Abstract
BackgroundThe pretreatment albumin to globulin ratio (AGR) has been reported to correlate with the long-term survival in patients with various cancers. However, there are no reports regarding the correlation between the pretreatment AGR and chemotherapeutic outcomes in patients with unresectable metastatic colorectal cancer. The aim of this study was to evaluate the prognostic significance of the pretreatment AGR in patients with unresectable metastatic colorectal cancer.MethodsA total of 66 patients with unresectable metastatic colorectal cancer who underwent palliative chemotherapy for metastatic tumors were enrolled. The AGR was calculated as follows: Albumin/(Total protein - Albumin).ResultsThe median pretreatment AGR was 1.254 (range: 0.849-1.840). We set 1.25 as the cut-off value based on the receiver operating characteristic curve. Based on the cut-off value of 1.25, 34 patients were classified into the high-AGR group and 32 patients were classified into the low-AGR group. The high-AGR group had a significantly higher chemotherapeutic disease control rate (p = 0.040) and better progression-free survival (p = 0.0171) and overall survival (p = 0.0360) rates than the low-AGR group. According to a multivariate analysis of survival, the AGR was identified to be an independent prognostic factor for progression-free survival (Hazard Ratio: 2.662, 95% Confidence Interval: 1.085-6.631, p = 0.033) and overall survival (Hazard Ratio: 2.247, 95% Confidence Interval: 1.069-4.722, p = 0.033).ConclusionsThe pretreatment AGR is a useful prognostic marker in patients with unresectable metastatic colorectal cancer who receive palliative chemotherapy.
Highlights
The pretreatment albumin to globulin ratio (AGR) has been reported to correlate with the long-term survival in patients with various cancers
There have been major advances in the treatment of unresectable metastatic colorectal cancer within the last 10 years, including the introduction of new cytotoxic and molecular targeted therapies [2,3,4,5], the response to palliative chemotherapy varies and many patients die in the early stage after the initiation of treatment due to the ineffectiveness of chemotherapy
Patients We retrospectively reviewed a database of 66 patients who underwent palliative combination chemotherapy for unresectable colorectal cancer at the Department of Surgical Oncology of Osaka City University between 2006 and 2011
Summary
The pretreatment albumin to globulin ratio (AGR) has been reported to correlate with the long-term survival in patients with various cancers. There have been major advances in the treatment of unresectable metastatic colorectal cancer within the last 10 years, including the introduction of new cytotoxic and molecular targeted therapies [2,3,4,5], the response to palliative chemotherapy varies and many patients die in the early stage after the initiation of treatment due to the ineffectiveness of chemotherapy It is Markers of the systemic inflammatory response, such as the neutrophil to lymphocyte ratio (NLR), C-reactive protein level and Glasgow prognostic score (GPS), have been investigated as prognostic factors in colorectal cancer [6,7,8,9,10,11].
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