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Prognostic significance of preoperative albumin-to-globulin ratio and prognostic nutritional index combined score in Siewert type 3 adenocarcinoma of esophagogastric junction

Authors Wang Y, Zhu Z, Li C, Ma Y, You Q, Li Z, Zhang H, Song H, Xue Y

Received 18 October 2018

Accepted for publication 22 February 2019

Published 14 August 2019 Volume 2019:11 Pages 7631—7638


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Rituraj Purohit

Yimin Wang*, Ziyu Zhu*, Chunfeng Li, Yan Ma, Qi You, Zhiguo Li, Hongfeng Zhang, Hongjiang Song, Yingwei Xue

Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, People’s Republic of China

*These authors contributed equally to this work

Purpose: Preoperative nutrition-inflammation-based indicators have been reported to predict the prognosis of malignancies. We evaluated the prognostic significance of a combined score of the albumin-to-globulin ratio (AGR) and prognostic nutritional index (PNI) for overall survival (OS) outcomes in patients with Siewert type 3 adenocarcinoma of esophagogastric junction (S3-AEG).
Patients and methods: The prognostic significance of variables associated with 215 S3-AEG patients’ OS were assessed through univariate and multivariate analyses. The cutoff value of the preoperative AGR and PNI were calculated by the receiver operating characteristic curve (ROC). Patients with either an elevated AGR (≥1.72, cutoff value) or PNI (≥45.55, cutoff value) were given a score of 1; otherwise, they were given a score of 0. The AGR-PNI score ranged from 0 to 2.
Results: OS was independently associated with the N stage (HR: 0.336, 95% CI: 0.141–0.805, P=0.014) and AGR-PNI score (HR: 0.623, 95% CI: 0.487–0.797, P<0.001). Patients with AGR-PNI scores of 0, 1 and 2 had significant differences in OS (P=0.001). The prognostic role of AGR-PNI was significant in patients with stage I + II (P=0.043) and stage III S3-AEGs (P=0.003). ROC analysis indicated that the predictive ability of the AGR-PNI score was better than that of the other parameters.
Conclusion: The preoperative AGR-PNI score was a significant prognosticator of postoperative survival in patients with S3-AEG and could identify high-risk populations for reasonable therapy and effective follow-up.

Keywords: adenocarcinoma of esophagogastric junction, albumin-to-globulin ratio, prognostic nutritional index

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