Pre-therapy serum albumin-to-globulin ratio in patients treated with neoadjuvant chemotherapy and radical nephroureterectomy for upper tract urothelial carcinoma
Purpose The accurate selection of patients who are most likely to benefit from neoadjuvant chemotherapy is an important challenge in oncology. Serum AGR has been found to be associated with oncological outcomes in various malignancies. We assessed the association of pre-therapy serum albumin-to-glob...
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| Veröffentlicht in: | World journal of urology 2021-07, Vol.39 (7), p.2567-2577 |
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| creator | Pradere, Benjamin D’Andrea, David Schuettfort, Victor M. Foerster, Beat Quhal, Fahad Mori, Keiichiro Abufaraj, Mohammad Margulis, Vitaly Deuker, Marine Briganti, Alberto Muilwijk, Tim Hendricksen, Kees Lotan, Yair Karakiewic, Pierre F.Shariat, Shahrokh |
| description | Purpose
The accurate selection of patients who are most likely to benefit from neoadjuvant chemotherapy is an important challenge in oncology. Serum AGR has been found to be associated with oncological outcomes in various malignancies. We assessed the association of pre-therapy serum albumin-to-globulin ratio (AGR) with pathologic response and oncological outcomes in patients treated with neoadjuvant platin-based chemotherapy followed by radical nephroureterectomy (RNU) for clinically non-metastatic UTUC.
Methods
We retrospectively included all clinically non-metastatic patients from a multicentric database who had neoadjuvant platin-based chemotherapy and RNU for UTUC. After assessing the pretreatment AGR cut‐off value, we found 1.42 to have the maximum Youden index value. The overall population was therefore divided into two AGR groups using this cut‐off (low, |
| doi_str_mv | 10.1007/s00345-020-03479-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8332553</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2451861374</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-1f765528cbcdac5d0dcadb4e1f2c780a7f7ece05eaca5bca61333a4fc72a5ccc3</originalsourceid><addsrcrecordid>eNp9kk1v1DAQhiMEokvhD3BAlrhwMThxHGcvSKiigFQJDnC2JpPJxqskDv4o2p_DP8XbbcvHgZNHmmfe-fBbFM9L8boUQr8JQshacVEJngO95fJBsSlrKXmrq-ZhsRG6qnm9beVZ8SSEvRClboR6XJxJKRqdmU3x84snHkfysB5YIJ9mBlOXZrvw6Phucl2a7MI8ROtYDtYc0BIDi54gUs9-2DiyhRz0-3QNS2Q40uzuFGHpc21vEaYMraN3yVMkTxjdfGCD8yytK_ksBxhZ8sfKyWYawaNd3AxPi0cDTIGe3b7nxbfL918vPvKrzx8-Xby74ljrOvJy0I1SVYsd9oCqFz1C39VUDhXqVoAeNCEJRYCgOoSmlFJCPaCuQCGiPC_ennTX1M3UY97Sw2RWb2fwB-PAmr8zix3Nzl2bVspKKZkFXt0KePc9UYhmtgFpmiCfJwVT1apsc1tdZ_TlP-g-H2bJ65kspRutmmqbqepEoXcheBruhymFOTrAnBxgsgPMjQPMcYoXf65xX3L35RmQJyDk1LIj_7v3f2R_AU8Lw7w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2557675629</pqid></control><display><type>article</type><title>Pre-therapy serum albumin-to-globulin ratio in patients treated with neoadjuvant chemotherapy and radical nephroureterectomy for upper tract urothelial carcinoma</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Pradere, Benjamin ; D’Andrea, David ; Schuettfort, Victor M. ; Foerster, Beat ; Quhal, Fahad ; Mori, Keiichiro ; Abufaraj, Mohammad ; Margulis, Vitaly ; Deuker, Marine ; Briganti, Alberto ; Muilwijk, Tim ; Hendricksen, Kees ; Lotan, Yair ; Karakiewic, Pierre ; F.Shariat, Shahrokh</creator><creatorcontrib>Pradere, Benjamin ; D’Andrea, David ; Schuettfort, Victor M. ; Foerster, Beat ; Quhal, Fahad ; Mori, Keiichiro ; Abufaraj, Mohammad ; Margulis, Vitaly ; Deuker, Marine ; Briganti, Alberto ; Muilwijk, Tim ; Hendricksen, Kees ; Lotan, Yair ; Karakiewic, Pierre ; F.Shariat, Shahrokh ; UTUC collaboration ; For the UTUC collaboration</creatorcontrib><description>Purpose
The accurate selection of patients who are most likely to benefit from neoadjuvant chemotherapy is an important challenge in oncology. Serum AGR has been found to be associated with oncological outcomes in various malignancies. We assessed the association of pre-therapy serum albumin-to-globulin ratio (AGR) with pathologic response and oncological outcomes in patients treated with neoadjuvant platin-based chemotherapy followed by radical nephroureterectomy (RNU) for clinically non-metastatic UTUC.
