TY - JOUR
T1 - Clinical impact of preoperative albumin-globulin ratio in patients with rectal cancer treated with preoperative chemoradiotherapy
AU - Toiyama, Yuji
AU - Oki, Satoshi
AU - Okugawa, Yoshinaga
AU - Ide, Shozou
AU - Yasuda, Hiromi
AU - Fujikawa, Hiroyuki
AU - Yoshiyama, Shigeyuki
AU - Hiro, Junichiro
AU - Ohi, Masaki
AU - Inoue, Yasuhiro
AU - Araki, Toshimitsu
AU - Kusunoki, Masato
N1 - Publisher Copyright:
© 2018 S. Karger AG, Basel.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Objective: The serum albumin-globulin ratio (AGR) is associated with malignancy outcomes. However, among patients with rectal cancer (RC) who undergo neoadjuvant chemoradiotherapy (nCRT), the clinical and prognostic significance of the pretreatment AGR is unclear. Methods: We investigated whether the pre-nCRT AGR can help predict oncological outcomes in patients with RC receiving nCRT. We analyzed 114 patients with RC who received nCRT followed by total mesorectal excision at our institution. Results: A lower AGR in pre-nCRT serum was significantly correlated with shorter overall survival and disease-free survival in patients with nCRT-treated RC. In multivariate analysis, a high carcinoembryonic antigen (CEA) level and a low AGR in pre-nCRT serum were independent predictors of a poor prognosis in these patients. Furthermore, combining the AGR with CEA provided a more accurate indicator of poor prognosis and early recurrence in these patients. In particular, a low pre-nCRT AGR was a stronger indicator of a poor prognosis and early recurrence in patients without than with pathological lymph node metastasis. Combining the pre-nCRT AGR with CEA could more precisely stratify patients' oncological outcome risks. Conclusion: Assessment of the pretreatment AGR with or without CEA can guide postoperative treatment in patients with RC who undergo nCRT.
AB - Objective: The serum albumin-globulin ratio (AGR) is associated with malignancy outcomes. However, among patients with rectal cancer (RC) who undergo neoadjuvant chemoradiotherapy (nCRT), the clinical and prognostic significance of the pretreatment AGR is unclear. Methods: We investigated whether the pre-nCRT AGR can help predict oncological outcomes in patients with RC receiving nCRT. We analyzed 114 patients with RC who received nCRT followed by total mesorectal excision at our institution. Results: A lower AGR in pre-nCRT serum was significantly correlated with shorter overall survival and disease-free survival in patients with nCRT-treated RC. In multivariate analysis, a high carcinoembryonic antigen (CEA) level and a low AGR in pre-nCRT serum were independent predictors of a poor prognosis in these patients. Furthermore, combining the AGR with CEA provided a more accurate indicator of poor prognosis and early recurrence in these patients. In particular, a low pre-nCRT AGR was a stronger indicator of a poor prognosis and early recurrence in patients without than with pathological lymph node metastasis. Combining the pre-nCRT AGR with CEA could more precisely stratify patients' oncological outcome risks. Conclusion: Assessment of the pretreatment AGR with or without CEA can guide postoperative treatment in patients with RC who undergo nCRT.
UR - http://www.scopus.com/inward/record.url?scp=85049922536&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049922536&partnerID=8YFLogxK
U2 - 10.1159/000490149
DO - 10.1159/000490149
M3 - Article
C2 - 29996133
AN - SCOPUS:85049922536
SN - 0030-2414
VL - 95
SP - 270
EP - 280
JO - Oncology
JF - Oncology
IS - 5
ER -