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

Yun Ting Wang; Liang Tseng Kuo; Chia Hsuan Lai; Yuan Hsiung Tsai; Yi Chan Lee; Cheng Ming Hsu; Chun Ta Liao; Chung Jan Kang; Ethan I. Huang; Ming Shao Tsai; Geng He Chang; Yao Te Tsai

doi:10.7150/jca.80955

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

Yun Ting Wang, Liang Tseng Kuo, Chia Hsuan Lai, Yuan Hsiung Tsai, Yi Chan Lee, Cheng Ming Hsu, Chun Ta Liao, Chung Jan Kang, Ethan I. Huang, Ming Shao Tsai, Geng He Chang, Yao Te Tsai^*

^*Corresponding author for this work

School of Medicine

Research output: Contribution to journal › Review article › peer-review

8 Scopus citations

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.

Original language	English
Pages (from-to)	281-289
Number of pages	9
Journal	Journal of Cancer
Volume	14
Issue number	2
DOIs	https://doi.org/10.7150/jca.80955
State	Published - 2023

Bibliographical note

Publisher Copyright:
© The author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.

Keywords

albumin-to-globulin ratio
biomarker
head and neck cancer
meta-analysis
survival outcomes

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10.7150/jca.80955

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Wang, Y. T., Kuo, L. T., Lai, C. H., Tsai, Y. H., Lee, Y. C., Hsu, C. M., Liao, C. T., Kang, C. J., Huang, E. I., Tsai, M. S., Chang, G. H., & Tsai, Y. T. (2023). Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis. Journal of Cancer, 14(2), 281-289. https://doi.org/10.7150/jca.80955

@article{44f5a063872d4ddd921b98ce35d38d0e,

title = "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.",

keywords = "albumin-to-globulin ratio, biomarker, head and neck cancer, meta-analysis, survival outcomes",

author = "Wang, {Yun Ting} and Kuo, {Liang Tseng} and Lai, {Chia Hsuan} and Tsai, {Yuan Hsiung} and Lee, {Yi Chan} and Hsu, {Cheng Ming} and Liao, {Chun Ta} and Kang, {Chung Jan} and Huang, {Ethan I.} and Tsai, {Ming Shao} and Chang, {Geng He} and Tsai, {Yao Te}",

note = "Publisher Copyright: {\textcopyright} The author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.",

year = "2023",

doi = "10.7150/jca.80955",

language = "英语",

volume = "14",

pages = "281--289",

journal = "Journal of Cancer",

issn = "1837-9664",

number = "2",

}

TY - JOUR

T1 - Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer

T2 - A Systematic Review and Meta-analysis

AU - Wang, Yun Ting

AU - Kuo, Liang Tseng

AU - Lai, Chia Hsuan

AU - Tsai, Yuan Hsiung

AU - Lee, Yi Chan

AU - Hsu, Cheng Ming

AU - Liao, Chun Ta

AU - Kang, Chung Jan

AU - Huang, Ethan I.

AU - Tsai, Ming Shao

AU - Chang, Geng He

AU - Tsai, Yao Te

N1 - Publisher Copyright: © The author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

KW - albumin-to-globulin ratio

KW - biomarker

KW - head and neck cancer

KW - meta-analysis

KW - survival outcomes

UR - http://www.scopus.com/inward/record.url?scp=85146481509&partnerID=8YFLogxK

U2 - 10.7150/jca.80955

DO - 10.7150/jca.80955

M3 - 文献综述

AN - SCOPUS:85146481509

SN - 1837-9664

VL - 14

SP - 281

EP - 289

JO - Journal of Cancer

JF - Journal of Cancer

IS - 2

ER -

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

Abstract

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Keywords

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