Prognostic value of albumin to globulin ratio in non-muscle-invasive bladder cancer

. 2021 Sep ; 39 (9) : 3345-3352. [epub] 20210126

Jazyk angličtina Země Německo Médium print-electronic

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/pmid33496841
Odkazy

PubMed 33496841
PubMed Central PMC8510920
DOI 10.1007/s00345-020-03586-1
PII: 10.1007/s00345-020-03586-1
Knihovny.cz E-zdroje

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.

Zobrazit více v PubMed

Antoni S, Ferlay J, Soerjomataram I, et al. Bladder cancer incidence and mortality: a global overview and recent trends. Eur Urol. 2017;71:96. doi: 10.1016/j.eururo.2016.06.010. PubMed DOI

Babjuk M, Burger M, Comperat EM, et al. European Association of Urology Guidelines on non-muscle-invasive bladder cancer (TaT1 and carcinoma in situ)—2019 Update. Eur Urol. 2019;76:639. doi: 10.1016/j.eururo.2019.08.016. PubMed DOI

Gontero P, Sylvester R, Pisano F, et al. Prognostic factors and risk groups in T1G3 non-muscle-invasive bladder cancer patients initially treated with Bacillus Calmette-Guérin: results of a retrospective multicenter study of 2451 patients. Eur Urol. 2015;67:74. doi: 10.1016/j.eururo.2014.06.040. PubMed DOI

Xylinas E, Kent M, Kluth L, et al. Accuracy of the EORTC risk tables and of the CUETO scoring model to predict outcomes in non-muscle-invasive urothelial carcinoma of the bladder. Br J Cancer. 2013;109:1460. doi: 10.1038/bjc.2013.372. PubMed DOI PMC

Shariat SF, Karakiewicz PI, Palapattu GS, et al. Outcomes of radical cystectomy for transitional cell carcinoma of the bladder: a contemporary series from the Bladder Cancer Research Consortium. J Urol. 2006;176:2414. doi: 10.1016/j.juro.2006.08.004. PubMed DOI

Schrier BP, Hollander MP, van Rhijn BW, et al. Prognosis of muscle-invasive bladder cancer: difference between primary and progressive tumours and implications for therapy. Eur Urol. 2004;45:292. doi: 10.1016/j.eururo.2003.10.006. PubMed DOI

Abufaraj M, Foerster B, Schernhammer E, et al. Micropapillary urothelial carcinoma of the bladder: a systematic review and meta-analysis of disease characteristics and treatment outcomes. Eur Urol. 2019;75:649. doi: 10.1016/j.eururo.2018.11.052. PubMed DOI

Mari A, Kimura S, Foerster B, et al. A systematic review and meta-analysis of the impact of lymphovascular invasion in bladder cancer transurethral resection specimens. BJU Int. 2019;123:11. doi: 10.1111/bju.14417. PubMed DOI PMC

Fritsche HM, Burger M, Svatek RS, et al. Characteristics and outcomes of patients with clinical T1 grade 3 urothelial carcinoma treated with radical cystectomy: results from an international cohort. Eur Urol. 2010;57:300. doi: 10.1016/j.eururo.2009.09.024. PubMed DOI

Svatek RS, Shariat SF, Novara G, et al. Discrepancy between clinical and pathological stage: external validation of the impact on prognosis in an international radical cystectomy cohort. BJU Int. 2011;107:898. doi: 10.1111/j.1464-410X.2010.09628.x. PubMed DOI

Shariat SF, Lotan Y, Vickers A, et al. Statistical consideration for clinical biomarker research in bladder cancer. Urol Oncol. 2010;28:389. doi: 10.1016/j.urolonc.2010.02.011. PubMed DOI PMC

Soria F, Krabbe LM, Todenhöfer T, et al. Molecular markers in bladder cancer. World J Urol. 2019;37:31. doi: 10.1007/s00345-018-2503-4. PubMed DOI PMC

Schmitz-Dräger BJ, Droller M, Lokeshwar VB, et al. Molecular markers for bladder cancer screening, early diagnosis, and surveillance: the WHO/ICUD consensus. Urol Int. 2015;94:1. doi: 10.1159/000369357. PubMed DOI

Shariat SF, Kim J, Raptidis G, et al. Association of p53 and p21 expression with clinical outcome in patients with carcinoma in situ of the urinary bladder. Urology. 2003;61:1140. doi: 10.1016/S0090-4295(03)00236-X. PubMed DOI

