The value of the pretreatment albumin/globulin ratio in predicting the long-term survival in colorectal cancer
Background Low serum albumin was found as a predictor of long-term mortality in colorectal cancer (CRC) patients. Our aim was to evaluate the value of the pretreatment albumin/globulin ratio (AGR) to predict the long-term mortality in CRC patients. Methods Patients were included if they had comprehe...
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| Veröffentlicht in: | International journal of colorectal disease 2013-12, Vol.28 (12), p.1629-1636 |
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| container_title | International journal of colorectal disease |
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| creator | Azab, Basem Kedia, Shiksha Shah, Neeraj Vonfrolio, Steven Lu, William Naboush, Ali Mohammed, Farhan Bloom, Scott W. |
| description | Background
Low serum albumin was found as a predictor of long-term mortality in colorectal cancer (CRC) patients. Our aim was to evaluate the value of the pretreatment albumin/globulin ratio (AGR) to predict the long-term mortality in CRC patients.
Methods
Patients were included if they had comprehensive metabolic panel (CMP) before treatment (surgery or chemotherapy). The albumin/globulin ratio, routinely reported in CMP, is calculated [AGR = Albumin/(Total protein − Albumin)]. Patients were divided into three equal tertiles according to their pretreatment AGR. The primary outcome was cancer-related mortality, which was obtained from our cancer registry database.
Results
A total of 534 consecutive CRC patients had pretreatment CMP. The 1st AGR tertile had a significant higher 4-year mortality compared to the second and third AGR tertiles (42 vs. 19 and 7 %,
p
3.5 g/dl), patients with lower globulins but higher albumin and AGR levels had better survival. |
| doi_str_mv | 10.1007/s00384-013-1748-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1459159815</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3126949381</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-5085a5261366ae7987a510f082be34466d639beb9bf04060e234312d2bee07dc3</originalsourceid><addsrcrecordid>eNp1kU1rFTEYhYMo9rb6A9zIgBs3sfn-WErxo1BwU9chk3nnOiWTXJNMwf56c71VRHCVHN7nnDfkIPSKkneUEH1ZCeFGYEI5ploY_PAE7ajgDFOm2FO0I1RbTK00Z-i81jvStdLiOTpj3Egtrd2hdPsNhnsfNxjyPLQuDgVaAd9WSG3wcdzWJV3uYx63uKSh-LbkoV86Ni2hLWn_yxVz2uMGZR3qVu6XnniEQo65QGhdBZ8ClBfo2exjhZeP5wX6-vHD7dVnfPPl0_XV-xscBDcNS2Kkl0xRrpQHbY32kpKZGDYCF0KpSXE7wmjHmQiiCDAuOGVTHwPRU-AX6O0p91Dy9w1qc-tSA8ToE-StOiqkpdIaKjv65h_0Lm8l9dcdKSMME1J3ip6oUHKtBWZ3KMvqyw9HiTuW4U5luF6GO5bhHrrn9WPyNq4w_XH8_v0OsBNQ-yjtofy1-r-pPwEIXZVm</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1458482457</pqid></control><display><type>article</type><title>The value of the pretreatment albumin/globulin ratio in predicting the long-term survival in colorectal cancer</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Azab, Basem ; Kedia, Shiksha ; Shah, Neeraj ; Vonfrolio, Steven ; Lu, William ; Naboush, Ali ; Mohammed, Farhan ; Bloom, Scott W.</creator><creatorcontrib>Azab, Basem ; Kedia, Shiksha ; Shah, Neeraj ; Vonfrolio, Steven ; Lu, William ; Naboush, Ali ; Mohammed, Farhan ; Bloom, Scott W.</creatorcontrib><description>Background
Low serum albumin was found as a predictor of long-term mortality in colorectal cancer (CRC) patients. Our aim was to evaluate the value of the pretreatment albumin/globulin ratio (AGR) to predict the long-term mortality in CRC patients.
Methods
Patients were included if they had comprehensive metabolic panel (CMP) before treatment (surgery or chemotherapy). The albumin/globulin ratio, routinely reported in CMP, is calculated [AGR = Albumin/(Total protein − Albumin)]. Patients were divided into three equal tertiles according to their pretreatment AGR. The primary outcome was cancer-related mortality, which was obtained from our cancer registry database.
Results
A total of 534 consecutive CRC patients had pretreatment CMP. The 1st AGR tertile had a significant higher 4-year mortality compared to the second and third AGR tertiles (42 vs. 19 and 7 %,
p
< 0.0001 according to Fisher’s exact two-tailed test). In the multivariate model, AGR remained an independent predictor of survival with 75 % decrease in mortality among the highest AGR tertile in comparison to the lowest AGR tertile,
p
< 0.0001. In the subset of 234 patients with normal serum albumin (albumin of >3.5 g/dl), serum AGR continues to be an independent predictor of cancer-related mortality with an adjusted hazard ratio of the third tertile compared to the first tertile equal to 0.05 (95 % confidence interval 0.01–0.33,
p
= 0.002).
