Impact of preoperative serum albumin-globulin ratio on disease outcome after radical cystectomy for urothelial carcinoma of the bladder
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, přehledy
PubMed
33189530
DOI
10.1016/j.urolonc.2020.11.005
PII: S1078-1439(20)30574-3
Knihovny.cz E-zdroje
- Klíčová slova
- AGR, Biomarker, Bladder cancer, MIBC, NMIBC, Transitional cell carcinoma,
- 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
- Názvy látek
- sérové globuliny MeSH
- sérový albumin 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 Jagiellonian University Medical College Krakow Poland
Department of Urology University Medical Center Hamburg Eppendorf Hamburg Germany
Citace poskytuje Crossref.org
