Dataset Information

Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis.

ABSTRACT: Background: Studies have indicated that a low albumin-to-globulin ratio (AGR) before treatment is linked to poor prognosis of many cancers, but the prognostic impact of AGR remains controversial in head and neck cancer (HNC). This meta-analysis examined the prognostic value of AGR in HNC. Methods: We systematically searched the Embase, PubMed, and Cochrane library for relevant articles from inception to July 22, 2022. Studies conducted from 2000 to 2022 exploring the prognostic value of AGR in HNC were retrieved. We employed a random-effects model and calculated pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) to examine the associations of AGR with survival outcome. Results: Our analysis included nine studies involving 3211 patients with HNC. The pooled results revealed significant associations between low pretreatment AGRs and poor disease-free survival (HR = 1.97, 95% CI 1.58-2.45, p < 0.001), distant metastasis-free survival (HR = 1.64, 95% CI 1.25-2.16, p < 0.001), overall survival (HR = 2.18, 95% CI 1.65-2.88, p < 0.001), T3-T4 status (OR = 2.22, 95% CI 1.43-3.44, p < 0.001), stage III-IV disease (OR = 2.62, 95% CI 1.62-4.23, p < 0.001), and lymph node metastasis (OR = 1.95, 95% CI 1.29-2.82, p = 0.001) in patients with HNC. Conclusion: AGR can serve as a prognostic biomarker in managing HNC, and a low pretreatment AGR is strongly associated with adverse survival outcomes and advanced cancer status. Additional large-scale prospective trials must be conducted to assess the validity of our findings.

SUBMITTER: Wang YT

PROVIDER: S-EPMC9891875 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis.

Wang Yun-Ting YT Kuo Liang-Tseng LT Lai Chia-Hsuan CH Tsai Yuan-Hsiung YH Lee Yi-Chan YC Hsu Cheng-Ming CM Liao Chun-Ta CT Kang Chung-Jan CJ Huang Ethan I EI Tsai Ming-Shao MS Chang Geng-He GH Tsai Yao-Te YT

Journal of Cancer 20230109 2

<b>Background:</b> Studies have indicated that a low albumin-to-globulin ratio (AGR) before treatment is linked to poor prognosis of many cancers, but the prognostic impact of AGR remains controversial in head and neck cancer (HNC). This meta-analysis examined the prognostic value of AGR in HNC. <b>Methods:</b> We systematically searched the Embase, PubMed, and Cochrane library for relevant articles from inception to July 22, 2022. Studies conducted from 2000 to 2022 exploring the prognostic val ...[more]

PMID: 36741261

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Project description:BackgroundThe albumin-to-creatinine ratio (ACR) is known to predict prognosis in liposarcoma patients, but its role in other tumors remains unclear. This study aimed to evaluate the prognostic relationship between ACR and common solid tumors.MethodsData from the Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) between 2013 and 2022 were used to analyze patients under 65 years old with solid tumors. Patients were divided into a training cohort (n = 12,027) and a validation cohort (n = 7,985) using simple random sampling. Correlation analysis, Kaplan-Meier method, and restricted cubic spline analysis were conducted to explore ACR's relationship with overall survival (OS). Multivariable logistic regression assessed associations between ACR and Patient-Generated Subjective Global Assessment (PG-SGA), Length of Stay (LOS), and Karnofsky Performance Status (KPS).ResultsIn Cox regression, higher ACR levels were associated with better OS in solid tumor patients. Specifically, when using the cutoff value with low ACR as the reference, higher ACR levels were significantly associated with improved OS. For nasopharyngeal carcinoma (HR = 0.49, 95% CI: 0.35-0.67, P < 0.001), gastrointestinal tract tumors (HR = 0.84, 95% CI: 0.74-0.95, P = 0.007), and urogenital neoplasms (HR = 0.55, 95% CI: 0.43-0.71, P < 0.001), higher ACR levels were linked to better OS. When ACR was categorized into tertiles, the results were consistent with those observed using the cutoff value. In gastrointestinal tract tumor patients, higher ACR levels were linked to lower PG-SGA scores and improved KPS scores (P < 0.05). In urogenital neoplasm patients, higher ACR levels were associated with improved KPS scores (P < 0.05).ConclusionElevated ACR levels were significantly associated with improved OS in cancer patients, particularly in nasopharyngeal carcinoma, gastrointestinal tract tumors, and urogenital neoplasms. ACR was also linked to better nutritional and functional status, suggesting its potential as a prognostic biomarker.

Project description:Gene expression signatures that are predictive of therapeutic response or prognosis are increasingly useful in clinical care; however, mechanistic (and intuitive) interpretation of expression arrays remains an unmet challenge. Additionally, there is surprisingly little gene overlap among distinct clinically validated expression signatures. These "causality challenges" hinder the adoption of signatures as compared to functionally well-characterized single gene biomarkers. To increase the utility of multi-gene signatures in survival studies, we developed a novel approach to generate "personal mechanism signatures" of molecular pathways and functions from gene expression arrays. FAIME, the Functional Analysis of Individual Microarray Expression, computes mechanism scores using rank-weighted gene expression of an individual sample. By comparing head and neck squamous cell carcinoma (HNSCC) samples with non-tumor control tissues, the precision and recall of deregulated FAIME-derived mechanisms of pathways and molecular functions are comparable to those produced by conventional cohort-wide methods (e.g. GSEA). The overlap of "Oncogenic FAIME Features of HNSCC" (statistically significant and differentially regulated FAIME-derived genesets representing GO functions or KEGG pathways derived from HNSCC tissue) among three distinct HNSCC datasets (pathways:46%, p<0.001) is more significant than the gene overlap (genes:4%). These Oncogenic FAIME Features of HNSCC can accurately discriminate tumors from control tissues in two additional HNSCC datasets (n?=?35 and 91, F-accuracy?=?100% and 97%, empirical p<0.001, area under the receiver operating characteristic curves?=?99% and 92%), and stratify recurrence-free survival in patients from two independent studies (p?=?0.0018 and p?=?0.032, log-rank). Previous approaches depending on group assignment of individual samples before selecting features or learning a classifier are limited by design to discrete-class prediction. In contrast, FAIME calculates mechanism profiles for individual patients without requiring group assignment in validation sets. FAIME is more amenable for clinical deployment since it translates the gene-level measurements of each given sample into pathways and molecular function profiles that can be applied to analyze continuous phenotypes in clinical outcome studies (e.g. survival time, tumor volume).

Dataset Information

Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis.

Publications

Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis.

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