Prognostic value of the monocyte-to-albumin ratio in nasopharyngeal carcinoma: A retrospective cohort study.

INTRODUCTION

Although monocyte and albumin levels have been associated with survival in various malignant tumours, their specific prognostic significance in nasopharyngeal carcinoma (NPC) remains under-explored. This study seeks to examine the relationship between the monocyte-to-albumin ratio (MAR) and overall survival (OS) in NPC patients to create a precise prediction model.

METHOD: The authors retrospectively analysed data from 860 NPC patients who underwent concurrent chemoradiotherapy. The optimal cut-off for MAR was determined using the maximum selection log-rank method. Univariate and multivariate Cox proportional hazards models were applied to identify factors significantly related to OS. A predictive nomogram was then developed and rigorously validated for its accuracy.

RESULTS

The optimal MAR threshold was determined to be 11.63, effectively categorising the 860 NPC patients into 2 prognostic subgroups (hazard ratio 0.56; 95% confidence interval [CI] 0.41-0.77, P<0.001). The predictive nomogram exhibited strong predictive capability for OS, factoring in T stage, N stage, MAR value, body mass index, and age over 45 years. The concordance index (C-index) of the traditional tumour- node-metastasis staging system was found to be 0.64 (95% CI 0.57-0.70), which was less than the C-index of the nomogram (0.68; 95% CI 0.64-0.72) for OS.

CONCLUSION

MAR was identified as an innovative and independent prognostic factor in NPC patients, presenting a potential biomarker for personalised treatment strategies.