Conclusion
Low AGR was a strong independent predictor of long-term cancer-specific survival among colorectal cancer patients. Additionally, among the patients with normal albumin (>3.5 g/dl), patients with lower globulins but higher albumin and AGR levels had better survival.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-013-1748-z</identifier><identifier>PMID: 23857599</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Colorectal Neoplasms - drug therapy ; Colorectal Neoplasms - metabolism ; Colorectal Neoplasms - mortality ; Female ; Gastroenterology ; Globulins - metabolism ; Hepatology ; Humans ; Internal Medicine ; Kaplan-Meier Estimate ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate Analysis ; Original Article ; Proctology ; Proportional Hazards Models ; Serum Albumin - metabolism ; Surgery</subject><ispartof>International journal of colorectal disease, 2013-12, Vol.28 (12), p.1629-1636</ispartof><rights>Springer-Verlag Berlin Heidelberg 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-5085a5261366ae7987a510f082be34466d639beb9bf04060e234312d2bee07dc3</citedby><cites>FETCH-LOGICAL-c438t-5085a5261366ae7987a510f082be34466d639beb9bf04060e234312d2bee07dc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-013-1748-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-013-1748-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23857599$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Azab, Basem</creatorcontrib><creatorcontrib>Kedia, Shiksha</creatorcontrib><creatorcontrib>Shah, Neeraj</creatorcontrib><creatorcontrib>Vonfrolio, Steven</creatorcontrib><creatorcontrib>Lu, William</creatorcontrib><creatorcontrib>Naboush, Ali</creatorcontrib><creatorcontrib>Mohammed, Farhan</creatorcontrib><creatorcontrib>Bloom, Scott W.</creatorcontrib><title>The value of the pretreatment albumin/globulin ratio in predicting the long-term survival in colorectal cancer</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Background
Low serum albumin was found as a predictor of long-term mortality in colorectal cancer (CRC) patients. Our aim was to evaluate the value of the pretreatment albumin/globulin ratio (AGR) to predict the long-term mortality in CRC patients.
Methods
Patients were included if they had comprehensive metabolic panel (CMP) before treatment (surgery or chemotherapy). The albumin/globulin ratio, routinely reported in CMP, is calculated [AGR = Albumin/(Total protein − Albumin)]. Patients were divided into three equal tertiles according to their pretreatment AGR. The primary outcome was cancer-related mortality, which was obtained from our cancer registry database.
Results
A total of 534 consecutive CRC patients had pretreatment CMP. The 1st AGR tertile had a significant higher 4-year mortality compared to the second and third AGR tertiles (42 vs. 19 and 7 %,
p
< 0.0001 according to Fisher’s exact two-tailed test). In the multivariate model, AGR remained an independent predictor of survival with 75 % decrease in mortality among the highest AGR tertile in comparison to the lowest AGR tertile,
p
< 0.0001. In the subset of 234 patients with normal serum albumin (albumin of >3.5 g/dl), serum AGR continues to be an independent predictor of cancer-related mortality with an adjusted hazard ratio of the third tertile compared to the first tertile equal to 0.05 (95 % confidence interval 0.01–0.33,
p
= 0.002).
