Prognostic value of albumin to globulin ratio in non-muscle-invasive bladder cancer
Jazyk angličtina Země Německo Médium print-electronic
Typ dokumentu časopisecké články
PubMed
33496841
PubMed Central
PMC8510920
DOI
10.1007/s00345-020-03586-1
PII: 10.1007/s00345-020-03586-1
Knihovny.cz E-zdroje
- Klíčová slova
- AGR, Albumin, BCG, Bladder cancer, Globulin, Non-muscle-invasive, Progression,
- MeSH
- cystektomie * metody MeSH
- invazivní růst nádoru MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory močového měchýře krev patologie chirurgie MeSH
- předoperační období MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- senioři MeSH
- sérové globuliny analýza MeSH
- sérový albumin analýza MeSH
- uretra MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- sérové globuliny MeSH
- sérový albumin MeSH
PURPOSE: 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). MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology Jikei University School of Medicine Tokyo Japan
Department of Urology King Fahad Specialist Hospital Dammam Saudi Arabia
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 USA
Department of Urology Weill Cornell Medical College New York NY USA
European Association of Urology Research Foundation Arnhem Netherlands
Institute for Urology and Reproductive Health Sechenov University Moscow Russia
Karl Landsteiner Institute Wahringer Gurtel 18 20 1090 Vienna Austria
Research Center for Evidence Based Medicine Tabriz University of Medical Sciences Tabriz Iran
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