Methods
We retrospectively included all clinically non-metastatic patients from a multicentric database who had neoadjuvant platin-based chemotherapy and RNU for UTUC. After assessing the pretreatment AGR cut‐off value, we found 1.42 to have the maximum Youden index value. The overall population was therefore divided into two AGR groups using this cut‐off (low, < 1.42 vs high, ≥ 1.42)
.
A logistic regression was performed to measure the association with pathologic response after NAC. Univariable and multivariable Cox regression analyses tested the association of AGR with OS and RFS.
Results
Of 172 patients, 58 (34%) patients had an AGR < 1.42. Median follow-up was 26 (IQR 11–56) months. In logistic regression, low AGR was not associated with pathologic response. On univariable analyses, pre-therapy serum AGR was neither associated with OS HR 1.15 (95% CI 0.77–1.74;
p
= 0.47) nor RFS HR 1.48 (95% CI 0.98–1.22;
p
= 0.06). These results remained true regardless of the response to NAC.
Conclusion
Pre-therapy low serum AGR before NAC followed by RNU for clinically high-risk UTUC was not associated with pathological response or long-term oncological outcomes. Biomarkers that can complement clinical factors in UTUC are needed as clinical staging and risk stratification are still suboptimal leading to both over and under treatment despite the availability of effective therapies.</description><identifier>ISSN: 0724-4983</identifier><identifier>EISSN: 1433-8726</identifier><identifier>DOI: 10.1007/s00345-020-03479-3</identifier><identifier>PMID: 33067726</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Albumin ; Bladder cancer ; Carcinoma, Transitional Cell - blood ; Carcinoma, Transitional Cell - therapy ; Chemotherapy ; Globulins ; Globulins - analysis ; Humans ; Kidney Neoplasms - blood ; Kidney Neoplasms - therapy ; Medicine ; Medicine & Public Health ; Metastases ; Metastasis ; Middle Aged ; Neoadjuvant Therapy ; Neoplasms, Multiple Primary - blood ; Neoplasms, Multiple Primary - therapy ; Nephrology ; Nephroureterectomy ; Oncology ; Original ; Original Article ; Patients ; Retrospective Studies ; Serum Albumin - analysis ; Treatment Outcome ; Ureteral Neoplasms - blood ; Ureteral Neoplasms - therapy ; Urology ; Urothelial carcinoma</subject><ispartof>World journal of urology, 2021-07, Vol.39 (7), p.2567-2577</ispartof><rights>The Author(s) 2020</rights><rights>2020. The Author(s).</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-1f765528cbcdac5d0dcadb4e1f2c780a7f7ece05eaca5bca61333a4fc72a5ccc3</citedby><cites>FETCH-LOGICAL-c474t-1f765528cbcdac5d0dcadb4e1f2c780a7f7ece05eaca5bca61333a4fc72a5ccc3</cites><orcidid>0000-0002-7768-8558</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00345-020-03479-3$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00345-020-03479-3$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33067726$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pradere, Benjamin</creatorcontrib><creatorcontrib>D’Andrea, David</creatorcontrib><creatorcontrib>Schuettfort, Victor M.</creatorcontrib><creatorcontrib>Foerster, Beat</creatorcontrib><creatorcontrib>Quhal, Fahad</creatorcontrib><creatorcontrib>Mori, Keiichiro</creatorcontrib><creatorcontrib>Abufaraj, Mohammad</creatorcontrib><creatorcontrib>Margulis, Vitaly</creatorcontrib><creatorcontrib>Deuker, Marine</creatorcontrib><creatorcontrib>Briganti, Alberto</creatorcontrib><creatorcontrib>Muilwijk, Tim</creatorcontrib><creatorcontrib>Hendricksen, Kees</creatorcontrib><creatorcontrib>Lotan, Yair</creatorcontrib><creatorcontrib>Karakiewic, Pierre</creatorcontrib><creatorcontrib>F.Shariat, Shahrokh</creatorcontrib><creatorcontrib>UTUC collaboration</creatorcontrib><creatorcontrib>For the UTUC collaboration</creatorcontrib><title>Pre-therapy serum albumin-to-globulin ratio in patients treated with neoadjuvant chemotherapy and radical nephroureterectomy for upper tract urothelial carcinoma</title><title>World journal of urology</title><addtitle>World J Urol</addtitle><addtitle>World J Urol</addtitle><description>Purpose