Conclusion
Low AGR was a strong independent predictor of long-term cancer-specific survival among colorectal cancer patients. Additionally, among the patients with normal albumin (>3.5 g/dl), patients with lower globulins but higher albumin and AGR levels had better survival.</description><subject>Aged</subject><subject>Colorectal Neoplasms - drug therapy</subject><subject>Colorectal Neoplasms - metabolism</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Globulins - metabolism</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Original Article</subject><subject>Proctology</subject><subject>Proportional Hazards Models</subject><subject>Serum Albumin - metabolism</subject><subject>Surgery</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1rFTEYhYMo9rb6A9zIgBs3sfn-WErxo1BwU9chk3nnOiWTXJNMwf56c71VRHCVHN7nnDfkIPSKkneUEH1ZCeFGYEI5ploY_PAE7ajgDFOm2FO0I1RbTK00Z-i81jvStdLiOTpj3Egtrd2hdPsNhnsfNxjyPLQuDgVaAd9WSG3wcdzWJV3uYx63uKSh-LbkoV86Ni2hLWn_yxVz2uMGZR3qVu6XnniEQo65QGhdBZ8ClBfo2exjhZeP5wX6-vHD7dVnfPPl0_XV-xscBDcNS2Kkl0xRrpQHbY32kpKZGDYCF0KpSXE7wmjHmQiiCDAuOGVTHwPRU-AX6O0p91Dy9w1qc-tSA8ToE-StOiqkpdIaKjv65h_0Lm8l9dcdKSMME1J3ip6oUHKtBWZ3KMvqyw9HiTuW4U5luF6GO5bhHrrn9WPyNq4w_XH8_v0OsBNQ-yjtofy1-r-pPwEIXZVm</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Azab, Basem</creator><creator>Kedia, Shiksha</creator><creator>Shah, Neeraj</creator><creator>Vonfrolio, Steven</creator><creator>Lu, William</creator><creator>Naboush, Ali</creator><creator>Mohammed, Farhan</creator><creator>Bloom, Scott W.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>The value of the pretreatment albumin/globulin ratio in predicting the long-term survival in colorectal cancer</title><author>Azab, Basem ; Kedia, Shiksha ; Shah, Neeraj ; Vonfrolio, Steven ; Lu, William ; Naboush, Ali ; Mohammed, Farhan ; Bloom, Scott W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-5085a5261366ae7987a510f082be34466d639beb9bf04060e234312d2bee07dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Colorectal Neoplasms - drug therapy</topic><topic>Colorectal Neoplasms - metabolism</topic><topic>Colorectal Neoplasms - mortality</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Globulins - metabolism</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Original Article</topic><topic>Proctology</topic><topic>Proportional Hazards Models</topic><topic>Serum Albumin - metabolism</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Azab, Basem</creatorcontrib><creatorcontrib>Kedia, Shiksha</creatorcontrib><creatorcontrib>Shah, Neeraj</creatorcontrib><creatorcontrib>Vonfrolio, Steven</creatorcontrib><creatorcontrib>Lu, William</creatorcontrib><creatorcontrib>Naboush, Ali</creatorcontrib><creatorcontrib>Mohammed, Farhan</creatorcontrib><creatorcontrib>Bloom, Scott W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Azab, Basem</au><au>Kedia, Shiksha</au><au>Shah, Neeraj</au><au>Vonfrolio, Steven</au><au>Lu, William</au><au>Naboush, Ali</au><au>Mohammed, Farhan</au><au>Bloom, Scott W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The value of the pretreatment albumin/globulin ratio in predicting the long-term survival in colorectal cancer</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>28</volume><issue>12</issue><spage>1629</spage><epage>1636</epage><pages>1629-1636</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Background
Low serum albumin was found as a predictor of long-term mortality in colorectal cancer (CRC) patients. Our aim was to evaluate the value of the pretreatment albumin/globulin ratio (AGR) to predict the long-term mortality in CRC patients.
Methods
Patients were included if they had comprehensive metabolic panel (CMP) before treatment (surgery or chemotherapy). The albumin/globulin ratio, routinely reported in CMP, is calculated [AGR = Albumin/(Total protein − Albumin)]. Patients were divided into three equal tertiles according to their pretreatment AGR. The primary outcome was cancer-related mortality, which was obtained from our cancer registry database.
Results
A total of 534 consecutive CRC patients had pretreatment CMP. The 1st AGR tertile had a significant higher 4-year mortality compared to the second and third AGR tertiles (42 vs. 19 and 7 %,
p
< 0.0001 according to Fisher’s exact two-tailed test). In the multivariate model, AGR remained an independent predictor of survival with 75 % decrease in mortality among the highest AGR tertile in comparison to the lowest AGR tertile,
p
< 0.0001. In the subset of 234 patients with normal serum albumin (albumin of >3.5 g/dl), serum AGR continues to be an independent predictor of cancer-related mortality with an adjusted hazard ratio of the third tertile compared to the first tertile equal to 0.05 (95 % confidence interval 0.01–0.33,
p
= 0.002).
Conclusion
Low AGR was a strong independent predictor of long-term cancer-specific survival among colorectal cancer patients. Additionally, among the patients with normal albumin (>3.5 g/dl), patients with lower globulins but higher albumin and AGR levels had better survival.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>23857599</pmid><doi>10.1007/s00384-013-1748-z</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-1958 |
| ispartof | International journal of colorectal disease, 2013-12, Vol.28 (12), p.1629-1636 |
| issn | 0179-1958 1432-1262 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1459159815 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Colorectal Neoplasms - drug therapy Colorectal Neoplasms - metabolism Colorectal Neoplasms - mortality Female Gastroenterology Globulins - metabolism Hepatology Humans Internal Medicine Kaplan-Meier Estimate Male Medicine Medicine & Public Health Middle Aged Multivariate Analysis Original Article Proctology Proportional Hazards Models Serum Albumin - metabolism Surgery |
| title | The value of the pretreatment albumin/globulin ratio in predicting the long-term survival in colorectal cancer |
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