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Impact of preoperative serum albumin-globulin ratio on disease outcome after radical cystectomy for urothelial carcinoma of the bladder
VM. Schuettfort, D. D Andrea, F. Quhal, H. Mostafaei, E. Laukhtina, K. Mori, R. Sari Motlagh, M. Rink, M. Abufaraj, PI. Karakiewicz, S. Luzzago, M. Rouprêt, P. Chlosta, M. Babjuk, M. Deuker, M. Moschini, SF. Shariat, B. Pradere
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, přehledy
- MeSH
- cystektomie * metody MeSH
- karcinom z přechodných buněk krev chirurgie MeSH
- lidé MeSH
- nádory močového měchýře krev chirurgie MeSH
- předoperační období MeSH
- sérové globuliny analýza MeSH
- sérový albumin analýza MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
INTRODUCTION: The Albumin-Globulin Ratio (AGR; albumin/total protein - albumin) has been associated with oncological outcome in various malignancies. However, its role in urothelial carcinoma of the bladder (UCB) has not been clearly established. In this study, we assessed the association of preoperative AGR (pAGR) with survival in patients who underwent radical cystectomy (RC) for UCB. MATERIAL AND METHODS: We conducted a retrospective analysis of an established multicenter database of 4.335 patients who were treated with RC for UCB. The cohort was divided into 2 groups according to the pAGR status. Binominal logistic regression as well as uni- and multivariable Cox regression analyses were used. The predictive value of the models was assessed by calculating receiver operating characteristics curves and concordance-indices (C-Index). The additional clinical value was assessed using the decision curve analysis (DCA). RESULTS: Overall, 1.670 patients (38.5%) had a low pAGR. On multivariable logistic regression analyses, low pAGR was associated with an increased risk of ≥pT3 disease at RC (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.01-1.31, P= 0.04). On multivariable Cox regression analyses, low pAGR remained associated with worse recurrence-free survival (RFS, HR 1.24, 95% CI 1.1-1.37, P< 0.001), cancer-specific survival (CSS, HR 1.23, 95% CI 1.1-1.38, P< 0.001) and overall survival (OS, HR 1.17, 95% CI 1.07-1.28, P< 0.001). The addition of pAGR to multiple prognostic models that were respectively fitted for clinical and postoperative variables did not improve the predictive accuracy. CONCLUSION: pAGR status is an independent predictor of ≥pT3 disease, therefore it could help identify patients who have a higher likelihood to benefit from neoadjuvant systemic therapy. While pAGR was independently associated with RFS, CSS, and OS, it did not improve the predictive accuracy and clinical value beyond obtained by information already available. The predictive value of this biomarker in the age of immunotherapy needs further evaluation.
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology European Institute of Oncology IRCCS Milan Italy
Department of Urology Hospital Motol 2nd Faculty of Medicine Charles University Praha Czech Republic
Department of Urology Institut Mutualiste Montsouris Paris France
Department of Urology Jagiellonian University Medical College Krakow Poland
Department of Urology King Fahad Specialist Hospital Dammam Saudi Arabia
Department of Urology Luzerner Kantonsspital Lucerne Switzerland
Department of Urology The Jikei University School of Medicine Tokyo Japan
Department of Urology University Hospital Frankfurt Frankfurt Germany
Department of Urology University Hospital of Tours Tours France
Department of Urology University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Urology University of Texas Southwestern Dallas TX
Department of Urology Weill Cornell Medical College New York NY
European Association of Urology Research Foundation Arnhem Netherlands
Institute for Urology and Reproductive Health Sechenov University Moscow Russia
Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Research Center for Evidence Based Medicine Tabriz University of Medical Sciences Tabriz Iran
Citace poskytuje Crossref.org
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- $a Schuettfort, Victor M $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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- $a Impact of preoperative serum albumin-globulin ratio on disease outcome after radical cystectomy for urothelial carcinoma of the bladder / $c VM. Schuettfort, D. D Andrea, F. Quhal, H. Mostafaei, E. Laukhtina, K. Mori, R. Sari Motlagh, M. Rink, M. Abufaraj, PI. Karakiewicz, S. Luzzago, M. Rouprêt, P. Chlosta, M. Babjuk, M. Deuker, M. Moschini, SF. Shariat, B. Pradere
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- $a INTRODUCTION: The Albumin-Globulin Ratio (AGR; albumin/total protein - albumin) has been associated with oncological outcome in various malignancies. However, its role in urothelial carcinoma of the bladder (UCB) has not been clearly established. In this study, we assessed the association of preoperative AGR (pAGR) with survival in patients who underwent radical cystectomy (RC) for UCB. MATERIAL AND METHODS: We conducted a retrospective analysis of an established multicenter database of 4.335 patients who were treated with RC for UCB. The cohort was divided into 2 groups according to the pAGR status. Binominal logistic regression as well as uni- and multivariable Cox regression analyses were used. The predictive value of the models was assessed by calculating receiver operating characteristics curves and concordance-indices (C-Index). The additional clinical value was assessed using the decision curve analysis (DCA). RESULTS: Overall, 1.670 patients (38.5%) had a low pAGR. On multivariable logistic regression analyses, low pAGR was associated with an increased risk of ≥pT3 disease at RC (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.01-1.31, P= 0.04). On multivariable Cox regression analyses, low pAGR remained associated with worse recurrence-free survival (RFS, HR 1.24, 95% CI 1.1-1.37, P< 0.001), cancer-specific survival (CSS, HR 1.23, 95% CI 1.1-1.38, P< 0.001) and overall survival (OS, HR 1.17, 95% CI 1.07-1.28, P< 0.001). The addition of pAGR to multiple prognostic models that were respectively fitted for clinical and postoperative variables did not improve the predictive accuracy. CONCLUSION: pAGR status is an independent predictor of ≥pT3 disease, therefore it could help identify patients who have a higher likelihood to benefit from neoadjuvant systemic therapy. While pAGR was independently associated with RFS, CSS, and OS, it did not improve the predictive accuracy and clinical value beyond obtained by information already available. The predictive value of this biomarker in the age of immunotherapy needs further evaluation.
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- $a D Andrea, David $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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