ArticleThe Canadian journal of urology2025
Association of urinary tract infection and low albumin/globulin ratio with chemoresistance to gemcitabine-cisplatin in advanced urothelial carcinoma.
Article in The Canadian journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveUrothelial carcinoma (UC) remains a prevalent malignancy with high recurrence and chemoresistance rates despite gemcitabine-cisplatin (GC) chemotherapy. The study aimed to identify clinical risk factors for chemoresistance in advanced UC patients and develop a predictive model.
methodA retrospective analysis was conducted on 375 UC patients who received postoperative GC chemotherapy between 2013 and 2024. Patients were categorized into chemotherapy-resistant (CR, n = 91) and non-chemotherapy resistant (NCR, n = 284) groups based on tumor progression. Clinical, pathological, and laboratory variables were compared using t-tests and chi-square tests. Kaplan-Meier assessed overall survival (OS), and binary logistic regression identified independent predictors of chemoresistance.
resultOverall survival (OS) was significantly lower in the CR group than in the NCR group urinary tract infection (OR: 54.60; 95% CI: [21.19, 140.67]) and low A/G (OR: 0.18;95% CI: [0.03, 0.94]). The prediction model was: Logit(P)=-3.69+0.96×multifocal tumor+1.05×Tstage+4.00×long-termurinary tract infection(UTI)-1.73×A/G.
conclusionMultifocality, high T stage, persistent UTI, and low A/G ratio are significantly associated with chemoresistance to GC in UC. These routine clinical indicators may support early identification of high-risk patients and guide treatment decisions.
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