Prognostic role of the preoperative serum albumin : globulin ratio after radical nephroureterectomy for upper tract urothelial carcinoma

Otsuka, Masafumi; Kamasako, Tomohiko; Uemura, Toshihiro; Takeshita, Nobushige; Shinozaki, Tetsuo; Kobayashi, Masayuki; Komaru, Atsushi; Fukasawa, Satoshi

doi:10.1111/iju.13767

Cited by 17 publications

(21 citation statements)

References 30 publications

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“…Several studies have reported on the association of hypoalbuminemia with poor prognosis in patients with UC ( Table 5) (49,68,72,(78)(79)(80)(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91). The cutoff value of albumin varies from 2 to 4 mg/L, although it is normally around 3.5 mg/L.…”

Section: Albumin and Albumin-globulin Ratiomentioning

confidence: 99%

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Role of Systemic Inflammatory Response Markers in Urothelial Carcinoma

Yuk

2020

Front. Oncol.

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Urothelial carcinoma (UC) can occur in various parts of the urinary tract and occurs in different stages and grades. The disease recurs frequently and is monitored through a series of invasive tests, such as cystoscopy or ureteroscopy, over the lifetime of an individual. Although many researchers have attempted to stratify the risks of UC, with the majority being based on cancer characteristics and host factors such as performance status, a risk classification system has yet to be fully developed. Cancer affects various parts of the body through the systemic immune response, including changes in hormones, the number and ratio of white blood cells and platelets, and C-reactive protein (CRP) or albumin levels under the influence of neuroendocrine metabolism, hematopoietic function, and protein and energy metabolism, respectively. Herein, we reviewed various systemic inflammatory response markers (SIRs) related to UC, including CRP, albumin-globulin ratio, albumin, Glasgow prognostic score (GPS), modified GPS, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio. Our aim was to summarize the role of various SIRs in the treatment of patients with UC.

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Section: Albumin and Albumin-globulin Ratiomentioning

confidence: 99%

“…However, considering the limited number of studies, the utility of this combination remains to be established. Recent studies have reported on the prognostic effect of AGR in patients with UC (85)(86)(87)(88)(89)(90)(91).…”

Section: Albumin and Albumin-globulin Ratiomentioning

confidence: 99%

Role of Systemic Inflammatory Response Markers in Urothelial Carcinoma

Yuk

2020

Front. Oncol.

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“…Clinicopathological factors that serve as prognostic factors for UTUC [5][6][7][8][9][10][11][12][13][14][15] include sex [5], age [6], tumor size [7,8], ureteral involvement [9], and body mass index [10], as well as laboratory markers [11][12][13][14][15] such as the neutrophil-to-lymphocyte ratio [11,12], albumin [13], hemoglobin [14], and the prognostic nutritional index [15]. On the other hand, the AGR has been reported as a useful biomarker in various malignancies [16][17][18][19][20][21][22][23][24][25][26], including urological cancers [20][21][22][23][24][25][26]. However, the significance of the AGR as a prognostic marker for UTUC has not been fully investigated [23][24]…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the AGR has been reported as a useful biomarker in various malignancies [16][17][18][19][20][21][22][23][24][25][26], including urological cancers [20][21][22][23][24][25][26]. However, the significance of the AGR as a prognostic marker for UTUC has not been fully investigated [23][24][25][26]. For example, a study of a Chinese cohort of 187 operable patients with UTUC [23] demonstrated that AGR < 1.45 is an independent risk factor for poorer CSS and OS.…”

Section: Discussionmentioning

confidence: 99%

“…Clinicopathological factors [5][6][7][8][9][10][11][12][13][14][15] including laboratory markers [11][12][13][14][15] serve as prognostic markers for UTUC. In contrast, the significance of the albumin-to-globulin ratio (AGR), which serves as a useful biomarker for various malignancies [16][17][18][19][20][21][22][23][24][25][26], has not been fully investigated in UTUC [23][24][25][26]. Therefore, the present study assessed the significance of the association of preoperative AGR on oncological outcomes of patients with UTUC undergoing radical nephroureterectomy.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic significance of the albumin-to-globulin ratio for upper tract urothelial carcinoma

et al. 2020

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Background: Although the albumin-to-globulin ratio (AGR) is a promising biomarker for various malignancies, few studies have investigated its prognostic significance for upper tract urothelial carcinoma (UTUC). Methods: This retrospective study conformed to the REporting recommendations for tumour MARKer prognostic studies (REMARK) guideline. We reviewed 179 patients with UTUC who underwent radical nephroureterectomy at our institution between 2008 and 2018. Associations of preoperative clinicopathological factors, including the AGR, with cancer-specific survival (CSS) and overall survival (OS) were assessed. The Cox proportional hazards model was used for univariate and multivariable analyses. AGR was dichotomized as < 1.25 and ≥ 1.25, according to the most discriminatory cutoff determined from the receiver operating characteristic curve analysis. Results: During a median follow-up of 34 months after surgery, 37 patients died from UTUC and 13 died of other causes. The preoperative AGR significantly correlated with pathological T stage, pathological N stage, and adjuvant chemotherapy. Multivariate analyses demonstrated that a decreased (< 1.25) preoperative AGR was an independent poor prognostic factor for both CSS (hazard ratio [HR] = 2.81, P < 0.01) and OS (HR = 2.09, P < 0.05). Conclusions: Preoperative AGR < 1.25 might serve as a useful prognostic marker for patients with UTUC undergoing radical nephroureterectomy.

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