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Prognostic value of the pre-operative serum albumin to globulin ratio in patients with non-metastatic prostate cancer undergoing radical prostatectomy.

Authors
  • Aydh, Abdulmajeed1, 2
  • Mori, Keiichiro1, 3
  • D'Andrea, David1
  • Motlagh, Reza Sari1
  • Abufaraj, Mohammad1, 4
  • Pradere, Benjamin1, 5
  • Mostafaei, Hadi1, 6
  • Laukhtina, Ekaterina1, 7
  • Quhal, Fahad1, 8
  • Karakiewicz, Pierre I9
  • Luzzago, Stefano10
  • Briganti, Alberto11
  • Trinh, Quoc-Dien12
  • Parizi, Mehdi Kardoust13
  • Tilki, Derya14
  • Enikeev, Dmitry V7
  • Shariat, Shahrokh F15, 16, 17, 18, 19, 20, 21, 22
  • 1 Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. , (Austria)
  • 2 Department of Urology, King Faisal Medical City, Abha, Saudi Arabia. , (Saudi Arabia)
  • 3 Department of Urology, Jikei University School of Medicine, Tokyo, Japan. , (Japan)
  • 4 Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan. , (Jordan)
  • 5 Department of Urology, University Hospital of Tours, Tours, France. , (France)
  • 6 Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. , (Iran)
  • 7 Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
  • 8 Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia. , (Saudi Arabia)
  • 9 Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada. , (Canada)
  • 10 Department of Urology, IRCCS European Institute of Oncology (IEO), Milan, Italy. , (Italy)
  • 11 Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. , (Italy)
  • 12 Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • 13 Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Teheran, Iran. , (Iran)
  • 14 Martini-Klinik Prostate Cancer Center, Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. , (Germany)
  • 15 Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. [email protected] , (Austria)
  • 16 Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan. [email protected] , (Jordan)
  • 17 Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. [email protected]
  • 18 Departments of Urology, Weill Cornell Medical College, New York, NY, USA. [email protected]
  • 19 Department of Urology, University of Texas Southwestern, Dallas, TX, USA. [email protected]
  • 20 Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. [email protected] , (Czechia)
  • 21 European Association of Urology Research Foundation, Arnhem, Netherlands. [email protected] , (Netherlands)
  • 22 Karl Landsteiner Institute, Vienna, Austria. [email protected] , (Austria)
Type
Published Article
Journal
International journal of clinical oncology
Publication Date
Jun 28, 2021
Identifiers
DOI: 10.1007/s10147-021-01952-6
PMID: 34184136
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To evaluate the potential predictive value of the preoperative serum albumin to globulin ratio (AGR) for oncological outcomes in patients treated with radical prostatectomy (RP) for clinically non-metastatic prostate cancer (PCa). Pre-operative AGR was assessed in a multi-institutional cohort of 6041 patients treated with RP. Logistic regression analyses were performed to assess the association of the AGR with advanced disease. We performed Cox regression analyses to determine the relationship between AGR and biochemical recurrence (BCR). The optimal cut-off value was determined to be 1.31 according to receiver operating curve analysis. Compared to patients with a higher AGR, those with a lower preoperative AGR had worse BCR-free survival (P < 0.01) in the Kaplan-Meier analysis. Pre- and post-operative multivariable models that adjusted for the effects of established clinicopathologic features, confirmed its independent association with BCR [hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.31-1.75, P < 0.01, HR 1.55, 95% CI 1.34-1.79, P < 0.01, respectively]. However, the addition of AGR to established prognostic models did not improve their discrimination. While AGR is significantly associated with BCR, in the present study, the clinical impact of AGR was not large enough to affect patient management. Longer follow-up is necessary to observe the true effect of AGR.

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