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Minerva Urologica e Nefrologica 2020 Sep 29

DOI: 10.23736/S0393-2249.20.03938-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Prognostic value of preoperative albumin to globulin ratio in patients treated with salvage radical prostatectomy for radiation recurrent prostate cancer

Fahad QUHAL 1, 2, Benjamin PRADERE 1, 3, Reza SARI MOTLAGH 1, Keiichiro MORI 1, 4, Ekaterina LAUKHTINA 1, 5, Abdulmajeed AYDH 1, 6, Hadi MOSTAFAEI 1, 7, Ivan LYSENKO 1, Victor M. SCHUETTFORT 1, 8, Franziska STOLZENBACH 9, Carlotta PALUMBO 9, Axel HEIDENREICH 10, Alberto BRIGANTI 11, Pierre I. KARAKIEWICZ 9, Piotr CHLOSTA 12, Shahrokh F. SHARIAT 1, 5, 13, 14, 15, 16, 17, 18

1 Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; 2 Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 3 Department of Urology, University Hospital of Tours, Tours, France; 4 Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; 5 Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; 6 King Faisal Medical City, Abha, Saudi Arabia; 7 Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; 8 Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 9 Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada; 10 Department of Urology, University Hospital Cologne, Cologne, Germany; 11 Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; 12 Department of Urology, Jagiellonian University Medical College, Kraków, Poland; 13 Departments of Urology, Weill Cornell Medical College, New York, NY, USA; 14 Department of Urology, University of Texas Southwestern, Dallas, TX, USA; 15 Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; 16 Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan; 17 European Association of Urology Research Foundation, Arnhem, Netherlands; 18 Karl Landsteiner Institute, Vienna, Austria


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BACKGROUND: Serum albumin-to-globulin ratio (AGR) has been shown to be associated with poor prognosis in different malignancies. In this study we aimed to evaluate the predictive value of preoperative AGR for oncological outcomes in patients with radiation recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP).
METHODS: A retrospective review of 214 consecutive patients with radiation-recurrent PCa who underwent SRP at five referral centers. Levels of albumin and globulin were obtained before SRP and used to calculate the preoperative AGR level. The optimal cut off value of preoperative AGR was 1.4. Univariable and multivariable Cox regression analyses were performed.
RESULTS: Overall 89 (41.6%) patients had a low preoperative AGR. Low serum AGR was associated with biochemical recurrence (BCR) in univariable Cox regression analysis (HR 1.60, 95%CI 1.06-2.43, P=0.026). When adjusted for the effects of established preoperative and postoperative clinicopathologic confounders in different multivariable Cox regression models, this association did not retain its statistical significance. Moreover, preoperative AGR was not associated with metastasis free survival (P= 0.21), overall survival (P= 0.91) or cancer specific survival (P=0.61).
CONCLUSIONS: In patients with radiation recurrent PCa undergoing SRP, low preoperative AGR was associated with the risk of BCR only in univariable analysis. There was no association with metastasis or survival outcomes. Further studies are needed to evaluate this biomarker in the setting of primary PCa and to identify the patients most likely to benefit from a local therapy.


KEY WORDS: Albumin; Globulin; Salvage radical prostatectomy; Prostate cancer; Radiation therapy

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