Development of nomograms related to inflammatory biomarkers to estimate the prognosis of bladder cancer after radical cystectomy

Abstract

Background: Bladder cancer is one of the most common carcinomas and it brings about huge social economic burden. There is not a reliable way to predict the prognosis of bladder patients. We develop the nomogram to predict the prognosis of bladder cancer patients.Methods: A total of 127 bladder cancer patients after radical cystectomy were studied retrospectively. Their clinicopathological data were collected for statistical analysis.Results: The level of albumin/globulin ratio (AGR), C-reactive protein/albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) associated with pathological and hematological parameters like T stage and hemoglobin. Furthermore, the AGR was associated with overall survival (OS) and CAR, NLR, and PLR were associated with both OS and progression-free survival (PFS) (P<0.05). The multivariate analysis revealed that tobacco smoking, tumor T stage, M stage, NLR, CAR, and AGR were all independent predictors for OS of patients and tobacco smoking, tumor T stage, NLR, CAR, and AGR were independent predictors for PFS of patients. In addition, AGR, CAR, and NLR, as well as, the clinicopathological parameters in the development of nomograms with a C index of 0.901 (95% CI: 0.505-1.269) for OS, and 0.807 (95% CI: 0.755-0.858) for PFS. The nomograms were able to provide a prognosis of the OS with the area under the curve (AUC) =0.86. Further, tests assessed the PFS with the AUC =0.84.Conclusions: This study demonstrates that the nomograms of the inflammatory biomarkers were able to predict prognosis of bladder cancer patients after radical cystectomy.

Prognostic Role of Pretreatment C-Reactive Protein to Albumin Ratio in Urological Cancers: A Systematic Review and Meta-Analysis

“…The median or mean age of subjects ranged from 37 to 73.5 years, and the sample size ranged from 31 to 699. Of all studies, three looked at BC ( 14 – 16 ), eight looked at RCC ( 13 , 19 – 24 , 26 ), and two looked at PC ( 17 , 25 ). Most patients were in various stages of the disease and undergo surgery.…”

“…And newly published articles cannot be included. Moreover, several studies investigating the prognostic role of CAR in BC and PC have been published ( 14 – 17 ). In this case, we only included data from multivariable analyses.…”

“…Nevertheless, data with potential bias from univariable analysis was included, and the latest studies could not be included ( 13 ). Moreover, several studies focusing on the prognostic role of CAR in BC and PC have been published ( 14 – 17 ). This situation encouraged us to conduct the present study to present an integrated review of all related evidence exploring the value of CAR on outcomes in urological cancer patients.…”

Prognostic value of pretreatment serum albumin−globulin ratio in urothelial carcinoma: A systematic review and meta-analysis

“…Zhang et al. ( 36 ) developed a nomogram including the clinicopathological features, AGR, C-reactive protein/albumin ratio (CAR), and neutrophil-lymphocyte ratio (NLR) to predict OS and PFS after radical surgery for bladder cancer. Chen et al.…”

Decreased Preoperative Serum AGR as a Diagnostic Marker of Poor Prognosis after Radical Surgery of Upper Urinary Tract and Bladder Cancers from a Pooled Analysis of 9,002 Patients

“…Based on the inclusion and exclusion criteria, 344 articles were excluded. Finally, 12 retrospective studies were included in the eventual analysis, including 9, 002 UC cases [22][23][24][25][26][27][28][29][30][31][32][33]. Table 2 summarizes the details of each study.…”