Prognostic value of preoperative albumin to globulin ratio in elderly patients with rectal cancer

To identify the value of predictors of poor prognosis of elderly patients with rectal cancer who underwent surgery, we investigated the relations between albumin to globulin ratio (AGR) and clinicopathological findings. We conducted a retrospective cohort study of clinicopathological characteristics (general status, pathological features of tumors, preoperative laboratory data, disease free, and overall survival) for elderly patients with stage I-III rectal cancer. The AGR is calculated as albumin/(total protein − albumin). According to the optimal cut-off point of AGR (1.43), the enrolled patients were divided into low AGR (n = 83) and high AGR (n = 136) groups. Meanwhile, age, hemoglobin, tumor size, and differentiation degree were the independent risk factors of low preoperative AGR value. Compared to patients with high AGR, those with low AGR were related to worse disease-free survival (DFS) (P = .0008) and overall survival (OS) (P = .0003). Moreover, in multivariate analysis, low AGR and poor TNM stage were the independent predictor of poor DFS and OS. Finally, the nomograms illustrated the effect of prognostic factors on DFS and OS. Preoperative AGR has a significant prognostic value and was identified as an independent predictor of DFS and OS in elderly rectal cancer patients.