Evidence map›Paper›PMID 33496841›Full record

ArticleWorld journal of urology2021

Prognostic value of albumin to globulin ratio in non-muscle-invasive bladder cancer.

Fahad Quhal, Benjamin Pradere, Ekaterina Laukhtina, Reza Sari Motlagh, Hadi Mostafaei, Keiichiro Mori, Victor M Schuettfort, Pierre I Karakiewicz, Morgan Rouprêt, Dmitry Enikeev and 3 more

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In one paragraph

Article in World journal of urology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Fahad QuhalDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID http://orcid.org/0000-0002-8163-6953
Benjamin PradereDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Ekaterina LaukhtinaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Reza Sari MotlaghDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Hadi MostafaeiDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Keiichiro MoriDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Victor M SchuettfortDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Pierre I KarakiewiczCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada.
Morgan RouprêtPredictive onco-uro, AP-HP, Urology Hôpital Pitié-Salpêtrière, Sorbonne Université, GRC n°5, 75013, Paris, France.
Dmitry EnikeevInstitute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
Michael RinkDepartment of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Mohammad AbufarajDivision of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.
Shahrokh F ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. shahrokh.shariat@meduniwien.ac.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo investigate the prognostic value of preoperative serum albumin to globulin ratio (AGR) in patients with non-muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of bladder tumor (TURB) with or without intravesical therapy (IVT). MATERIALS AND

methodsWe retrospectively reviewed 1,096 consecutive patients with NMIBC. Levels of albumin and globulin were obtained before TURB and used to calculate the preoperative AGR level. Multivariable Cox regression analyses were performed to assess the prognostic effect of preoperative AGR on oncologic outcomes. Subgroup analyses were performed in patients based on the European Association of Urology (EAU) risk groups for NMIBC.

resultsLow AGR levels were observed in 389 (35.5%) patients. The median follow-up was 63.7 months (IQR 25.3-111). On multivariable Cox regression analysis, low AGR was associated with increased risk of progression to muscle-invasive BCa (MIBC) (HR 1.81, 95% CI 1.22-2.68, P = 0.003). The addition of AGR only minimally improved the discrimination ability of a base model that included established clinicopathologic features (C-index = 0.7354 vs. C-index = 0.7162). Low preoperative AGR was not significantly associated with the risk of disease recurrence (P = 0.31). In subgroup analyses based on patients' EAU risk groups, low preoperative AGR was not associated with recurrence-free survival (RFS) (P = 0.59) or progression-free survival (PFS) (P = 0.22) in any of the risk groups. Additionally, in patients treated with Bacillus Calmette-Guerin (BCG) for intermediate- or high-risk NMIBC, low AGR failed to predict disease recurrence or progression.

conclusionPreoperative serum AGR levels independently predicted the risk of disease progression in patients with NMIBC. However, it was not found to be associated with either RFS or PFS in NMIBC patients based on their EAU risk group. This marker seems to have a limited role in NMIBC at the present time. However, further research is needed to investigate this marker in combination with other systemic inflammatory markers to help improve prediction in this heterogeneous group of patients.

Indexed as

CystectomyAgedFemaleHumansMaleMiddle AgedNeoplasm InvasivenessPreoperative PeriodPrognosisRetrospective StudiesSerum AlbuminSerum GlobulinsUrethraUrinary Bladder NeoplasmsSerum AlbuminSerum GlobulinsAGRAlbuminBCGBladder cancerGlobulinNon-muscle-invasiveProgression

Identifiers

PMID33496841
PMCPMC8510920

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.