 2026 Published online: August 15, 2026 Processing time: 163 Days and 19.1 Hours
Core Tip
Core Tip: C-reactive protein/albumin ratio (CAR) has attracted attention because it is easy to obtain, highly reproducible in clinical practice, and biologically linked to systemic inflammation, malnutrition, cachexia, treatment tolerance, and immune competence. We argue that, in Immunochemotherapy for advanced gastric cancer, the greatest value of CAR is not as an independent determinant of treatment selection, but as a complementary host-state biomarker that should be interpreted alongside programmed death ligand 1, mismatch repair status, metastatic burden, and performance status. The field now needs prospective validation, dynamic monitoring of CAR, and clinical trials testing whether CAR-guided nutritional or anti-inflammatory interventions can improve clinically meaningful outcomes.
