Preoperative albumin-to-globulin ratio as a prognostic factor in patients undergoing curative hepatectomy for hepatocellular carcinoma: A systematic review and meta-analysis.
The albumin-to-globulin ratio (AGR) has emerged as a novel inflammation-based prognostic marker in various cancers; however, a comprehensive and quantitative assessment of its prognostic role in hepatocellular carcinoma (HCC) is lacking. Therefore, we conducted this meta-analysis to assess the prognostic value of the preoperative AGR in patients with HCC.
We systematically reviewed the literature for studies reporting the prognostic impact of AGR in patients undergoing curative hepatectomy for HCC. Random-effects meta-analyses of overall survival (OS) and recurrence-free survival were performed.
Six studies involving 2107 patients were included in this meta-analysis, with all conducted in Asian populations. Four studies were conducted in China, whereas 2 studies were conducted in Japan. Low pretreatment AGR was significantly correlated with decreased OS (hazard ratio: 1.69, 95% confidence interval: 1.37-2.08, P < .001) and recurrence-free survival (hazard ratio: 1.62, 95% confidence interval: 1.37-1.91, P < .001). Subgroup analyses suggested that a low AGR predicted decreased OS in patients with HCC, regardless of region, sample size, age, and cutoff values.
Low preoperative AGR was significantly associated with poor prognosis of patients with HCC. AGR may serve as a prognostic biomarker, although validation in prospective cohorts is required.
We systematically reviewed the literature for studies reporting the prognostic impact of AGR in patients undergoing curative hepatectomy for HCC. Random-effects meta-analyses of overall survival (OS) and recurrence-free survival were performed.
Six studies involving 2107 patients were included in this meta-analysis, with all conducted in Asian populations. Four studies were conducted in China, whereas 2 studies were conducted in Japan. Low pretreatment AGR was significantly correlated with decreased OS (hazard ratio: 1.69, 95% confidence interval: 1.37-2.08, P < .001) and recurrence-free survival (hazard ratio: 1.62, 95% confidence interval: 1.37-1.91, P < .001). Subgroup analyses suggested that a low AGR predicted decreased OS in patients with HCC, regardless of region, sample size, age, and cutoff values.
Low preoperative AGR was significantly associated with poor prognosis of patients with HCC. AGR may serve as a prognostic biomarker, although validation in prospective cohorts is required.
Authors
Utsumi Utsumi, Inagaki Inagaki, Omoto Omoto, Onoda Onoda, Kitada Kitada, Tokunaga Tokunaga, Okabayashi Okabayashi, Hamano Hamano, Miyaso Miyaso, Tsunemitsu Tsunemitsu, Otsuka Otsuka
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