Shariat SF, Kim JH, Ayala GE, et al. Cyclooxygenase-2 is highly expressed in carcinoma in situ and T1 transitional cell carcinoma of the bladder. J Urol. 2003;169:938. doi: 10.1097/01.ju.0000043638.89552.ed. PubMed DOI

Mao MJ, Wei XL, Sheng H, et al. Clinical significance of preoperative albumin and globulin ratio in patients with gastric cancer undergoing treatment. Biomed Res Int. 2017;2017:3083267. PubMed PMC

Li J., Wang Y., Wu Y. et al. Prognostic value of pretreatment albumin to globulin ratio in lung cancer: a meta-analysis. Nutr Cancer: 1, 2020 PubMed

Kimura S, Soria F, et al. Prognostic value of modified glasgow prognostic score in non-muscle-invasive bladder cancer. Urol Oncol. 2019;37:179.e19. doi: 10.1016/j.urolonc.2018.11.005. PubMed DOI

Youden WJ. Index for rating diagnostic tests. Cancer. 1950;3:32. doi: 10.1002/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3. PubMed DOI

D'Andrea D, Moschini M, Gust K, et al. Prognostic role of neutrophil-to-lymphocyte ratio in primary non-muscle-invasive bladder cancer. Clin Genitourin Cancer. 2017;15:e755. doi: 10.1016/j.clgc.2017.03.007. PubMed DOI

Lucca I, Jichlinski P, Shariat SF, et al. The neutrophil-to-lymphocyte ratio as a prognostic factor for patients with urothelial carcinoma of the bladder following radical cystectomy: validation and meta-analysis. Eur Urol Focus. 2016;2:79. doi: 10.1016/j.euf.2015.03.001. PubMed DOI

Cantiello F, Russo GI, Vartolomei MD, et al. Systemic inflammatory markers and oncologic outcomes in patients with high-risk non-muscle-invasive urothelial bladder cancer. Eur Urol Oncol. 2018;1:403. doi: 10.1016/j.euo.2018.06.006. PubMed DOI

Lucca I, Hofbauer SL, Leitner CV, et al. Development of a preoperative nomogram incorporating biomarkers of systemic inflammatory response to predict nonorgan-confined urothelial carcinoma of the bladder at radical cystectomy. Urology. 2016;95:132. doi: 10.1016/j.urology.2016.06.007. PubMed DOI

Xylinas E, Robinson BD, Kluth LA, et al. Association of T-cell co-regulatory protein expression with clinical outcomes following radical cystectomy for urothelial carcinoma of the bladder. Eur J Surg Oncol. 2014;40:121. doi: 10.1016/j.ejso.2013.08.023. PubMed DOI

Shariat SF, Matsumoto K, Kim J, et al. Correlation of cyclooxygenase-2 expression with molecular markers, pathological features and clinical outcome of transitional cell carcinoma of the bladder. J Urol. 2003;170:985. doi: 10.1097/01.ju.0000080401.85145.ee. PubMed DOI

Shariat SF, Bolenz C, Godoy G, et al. Predictive value of combined immunohistochemical markers in patients with pT1 urothelial carcinoma at radical cystectomy. J Urol. 2009;182:78. doi: 10.1016/j.juro.2009.02.125. PubMed DOI

Shariat SF, Kim JH, Andrews B, et al. Preoperative plasma levels of transforming growth factor beta(1) strongly predict clinical outcome in patients with bladder carcinoma. Cancer. 2001;92:2985. doi: 10.1002/1097-0142(20011215)92:12<2985::AID-CNCR10175>3.0.CO;2-5. PubMed DOI

Andrews B, Shariat SF, Kim JH, et al. Preoperative plasma levels of interleukin-6 and its soluble receptor predict disease recurrence and survival of patients with bladder cancer. J Urol. 2002;167:1475. doi: 10.1016/S0022-5347(05)65348-7. PubMed DOI

Bensalah K, Montorsi F, Shariat SF. Challenges of cancer biomarker profiling. Eur Urol. 2007;52:1601. doi: 10.1016/j.eururo.2007.09.036. PubMed DOI

Sylvester RJ, van der Meijden AP, Oosterlinck W, et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006;49:466. doi: 10.1016/j.eururo.2005.12.031. PubMed DOI

