Central European journal of urology · 2026
Is the albumin/globulin ratio a predictor of response to neoadjuvant chemotherapy before cystectomy for muscle-invasive bladder cancer?
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Ozcan Levent, Boylu Ahmet, Polat Emre Can, Culha Mehmet Gokhan, Erkoc Mustafa, Bozkurt Muammer, Danis Eyyup, Otunctemur Alper
Аннотация
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.
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.