Purpose

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).

Methods

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).

Results

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.

Conclusion

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.

中文翻译：

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术前血清白蛋白与球蛋白比值对接受根治性前列腺切除术的非转移性前列腺癌患者的预后价值

目的

评估术前血清白蛋白与球蛋白比值 (AGR) 对临床非转移性前列腺癌 (PCa) 根治性前列腺切除术 (RP) 患者肿瘤学结果的潜在预测价值。

方法

在一个由 6041 名接受 RP 治疗的患者组成的多机构队列中评估了术前 AGR。进行逻辑回归分析以评估 AGR 与晚期疾病的关联。我们进行了 Cox 回归分析以确定 AGR 与生化复发 (BCR) 之间的关系。

结果

根据接受者操作曲线分析，确定最佳截止值为 1.31。在 Kaplan-Meier 分析中，与 AGR 较高的患者相比，术前 AGR 较低的患者无 BCR 生存期更差（P  < 0.01）。针对已建立的临床病理学特征的影响进行调整的术前和术后多变量模型证实了其与 BCR 的独立关联 [风险比 (HR) 1.52, 95% 置信区间 (CI) 1.31-1.75, P  < 0.01, HR 1.55, 95% CI 1.34–1.79, P  < 0.01, 分别]。然而，将 AGR 添加到已建立的预后模型中并没有提高它们的辨别力。

结论

虽然 AGR 与 BCR 显着相关，但在本研究中，AGR 的临床影响不足以影响患者管理。需要更长时间的随访来观察 AGR 的真实效果。