ArticleCentral European journal of urology2026
Is the albumin/globulin ratio a predictor of response to neoadjuvant chemotherapy before cystectomy for muscle-invasive bladder cancer?
Article in Central European journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: The objective of this study is to ascertain whether the albumin-to-globulin ratio (AGR) can predict the response to neoadjuvant chemotherapy (NAC) in patients with muscle-invasive bladder cancer and pure urothelial carcinoma histology who have undergone NAC prior to cystectomy. Material and methods: The study population comprised patients who underwent diagnostic biopsy with complete transurethral resection of a bladder tumor in our hospital, and for whom the pathology result was muscle-invasive pure urothelial cell carcinoma (pT2), and who received a minimum of three courses of cisplatin-based NAC. Patients were divided into two groups, responders and non-responders, according to their chemotherapy response. Results: A response was observed in 81 (54%) patients. The most significant difference between the two groups was found in the AGR scores. The median AGR was 1.7 (1.1-3.2) in the responders and 1.4 (0.7-2.4) in the non-responders (p = 0.001). Using ROC analysis, the optimal cut-off value of AGR for predicting chemotherapy response was determined to be 1.61. Multivariate analysis demonstrated that elevated AGR values (>1.61) exhibited a more substantial impact on response in comparison to other parameters. When the parameters that had a significant effect on survival were investigated with Cox regression analysis, a high AGR with chemotherapy response was found to have more significant effect on survival. Conclusions: We think that, in conjunction with established clinicopathological factors, AGR can be utilized for the selection of patients for NAC.
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