biostudies-literatureLi ZNational Natural Science Foundation of China (National Science Foundation of China)23https://www.ebi.ac.uk/biostudies/studies/S-EPMC11761434biostudies-literatureUnknown9(1)Previous studies on serum albumin-to-globulin ratio (AGR) in human cancers were limited to its preoperative level, with postoperative serial AGR remeasurements ignored. In this study, 2844 CRC patients, 2267 NSCLC patients and 507 HCC patients who underwent curative resection were included. Postoperative AGR was a prognostic factor independent to preoperative AGR, performing a L shaped relation with OS. The 5-year OS rates for the persistently normal, normalized, lowered and persistently low perioperative AGR groups were 84.0%, 80.7%, 78.5% and 70.2%. Three longitudinal AGR trajectory groups were identified within 12 months after surgery. Compared with the normal-stable group, the adjusted HRs on OS for the rising-decreasing and decreasing-rising groups were 1.38 (95% CI: 1.13-1.68, P = 0.NPJ precision oncologyLongitudinal investigation of albumin-to-globulin ratio for human cancers demonstrates benefit in postoperative serial remeasurement.PMC117614348236034582222064820735698247373082001986Li WLi YLi ZLei MZhang TLi CLiu LYou DYou RPu HfalseLongitudinal investigation of albumin-to-globulin ratio for human cancers demonstrates benefit in postoperative serial remeasurement.Previous studies on serum albumin-to-globulin ratio (AGR) in human cancers were limited to its preoperative level, with postoperative serial AGR remeasurements ignored. In this study, 2844 CRC patients, 2267 NSCLC patients and 507 HCC patients who underwent curative resection were included. Postoperative AGR was a prognostic factor independent to preoperative AGR, performing a L shaped relation with OS. The 5-year OS rates for the persistently normal, normalized, lowered and persistently low perioperative AGR groups were 84.0%, 80.7%, 78.5% and 70.2%. Three longitudinal AGR trajectory groups were identified within 12 months after surgery. Compared with the normal-stable group, the adjusted HRs on OS for the rising-decreasing and decreasing-rising groups were 1.38 (95% CI: 1.13-1.68, P = 0.2025-01-01T00:00:00Z2025 Jan2025-04-21T23:56:49.535Z2025-04-05T19:21:12.385ZS-EPMC117614343985622510.1038/s41698-025-00809-9