Prognostic Significance of Preoperative Albumin-Globulin Ratio in Patients with Upper Tract Urothelial Carcinoma |
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Authors: | Bo Zhang Wei Yu Li-Qun Zhou Zhi-Song He Cheng Shen Qun He Jun Li Li-Bo Liu Cong Wang Xiao-Yu Chen Yu Fan Shuai Hu Lei Zhang Wen-Ke Han Jie Jin |
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Institution: | 1. Department of Urology, Peking University First Hospital, Beijing, People’s Republic of China.; 2. Institute of Urology, Peking University, Beijing, People’s Republic of China.; 3. National Urological Cancer Center, Beijing, People’s Republic of China.; 4. Peking University Health Science Center, Beijing, People’s Republic of China.; Sun Yat-sen University, CHINA, |
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Abstract: | BackgroundPreoperative albumin-globulin ratio (AGR) reflects both malnutrition and systemic inflammation in cancer patients. In particular, systemic inflammation has been reported to contribute to tumor progression and poor oncological outcome in various malignancies. However, the prognostic value of preoperative AGR in upper tract urothelial carcinoma (UTUC) has not been examined.MethodsWe retrospectively reviewed medical data of 187 operable UTUC patients in a Chinese cohort with a high incidence of chronic kidney disease (CKD). AGR was calculated as AGR = albumin/(serum total protein—albumin)]. The associations of preoperative AGR with clinicopathologic characteristics and prognosis were assessed. Multivariate analyses using Cox regression models were performed to determine the independent prognostic factors.ResultsThe median (IQR) preoperative AGR was 1.50 (1.30–1.70), and the optimal cutoff value was determined to be 1.45 according to the receiver operating curve analysis. Low AGR was significantly associated with female gender, high CKD stage and tumor grade (P < 0.05). Eighty-three patients died before the follow-up endpoint. Kaplan-Meier analysis showed that an AGR < 1.45 predicted significantly poorer overall and cancer-specific survivals compared to an AGR ≥ 1.45 (P < 0.001 and P = 0.008, respectively). Multivariate analyses showed that an AGR < 1.45 was an independent risk factor for poorer overall and cancer-specific survivals (P = 0.002 and P = 0.015, respectively).ConclusionsPreoperative AGR can act as an effective biomarker with easy accessibility for evaluating the prognosis of patients with UTUC. AGR should be applied in UTUC patients for risk stratification and determination of optimal therapeutic regimens. |
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