Purpose

With the development of therapy and prognostic criteria for metastatic Renal Cell Carcinoma (mRCC), the prognostic value of serum albumin level has remained in dispute. The aim of this meta-analysis was to evaluate the role of pre-treatment albumin in predicting the prognosis of mRCC patients in the era of tyrosine kinase inhibitor (TKI) treatments.

Methods

The qualitative and quantitative synthesis was conducted of studies retrieved from PubMed, Embase, and Cochrane library from inception of these databases to July 19, 2020. The hazard ratio (HR) and its 95% confidence interval (CI) of overall survival (OS) and progression-free survival (PFS) were extracted from studies comparing different levels of pre-treatment serum albumin (as a dichotomous or continuous variable) in mRCC patients treated with TKI agents.

Results

Within 5,638 primitive records, 16 were eligible and 14 had adequate data for quantitative analysis (N = 2,863 participants). Random-effects meta-analysis showed that lower albumin was related to poorer OS (dichotomous: HR = 2.01, 95% CI: 1.64-2.46, P < 0.001, I² = 28.8%; continuous: HR =0.93, 95% CI: 0.86-1.00, P = 0.040, I² = 67.5%) and PFS (dichotomous: HR = 1.45, 95% CI: 1.04-2.01, P = 0.029, I² = 57.4%; continuous: HR = 0.89, 95% CI: 0.80-0.98, P = 0.023, I² = 93.3%).

Conclusion

Lower pre-treatment serum albumin level is an independent adverse predictor of prognosis of mRCC patients receiving TKI therapy.

Registration

PROSPERO ID: CRD42020196802 Sep. 2^nd, 2020

中文翻译：

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白蛋白水平预测用酪氨酸激酶抑制剂治疗的晚期肾细胞癌的预后：系统评价和荟萃分析

目的

随着转移性肾细胞癌（mRCC）治疗和预后标准的发展，血清白蛋白水平的预后价值一直存在争议。这项荟萃分析的目的是评估治疗前白蛋白在预测酪氨酸激酶抑制剂 (TKI) 治疗时代 mRCC 患者预后中的作用。

方法

对从 PubMed、Embase 和 Cochrane 图书馆从这些数据库成立到 2020 年 7 月 19 日期间检索到的研究进行了定性和定量综合。总生存期 (OS) 的风险比 (HR) 及其 95% 置信区间 (CI)从比较使用 TKI 药物治疗的 mRCC 患者中不同水平的治疗前血清白蛋白（作为二分或连续变量）的研究中提取和无进展生存期 (PFS)。

结果

在 5,638 条原始记录中，16 条符合条件，14 条有足够的数据进行定量分析（N = 2,863 名参与者）。随机效应荟萃分析显示，较低的白蛋白与较差的 OS 相关（二分类：HR = 2.01, 95% CI：1.64-2.46，P < 0.001，I ²  = 28.8%；连续：HR = 0.93, 95% CI： 0.86-1.00，P  = 0.040，I ²  = 67.5%）和 PFS（二分法：HR = 1.45，95% CI：1.04-2.01，P  = 0.029，I ²  = 57.4%；连续：HR = 0.89，95% CI : 0.80-0.98, P  = 0.023, I ²  = 93.3%)。

结论

较低的治疗前血清白蛋白水平是接受 TKI 治疗的 mRCC 患者预后的独立不良预测因子。

登记

^PROSPERO ID：CRD42020196802 2020 年9 月 2 日