Prognostic and clinicopathological value of fibrinogen-to-albumin ratio in non-small cell lung cancer: a meta-analysis

Abstract

Background: The fibrinogen-to-albumin ratio (FAR) has been explored for its role in predicting non-small cell lung cancer (NSCLC) prognosis, but findings remain inconsistent. This study aimed to determine the exact impact of FAR on predicting NSCLC prognosis through a meta-analysis. Methods: This study conducted a comprehensive search of PubMed, Web of Science, Embase, Cochrane Library, and CNKI up to April 2, 2025, and determined pooled hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate the prognostic value of FAR in NSCLC. Results: This meta-analysis included seven studies with a total of 2,655 cases. The pooled analysis revealed that an elevated FAR significantly predicted poor overall survival (OS) (HR = 1.82, 95% CI = 1.56–2.14, p < 0.001) and poor progression-free survival (PFS) (HR = 1.50, 95% CI = 1.29–1.74, p < 0.001) in patients with NSCLC, which was strongly associated with male sex (OR = 1.53, 95% CI = 1.12–2.08, p = 0.008) and tumor size ≥ 5 cm (OR = 1.52, 95% CI = 1.08–2.14, p = 0.017). However, FAR showed no significant correlation with smoking history (OR = 1.44, 95% CI = 0.80–2.59, p = 0.218) or Eastern Cooperative Oncology Group performance status (OR = 1.60, 95% CI = 0.74–3.45, p = 0.230). Conclusion: This meta-analysis suggests that elevated FAR is a strong predictor of OS and PFS in patients with Chinese NSCLC and correlates with larger tumor size.