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

doi:10.7150/jca.80955

International Journal of Biological Sciences

International Journal of Medical Sciences

Theranostics

Journal of Genomics

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J Cancer 2023; 14(2):281-289. doi:10.7150/jca.80955 This issue Cite

Review

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^1,2, Liang-Tseng Kuo^2,3, Chia-Hsuan Lai^2,4, Yuan-Hsiung Tsai^2,5, Yi-Chan Lee^2,6, Cheng-Ming Hsu^1,2, Chun-Ta Liao^2,7, Chung-Jan Kang^2,7, Ethan I. Huang^1,2, Ming-Shao Tsai^1,2, Geng-He Chang^1,2, Yao-Te Tsai^1,2✉

1. Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
2. College of Medicine, Chang Gung University, Taoyuan, Taiwan.
3. Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
4. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
5. Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
6. Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan.
7. Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Citation:

Wang YT, Kuo LT, Lai CH, Tsai YH, Lee YC, Hsu CM, Liao CT, Kang CJ, Huang EI, Tsai MS, Chang GH, Tsai YT. Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis. J Cancer 2023; 14(2):281-289. doi:10.7150/jca.80955. https://www.jcancer.org/v14p0281.htm

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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, head and neck cancer, meta-analysis, survival outcomes, biomarker

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APA

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.

ACS

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. Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis. J. Cancer 2023, 14 (2), 281-289. DOI: 10.7150/jca.80955.

NLM

CSE

Wang YT, Kuo LT, Lai CH, Tsai YH, Lee YC, Hsu CM, Liao CT, Kang CJ, Huang EI, Tsai MS, Chang GH, Tsai YT. 2023. Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis. J Cancer. 14(2):281-289.

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