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Preoperative albumin-to-globulin ratio as a significant prognostic indicator in urologic cancers: a meta-analysis

Authors Zhang Y, Wang L, Lin S, Wang R

Received 26 June 2018

Accepted for publication 7 September 2018

Published 17 October 2018 Volume 2018:10 Pages 4695—4708

DOI https://doi.org/10.2147/CMAR.S178271

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Professor Raphael Catane


Yi Zhang,1 Lijuan Wang,2 Shibu Lin,3 Rong Wang1

1Department of General Surgery, The First People’s Hospital of Neijiang, Neijiang 641000, Sichuan Province, China; 2Department of Nephrology, Shangrao People’s Hospital, Shangrao 334000, Jiangxi Province, China; 3Department of Hepatobiliary Surgery, The First Affiliated Hospital of Hainan Medical College, Haikou 570102, Hainan Province, China

Background:
Emerging studies reported that preoperative albumin-to-globulin ratio (AGR) correlated with tumor progression and prognosis in several types of cancer. The aim of this study was to systematically explore the association between preoperative AGR and clinical outcomes in cancers of the urinary system.
Methods: Relevant articles were searched in PubMed, Embase and Web of Science by two independent investigators from inception to June 1, 2018. Eligible studies were selected based on predetermined selection criteria. Summarized HRs or ORs and 95% CIs were calculated for prognosis and clinicopathologic features with the fixed-effects or random-effects models.
Results: Eight cohort studies comprising 2,668 patients were included for analysis. The pooled results showed that a low AGR significantly correlated with poor OS (HR: 0.38, 95% CI: 0.27–0.48, P<0.001), worse cancer-specific survival (CSS) (HR: 0.36, 95% CI: 0.22–0.50, P<0.001) and inferior event-free survival (EFS) (HR: 0.36, 95% CI: 0.25–0.48, P<0.001) in urologic cancers. In addition, patients in low and high AGR groups showed significant differences in lymphovascular invasion (P<0.001), pT status (P<0.001) and pN status (P<0.001).
Conclusion: Preoperative AGR might be a valuable, cheap and reproducible prognostic biomarker in urologic cancers following surgical resection.

Keywords: albumin-to-globulin ratio, urologic cancer, prognosis, clinical features

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