Jeong Seock Oh1, Dong Jin Park2, Kyeong-Hyeon Byeon3, Yun-Sok Ha4, Tae-Hwan Kim5, Eun Sang Yoo6, Tae Gyun Kwon7, Hyun Tae Kim8. 1. Department of Urology, Kyungpook National University Hospital, Daegu, Korea. smilelife38@naver.com. 2. Department of Urology, Kyungpook National University Hospital, Daegu, Korea. parkdj0510@gmail.com. 3. Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea. qosrod@naver.com. 4. Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea. yunsokha@gmail.com. 5. Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea. doctork@knu.ac.kr. 6. Department of Urology, Kyungpook National University Hospital, Daegu, Korea. uroyoo@knu.ac.kr. 7. Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea. tgkwon@knu.ac.kr. 8. Department of Urology, Kyungpook National University Hospital, Daegu, Korea. urologistk@knu.ac.kr.
Abstract
PURPOSE: This study aims to evaluate whether preoperative serum albumin-to-globulin ratio (AGR) could predict the prognosis of patients with urothelial bladder cancer (UBC) after radical cystectomy (RC). MATERIALS AND METHODS: A total of 176 patients with UBC who underwent RC in a tertiary hospital between 2008 and 2019 were retrospectively analyzed. The AGR was calculated as albumin/(total protein - albumin). In addition, the AGR was divided into two groups for the time-dependent receiver operating characteristic curve (ROC) analysis. Survival was estimated using the Kaplan-Meier analysis and compared using the log-rank test. Cox proportional- hazards models were used for multivariate survival analysis. RESULTS: The best cutoff AGR value for metastasis prediction was 1.32 based on the ROC curve analysis. Patients who had lower pretreatment AGR (<1.32) values composed the low-AGR group (n = 57; 32.4%). On the other hand, the remaining patients (n = 119; 67.6%) composed the high-AGR group. The patients in the low-AGR group had more advanced stage tumors compared with the patients in the high-AGR group. The Kaplan-Meier curves revealed that the patients in the low-AGR group had significantly lower rates of metastasis-free survival (MFS) and cancer-specific survival (CSS). The multivariate Cox regression analysis showed that preoperative AGR was an independent prognostic factor for MFS and CSS. CONCLUSION: In this single-institution retrospective study, lower preoperative AGR values demonstrated a poor prognostic effect on MFS and CSS in patients with UBC who underwent RC.
PURPOSE: This study aims to evaluate whether preoperative serum albumin-to-globulin ratio (AGR) could predict the prognosis of patients with urothelial bladder cancer (UBC) after radical cystectomy (RC). MATERIALS AND METHODS: A total of 176 patients with UBC who underwent RC in a tertiary hospital between 2008 and 2019 were retrospectively analyzed. The AGR was calculated as albumin/(total protein - albumin). In addition, the AGR was divided into two groups for the time-dependent receiver operating characteristic curve (ROC) analysis. Survival was estimated using the Kaplan-Meier analysis and compared using the log-rank test. Cox proportional- hazards models were used for multivariate survival analysis. RESULTS: The best cutoff AGR value for metastasis prediction was 1.32 based on the ROC curve analysis. Patients who had lower pretreatment AGR (<1.32) values composed the low-AGR group (n = 57; 32.4%). On the other hand, the remaining patients (n = 119; 67.6%) composed the high-AGR group. The patients in the low-AGR group had more advanced stage tumors compared with the patients in the high-AGR group. The Kaplan-Meier curves revealed that the patients in the low-AGR group had significantly lower rates of metastasis-free survival (MFS) and cancer-specific survival (CSS). The multivariate Cox regression analysis showed that preoperative AGR was an independent prognostic factor for MFS and CSS. CONCLUSION: In this single-institution retrospective study, lower preoperative AGR values demonstrated a poor prognostic effect on MFS and CSS in patients with UBC who underwent RC.