Background: The prognostic value of the creatinine-cystatin C ratio (CCR) in individuals with cancer has been investigated in numerous studies, but the findings vary. To accurately identify the prognostic value of CCR in individuals with cancer, we conducted this meta-analysis.
Methods: Pertinent studies were retrieved across PubMed, Web of Science, Embase and Cochrane from their establishment to June 8, 2024. Additional searches were conducted until November 16, 2024. In this study, the calculation of the hazard ratio (HR) and its 95% confidence interval (CI) allowed us to determine the prognostic value of CCR in individuals with cancer. Additionally, Newcastle-Ottawa scale (NOS) was employed for quality evaluation, Cochrane I2 statistic for heterogeneity assessment, funnel plots for publication bias evaluation, and Egger test for quantitative identification. Significant publication bias is indicated by a P < 0.05. A software called STATA 15.1 was utilized for statistical analysis.
Results: Initially, 2001 articles were retrieved in total, and this study comprised twelve trials with 4439 individuals with cancer overall. Our findings demonstrated a substantial correlation between a low CCR and a reduced overall survival (OS) in individuals with cancer (HR 1.71, 95% CI 1.49-1.96). Similarly, a strong correlation between CCR and progression-free survival (PFS) CCR was also noted (HR 1.51, 95% CI 1.29-1.77).
Conclusion: This meta-analysis revealed that in individuals with cancer, a low CCR was strongly correlated with OS and PFS. Therefore, in clinical practice, CCR may be a promising and affordable prognostic biomarker for individuals with cancer.
Keywords: Cancer; Creatinine–cystatin C ratio (CCR); Meta-analysis; Prognostic value.
© 2026. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.