Abstract
OBJECTIVE: The concentration of albumin and globulin in the body can serve as indicators of both nutritional status and inflammation. The predictive significance of the albumin-to-globulin ratio (AGR) has been documented in multiple cancer types. Consequently, a meta-analysis was conducted in order to investigate the prognostic impact of AGR on survival outcomes among individuals diagnosed with renal cell carcinoma (RCC). METHODS: A systematic search was conducted across four electronic databases to identify pertinent studies that evaluated the predictive significance of pre-treatment albumin-to-globulin ratio (AGR) in patients with renal cell carcinoma (RCC). The main outcome of interest in this study was overall survival (OS), whereas additional outcomes included cancer-specific survival (CSS), progression-free survival (PFS), and disease-free survival (DFS). The researchers utilized random-effect models to summarize the time-to-event outcomes, presenting the results as adjusted hazard ratios (aHR) along with their corresponding 95% confidence intervals (CI). RESULTS: A total of 5,732 RCC patients in eight studies were included. Cut-off for AGR value varies among studies, with AGR higher than 1.1-1.47 regarded as normal. Pooled analysis from these studies showed that low AGR value was associated with shorter OS (aHR 1.84 (95% CI 1.35-2.51), p = 0.0001) and CSS (aHR 1.91 (95% CI 1.15-3.16), p = 0.01). CONCLUSIONS: This study suggests the role of AGR in predicting the OS and CSS of RCC. AGR values can be used in the risk stratification of patients with RCC, where a low AGR value indicates poorer prognosis.