Prognostic value of albumin to globulin ratio in non-muscle-invasive bladder cancer.
AGR
Albumin
BCG
Bladder cancer
Globulin
Non-muscle-invasive
Progression
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
13
09
2020
accepted:
29
12
2020
pubmed:
27
1
2021
medline:
1
2
2022
entrez:
26
1
2021
Statut:
ppublish
Résumé
To investigate the prognostic value of preoperative serum albumin to globulin ratio (AGR) in patients with non-muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of bladder tumor (TURB) with or without intravesical therapy (IVT). We retrospectively reviewed 1,096 consecutive patients with NMIBC. Levels of albumin and globulin were obtained before TURB and used to calculate the preoperative AGR level. Multivariable Cox regression analyses were performed to assess the prognostic effect of preoperative AGR on oncologic outcomes. Subgroup analyses were performed in patients based on the European Association of Urology (EAU) risk groups for NMIBC. Low AGR levels were observed in 389 (35.5%) patients. The median follow-up was 63.7 months (IQR 25.3-111). On multivariable Cox regression analysis, low AGR was associated with increased risk of progression to muscle-invasive BCa (MIBC) (HR 1.81, 95% CI 1.22-2.68, P = 0.003). The addition of AGR only minimally improved the discrimination ability of a base model that included established clinicopathologic features (C-index = 0.7354 vs. C-index = 0.7162). Low preoperative AGR was not significantly associated with the risk of disease recurrence (P = 0.31). In subgroup analyses based on patients' EAU risk groups, low preoperative AGR was not associated with recurrence-free survival (RFS) (P = 0.59) or progression-free survival (PFS) (P = 0.22) in any of the risk groups. Additionally, in patients treated with Bacillus Calmette-Guerin (BCG) for intermediate- or high-risk NMIBC, low AGR failed to predict disease recurrence or progression. Preoperative serum AGR levels independently predicted the risk of disease progression in patients with NMIBC. However, it was not found to be associated with either RFS or PFS in NMIBC patients based on their EAU risk group. This marker seems to have a limited role in NMIBC at the present time. However, further research is needed to investigate this marker in combination with other systemic inflammatory markers to help improve prediction in this heterogeneous group of patients.
Identifiants
pubmed: 33496841
doi: 10.1007/s00345-020-03586-1
pii: 10.1007/s00345-020-03586-1
pmc: PMC8510920
doi:
Substances chimiques
Serum Albumin
0
Serum Globulins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3345-3352Informations de copyright
© 2021. The Author(s).
Références
Clin Chem Lab Med. 2005;43(9):913-8
pubmed: 16176169
Curr Opin Urol. 2019 May;29(3):239-246
pubmed: 30762670
Eur Urol. 2015 Jan;67(1):74-82
pubmed: 25043942
Clin Genitourin Cancer. 2018 Jun;16(3):e655-e661
pubmed: 29366633
BJU Int. 2011 Mar;107(6):898-904
pubmed: 21244604
Clin Genitourin Cancer. 2017 Oct;15(5):e755-e764
pubmed: 28420564
Am J Surg. 2013 Nov;206(5):764-70
pubmed: 23866764
Nutr Cancer. 2021;73(1):75-82
pubmed: 32148098
Cancer. 2001 Dec 15;92(12):2985-92
pubmed: 11753975
J Urol. 2006 Dec;176(6 Pt 1):2414-22; discussion 2422
pubmed: 17085118
Urol Oncol. 2009 Mar-Apr;27(2):155-9
pubmed: 18367117
Br J Cancer. 2013 Sep 17;109(6):1460-6
pubmed: 23982601
World J Urol. 2019 Jan;37(1):31-40
pubmed: 30259123
Urology. 2003 Jun;61(6):1140-5
pubmed: 12809883
J Urol. 2009 Nov;182(5):2195-203
pubmed: 19758621
Eur J Surg Oncol. 2014 Jan;40(1):121-7
pubmed: 24140000
Urol Oncol. 2019 Mar;37(3):179.e19-179.e28
pubmed: 30580906
Eur Urol. 2019 Nov;76(5):639-657
pubmed: 31443960
Semin Cancer Biol. 2012 Feb;22(1):33-40
pubmed: 22210179
Urol Oncol. 2018 Jan;36(1):8.e17-8.e24
pubmed: 28947304
Int J Colorectal Dis. 2013 Dec;28(12):1629-36
pubmed: 23857599
Eur Urol. 2018 May;73(5):738-748
pubmed: 29055653
Urol Oncol. 2010 Jul-Aug;28(4):389-400
pubmed: 20610277
Cancer. 1950 Jan;3(1):32-5
pubmed: 15405679
Immunotherapy. 2019 Sep;11(13):1083-1086
pubmed: 31385744
Eur Urol Focus. 2016 Apr;2(1):79-85
pubmed: 28723455
Eur Urol. 2019 Apr;75(4):649-658
pubmed: 30553613
Eur Urol. 2004 Mar;45(3):292-6
pubmed: 15036673
J Clin Oncol. 2016 Jun 1;34(16):1935-44
pubmed: 26811532
Eur Urol. 2017 Jan;71(1):96-108
pubmed: 27370177
Eur Urol Oncol. 2018 Oct;1(5):403-410
pubmed: 31158079
Eur Urol. 2011 Sep;60(3):423-30
pubmed: 21621906
Urol Int. 2015;94(1):1-24
pubmed: 25501325
Biomed Res Int. 2017;2017:3083267
pubmed: 28424782
Eur Urol. 2006 Mar;49(3):466-5; discussion 475-7
pubmed: 16442208
Asian Pac J Cancer Prev. 2014;15(15):6449-53
pubmed: 25124641
BJU Int. 2019 Jan;123(1):11-21
pubmed: 29807387
J Urol. 2002 Mar;167(3):1475-81
pubmed: 11832773
Urology. 2016 Sep;95:132-8
pubmed: 27316373
Eur Urol. 2010 Feb;57(2):300-9
pubmed: 19766384
J Urol. 2009 Jul;182(1):78-84; discussion 84
pubmed: 19447418
Eur Urol. 2007 Dec;52(6):1601-9
pubmed: 17919807
J Urol. 2003 Sep;170(3):985-9
pubmed: 12913755
J Urol. 2003 Mar;169(3):938-42
pubmed: 12576817