title: Preoperative albumin to globulin ratio predicts survival in clear cell renal cell carcinoma patients.
abstract: In this retrospective analysis, we evaluated associations between albumin to globulin ratio (AGR), clinicopathological characteristics, and survival in 592 patients with localized or locally advanced clear cell renal cell carcinoma (CCRCC) prior to nephrectomy. We found that low AGR was associated with more aggressive tumor behavior; patients with low AGR had poorer overall survival (OS) and cancer-specific survival (CSS) in Kaplan-Meier survival analyses both before and after propensity score matching, which was used to compensate for differences in baseline clinicopathological characteristics. AGR was an independent prognostic factor for both OS (HR: 6.799; 95% CI: 3.215-14.377; P < 0.001) and CSS (HR: 8.806; 95% CI: 3.891-19.928; P < 0.001), and its prognostic value was higher than that of other established inflammation-based prognostic scores. When AGR was incorporated into a prognostic model that included T stage, neutrophil to lymphocyte ratio (NLR), and monocyte to lymphocyte ratio (MLR), the resulting nomogram predicted 3- and 5-year OS in the patients more accurately than when AGR was not included. In conclusion, AGR may be particularly useful for improving clinical outcome predictions for patients with localized or locally advanced CCRCC.
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China.
authors.forename: Yingjie
authors.initials: Y
authors.lastname: Shao
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Yao
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China.
authors.forename: Qianfeng
authors.initials: Q
authors.lastname: Zhuang
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China.
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China.
authors.forename: Zhaoyu
authors.initials: Z
authors.lastname: Xing
authors.affiliation: Department of Urology, Sir Run Run Shaw Hospital, Third Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, P.R. China.
authors.forename: Xianlin
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China.
authors.forename: Xiaozhou
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China.
authors.forename: Renfang
authors.initials: R
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D002292:Carcinoma, Renal Cell / Q000097:blood* / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000097:blood* / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012709:Serum Albumin; D012712:Serum Globulins
chemical_list: D014408:Biomarkers, Tumor; D012709:Serum Albumin; D012712:Serum Globulins
keywords: albumin; globulin; nomogram; prognosis; renal cell carcinoma