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The association of pretreatment serum albumin with outcomes in bladder cancer: a meta-analysis

Authors Li J, Cheng Y, Liu G, Ji Z

Received 9 January 2018

Accepted for publication 20 April 2018

Published 15 June 2018 Volume 2018:11 Pages 3449—3459


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Geoffrey Pietersz

Jialin Li,1,* Yusheng Cheng,2,* Guanghua Liu,1 Zhigang Ji1

1Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; 2Department of Liver Transplantation, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

*These authors contributed equally to this work

Background: Recently, numerous studies have shown that pretreatment serum albumin can be closely associated with the prognosis of patients with bladder cancer (BC). However, the conclusions regarding this issue are still conflicting. Hence, in this study, we performed a systematic review and meta-analysis to determine the prognostic significance of pretreatment serum albumin in BC patients.
Materials and methods: A systematic search was carried out in PubMed, Embase, and Web of Science. A total of 16 studies involving 13,917 patients were included in the current meta-analysis. hazard ratios (HRs) and 95% CIs were pooled to assess the intensity of association. Moreover, heterogeneity, sensitivity analysis and publication bias were explored. All statistical analyses were conducted by STATA 12.0.
Results: Our results suggested that a decreased pretreatment serum albumin level was closely related to a worse overall survival (HR 1.88, 95% CI 1.43, 2.48; P<0.01) and cancer-specific survival (HR 1.65, 95% CI 1.08, 2.52; P=0.02). In addition, from the results of this meta-analysis, it was also observed that a lower pretreatment serum albumin level was linked to higher incidence of postoperative 30-day complication (odds ratio [OR] 1.41, 95% CI 1.03, 1.91; P=0.03) and 90-day mortality (OR 2.51, 95% CI 1.82, 3.48; P<0.01). Furthermore, these findings were demonstrated to be reliable by our sensitivity and subgroup analysis stratified by ethnicity, analysis type, and cutoff value.
Conclusion: Our results revealed that a lower pretreatment serum albumin level yields a poor long-term prognosis and increases the risks of postoperative complication and mortality in BC patients and can be applied to risk stratification and individualized therapy in BC patients.

Keywords: albumin, prognosis, mortality, bladder cancer, meta-analysis

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