The accurate selection of patients who are most likely to benefit from neoadjuvant chemotherapy is an important challenge in oncology. Serum AGR has been found to be associated with oncological outcomes in various malignancies. We assessed the association of pre-therapy serum albumin-to-globulin ratio (AGR) with pathologic response and oncological outcomes in patients treated with neoadjuvant platin-based chemotherapy followed by radical nephroureterectomy (RNU) for clinically non-metastatic UTUC.
Methods
We retrospectively included all clinically non-metastatic patients from a multicentric database who had neoadjuvant platin-based chemotherapy and RNU for UTUC. After assessing the pretreatment AGR cut‐off value, we found 1.42 to have the maximum Youden index value. The overall population was therefore divided into two AGR groups using this cut‐off (low, < 1.42 vs high, ≥ 1.42)
.
A logistic regression was performed to measure the association with pathologic response after NAC. Univariable and multivariable Cox regression analyses tested the association of AGR with OS and RFS.
Results
Of 172 patients, 58 (34%) patients had an AGR < 1.42. Median follow-up was 26 (IQR 11–56) months. In logistic regression, low AGR was not associated with pathologic response. On univariable analyses, pre-therapy serum AGR was neither associated with OS HR 1.15 (95% CI 0.77–1.74;
p
= 0.47) nor RFS HR 1.48 (95% CI 0.98–1.22;
p
= 0.06). These results remained true regardless of the response to NAC.
Conclusion
Pre-therapy low serum AGR before NAC followed by RNU for clinically high-risk UTUC was not associated with pathological response or long-term oncological outcomes. Biomarkers that can complement clinical factors in UTUC are needed as clinical staging and risk stratification are still suboptimal leading to both over and under treatment despite the availability of effective therapies.</description><subject>Aged</subject><subject>Albumin</subject><subject>Bladder cancer</subject><subject>Carcinoma, Transitional Cell - blood</subject><subject>Carcinoma, Transitional Cell - therapy</subject><subject>Chemotherapy</subject><subject>Globulins</subject><subject>Globulins - analysis</subject><subject>Humans</subject><subject>Kidney Neoplasms - blood</subject><subject>Kidney Neoplasms - therapy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy</subject><subject>Neoplasms, Multiple Primary - blood</subject><subject>Neoplasms, Multiple Primary - therapy</subject><subject>Nephrology</subject><subject>Nephroureterectomy</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Serum Albumin - analysis</subject><subject>Treatment Outcome</subject><subject>Ureteral Neoplasms - blood</subject><subject>Ureteral Neoplasms - therapy</subject><subject>Urology</subject><subject>Urothelial carcinoma</subject><issn>0724-4983</issn><issn>1433-8726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kk1v1DAQhiMEokvhD3BAlrhwMThxHGcvSKiigFQJDnC2JpPJxqskDv4o2p_DP8XbbcvHgZNHmmfe-fBbFM9L8boUQr8JQshacVEJngO95fJBsSlrKXmrq-ZhsRG6qnm9beVZ8SSEvRClboR6XJxJKRqdmU3x84snHkfysB5YIJ9mBlOXZrvw6Phucl2a7MI8ROtYDtYc0BIDi54gUs9-2DiyhRz0-3QNS2Q40uzuFGHpc21vEaYMraN3yVMkTxjdfGCD8yytK_ksBxhZ8sfKyWYawaNd3AxPi0cDTIGe3b7nxbfL918vPvKrzx8-Xby74ljrOvJy0I1SVYsd9oCqFz1C39VUDhXqVoAeNCEJRYCgOoSmlFJCPaCuQCGiPC_ennTX1M3UY97Sw2RWb2fwB-PAmr8zix3Nzl2bVspKKZkFXt0KePc9UYhmtgFpmiCfJwVT1apsc1tdZ_TlP-g-H2bJ65kspRutmmqbqepEoXcheBruhymFOTrAnBxgsgPMjQPMcYoXf65xX3L35RmQJyDk1LIj_7v3f2R_AU8Lw7w</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Pradere, Benjamin</creator><creator>D’Andrea, David</creator><creator>Schuettfort, Victor M.