Prognostic and clinicopathological role of fibrinogen-to-albumin ratio in biliary tract cancers: a meta-analysis

Aims Fibrinogen-to-albumin ratio (FAR) is investigated for the prognostic value of biliary tract cancers (BTCs), but outcomes were heterogenous. Consequently, the current meta-analysis was carried out for analyzing its precise prognostic impact on BTCs.Materials and methods We systemically searched Web of Science, PubMed, Cochrane Library, and Embase till 20 November 2025. The significance of FAR in forecasting BTC overall survival (OS) along with recurrence-free survival (RFS) was examined through determining aggregate hazard ratios (HRs) alongside 95% confidence intervals (CIs).Results There were nine articles enrolling 2071 cases collected for the present meta-analysis. As shown by our combined findings, higher FAR showed obvious correlation with decreased OS (HR = 2.34, 95% CI = 1.80–3.05, p < 0.001) and inferior RFS (HR = 2.07, 95% CI = 1.37–3.12, p < 0.001) of BTCs. Furthermore, from our combined data, higher FAR exhibited obvious correlation with low differentiation (OR = 1.71, 95% CI = 1.38–2.12, p < 0.001), lymph node (LN) metastasis (OR = 1.36, 95% CI = 1.05–1.76, p = 0.018), and advanced T stage (OR = 2.64, 95% CI = 1.78–3.93, p < 0.001) of BTCs.Conclusion This meta-analysis demonstrated that elevated FAR was significantly associated with poor OS and inferior RFS in patients with BTCs. Moreover, high FAR was also tightly linked to low differentiation, LN metastasis, and higher T stage of BTCs.