Fernandez-Gomez J, Madero R, Solsona E, et al. Predicting nonmuscle invasive bladder cancer recurrence and progression in patients treated with Bacillus Calmette-Guerin: the CUETO scoring model. J Urol. 2009;182:2195. doi: 10.1016/j.juro.2009.07.016. PubMed DOI

Niwa N, Matsumoto K, Ide H, et al. Prognostic value of pretreatment albumin-to-globulin ratio in patients with non-muscle-invasive bladder cancer. Clin Genitourin Cancer. 2018;16:e655. doi: 10.1016/j.clgc.2017.12.013. PubMed DOI

Rieken M, Shariat SF, Kluth L, et al. Comparison of the EORTC tables and the EAU categories for risk stratification of patients with nonmuscle-invasive bladder cancer. Urol Oncol. 2018;36:8.e17. doi: 10.1016/j.urolonc.2017.08.027. PubMed DOI PMC

Fernandez-Gomez J, Madero R, Solsona E, et al. The EORTC tables overestimate the risk of recurrence and progression in patients with non-muscle-invasive bladder cancer treated with Bacillus Calmette-Guérin: external validation of the EORTC risk tables. Eur Urol. 2011;60:423. doi: 10.1016/j.eururo.2011.05.033. PubMed DOI

Lerner SP, Tangen CM, Sucharew H, et al. Failure to achieve a complete response to induction BCG therapy is associated with increased risk of disease worsening and death in patients with high risk non-muscle invasive bladder cancer. Urol Oncol. 2009;27:155. doi: 10.1016/j.urolonc.2007.11.033. PubMed DOI PMC

Kamat AM, Sylvester RJ, Bohle A, et al. Definitions, end points, and clinical trial designs for non-muscle-invasive bladder cancer: recommendations from the International Bladder Cancer Group. J Clin Oncol. 2016;34:1935. doi: 10.1200/JCO.2015.64.4070. PubMed DOI PMC

Hassler MR, Shariat SF, Soria F. Salvage therapeutic strategies for Bacillus Calmette-Guerin failure. Curr Opin Urol. 2019;29:239. doi: 10.1097/MOU.0000000000000593. PubMed DOI

Kamat AM, Li R, O'Donnell MA, et al. Predicting response to intravesical bacillus calmette-guérin immunotherapy: are we there yet? Sys Rev Eur Urol. 2018;73:738. doi: 10.1016/j.eururo.2017.10.003. PubMed DOI

Shariat SF, Enikeev DV, Mostafaei H. Six essential conditions for bladder-sparing strategies in bacillus Calmette-Guérin unresponsive bladder cancer. Immunotherapy. 2019;11:1083. doi: 10.2217/imt-2019-0083. PubMed DOI

Balkwill FR, Mantovani A. Cancer-related inflammation: common themes and therapeutic opportunities. Semin Cancer Biol. 2012;22:33. doi: 10.1016/j.semcancer.2011.12.005. PubMed DOI

Rasouli M, Okhovatian A, Enderami A. Serum proteins profile as an indicator of malignancy: multivariate logistic regression and ROC analyses. Clin Chem Lab Med. 2005;43:913. PubMed

Azab B, Kedia S, Shah N, et al. The value of the pretreatment albumin/globulin ratio in predicting the long-term survival in colorectal cancer. Int J Colorectal Dis. 2013;28:1629. doi: 10.1007/s00384-013-1748-z. PubMed DOI

Duran AO, Inanc M, Karaca H, et al. Albumin-globulin ratio for prediction of long-term mortality in lung adenocarcinoma patients. Asian Pac J Cancer Prev. 2014;15:6449. doi: 10.7314/APJCP.2014.15.15.6449. PubMed DOI

Azab BN, Bhatt VR, Vonfrolio S, et al. Value of the pretreatment albumin to globulin ratio in predicting long-term mortality in breast cancer patients. Am J Surg. 2013;206:764. doi: 10.1016/j.amjsurg.2013.03.007. PubMed DOI

Nejnovějších 20 citací...

Zobrazit více v
Medvik | PubMed

Prognostic value of the systemic immune-inflammation index in non-muscle invasive bladder cancer

. 2021 Dec ; 39 (12) : 4355-4361. [epub] 20210618

Najít záznam

Citační ukazatele

Nahrávání dat ...

Možnosti archivace

Nahrávání dat ...