</creator><creator>Foerster, Beat</creator><creator>Quhal, Fahad</creator><creator>Mori, Keiichiro</creator><creator>Abufaraj, Mohammad</creator><creator>Margulis, Vitaly</creator><creator>Deuker, Marine</creator><creator>Briganti, Alberto</creator><creator>Muilwijk, Tim</creator><creator>Hendricksen, Kees</creator><creator>Lotan, Yair</creator><creator>Karakiewic, Pierre</creator><creator>F.Shariat, Shahrokh</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><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>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7768-8558</orcidid></search><sort><creationdate>20210701</creationdate><title>Pre-therapy serum albumin-to-globulin ratio in patients treated with neoadjuvant chemotherapy and radical nephroureterectomy for upper tract urothelial carcinoma</title><author>Pradere, Benjamin ; D’Andrea, David ; Schuettfort, Victor M. ; Foerster, Beat ; Quhal, Fahad ; Mori, Keiichiro ; Abufaraj, Mohammad ; Margulis, Vitaly ; Deuker, Marine ; Briganti, Alberto ; Muilwijk, Tim ; Hendricksen, Kees ; Lotan, Yair ; Karakiewic, Pierre ; F.Shariat, Shahrokh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-1f765528cbcdac5d0dcadb4e1f2c780a7f7ece05eaca5bca61333a4fc72a5ccc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Albumin</topic><topic>Bladder cancer</topic><topic>Carcinoma, Transitional Cell - blood</topic><topic>Carcinoma, Transitional Cell - therapy</topic><topic>Chemotherapy</topic><topic>Globulins</topic><topic>Globulins - analysis</topic><topic>Humans</topic><topic>Kidney Neoplasms - blood</topic><topic>Kidney Neoplasms - therapy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy</topic><topic>Neoplasms, Multiple Primary - blood</topic><topic>Neoplasms, Multiple Primary - therapy</topic><topic>Nephrology</topic><topic>Nephroureterectomy</topic><topic>Oncology</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Serum Albumin - analysis</topic><topic>Treatment Outcome</topic><topic>Ureteral Neoplasms - blood</topic><topic>Ureteral Neoplasms - therapy</topic><topic>Urology</topic><topic>Urothelial carcinoma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pradere, Benjamin</creatorcontrib><creatorcontrib>D’Andrea, David</creatorcontrib><creatorcontrib>Schuettfort, Victor M.</creatorcontrib><creatorcontrib>Foerster, Beat</creatorcontrib><creatorcontrib>Quhal, Fahad</creatorcontrib><creatorcontrib>Mori, Keiichiro</creatorcontrib><creatorcontrib>Abufaraj, Mohammad</creatorcontrib><creatorcontrib>Margulis, Vitaly</creatorcontrib><creatorcontrib>Deuker, Marine</creatorcontrib><creatorcontrib>Briganti, Alberto</creatorcontrib><creatorcontrib>Muilwijk, Tim</creatorcontrib><creatorcontrib>Hendricksen, Kees</creatorcontrib><creatorcontrib>Lotan, Yair</creatorcontrib><creatorcontrib>Karakiewic, Pierre</creatorcontrib><creatorcontrib>F.Shariat, Shahrokh</creatorcontrib><creatorcontrib>UTUC collaboration</creatorcontrib><creatorcontrib>For the UTUC collaboration</creatorcontrib><collection>Springer Nature OA Free Journals</collection><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>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pradere, Benjamin</au><au>D’Andrea, David</au><au>Schuettfort, Victor M.</au><au>Foerster, Beat</au><au>Quhal, Fahad</au><au>Mori, Keiichiro</au><au>Abufaraj, Mohammad</au><au>Margulis, Vitaly</au><au>Deuker, Marine</au><au>Briganti, Alberto</au><au>Muilwijk, Tim</au><au>Hendricksen, Kees</au><au>Lotan, Yair</au><au>Karakiewic, Pierre</au><au>F.Shariat, Shahrokh</au><aucorp>UTUC collaboration</aucorp><aucorp>For the UTUC collaboration</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pre-therapy serum albumin-to-globulin ratio in patients treated with neoadjuvant chemotherapy and radical nephroureterectomy for upper tract urothelial carcinoma</atitle><jtitle>World journal of urology</jtitle><stitle>World J Urol</stitle><addtitle>World J Urol</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>39</volume><issue>7</issue><spage>2567</spage><epage>2577</epage><pages>2567-2577</pages><issn>0724-4983</issn><eissn>1433-8726</eissn><abstract>Purpose
The accurate selection of patients who are most likely to benefit from neoadjuvant chemotherapy is an important challenge in oncology. Serum AGR has been found to be associated with oncological outcomes in various malignancies. We assessed the association of pre-therapy serum albumin-to-globulin ratio (AGR) with pathologic response and oncological outcomes in patients treated with neoadjuvant platin-based chemotherapy followed by radical nephroureterectomy (RNU) for clinically non-metastatic UTUC.
Methods
We retrospectively included all clinically non-metastatic patients from a multicentric database who had neoadjuvant platin-based chemotherapy and RNU for UTUC. After assessing the pretreatment AGR cut‐off value, we found 1.42 to have the maximum Youden index value. The overall population was therefore divided into two AGR groups using this cut‐off (low, < 1.42 vs high, ≥ 1.42)
.
A logistic regression was performed to measure the association with pathologic response after NAC. Univariable and multivariable Cox regression analyses tested the association of AGR with OS and RFS.
Results
Of 172 patients, 58 (34%) patients had an AGR < 1.42. Median follow-up was 26 (IQR 11–56) months. In logistic regression, low AGR was not associated with pathologic response. On univariable analyses, pre-therapy serum AGR was neither associated with OS HR 1.15 (95% CI 0.77–1.74;
p
= 0.47) nor RFS HR 1.48 (95% CI 0.98–1.22;
p
= 0.06). These results remained true regardless of the response to NAC.
Conclusion
Pre-therapy low serum AGR before NAC followed by RNU for clinically high-risk UTUC was not associated with pathological response or long-term oncological outcomes. Biomarkers that can complement clinical factors in UTUC are needed as clinical staging and risk stratification are still suboptimal leading to both over and under treatment despite the availability of effective therapies.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33067726</pmid><doi>10.1007/s00345-020-03479-3</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-7768-8558</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | World journal of urology, 2021-07, Vol.39 (7), p.2567-2577 |
| issn | 0724-4983 1433-8726 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Aged Albumin Bladder cancer Carcinoma, Transitional Cell - blood Carcinoma, Transitional Cell - therapy Chemotherapy Globulins Globulins - analysis Humans Kidney Neoplasms - blood Kidney Neoplasms - therapy Medicine Medicine & Public Health Metastases Metastasis Middle Aged Neoadjuvant Therapy Neoplasms, Multiple Primary - blood Neoplasms, Multiple Primary - therapy Nephrology Nephroureterectomy Oncology Original Original Article Patients Retrospective Studies Serum Albumin - analysis Treatment Outcome Ureteral Neoplasms - blood Ureteral Neoplasms - therapy Urology Urothelial carcinoma |
| title | Pre-therapy serum albumin-to-globulin ratio in patients treated with neoadjuvant chemotherapy and radical nephroureterectomy for upper tract urothelial carcinoma |
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