Association Between Preoperative Albumin-to-Globulin Ratio (AGR) and Recurrence-Free Survival in High-Risk Resected Cutaneous Melanoma
Ömer Erkin11Private Practice, Ankara, Türkiye
Objectives: Recurrence risk varies among patients with resected stage II–III cutaneous melanoma. We evaluated whether preoperative albumin-to-globulin ratio (AGR) is associated with recurrence-free survival (RFS) in this high-risk population. Methods: This retrospective cohort included 190 patients with stage II–III cutaneous melanoma after curative-intent resection. Preoperative AGR was calculated from serum albumin and total protein values within one month before surgery. Receiver operating characteristic (ROC) analysis identified a cohort-specific AGR cut-off for recurrence prediction. RFS was estimated by Kaplan–Meier analysis, compared with the log-rank test, and factors associated with recurrence were evaluated using Cox proportional hazards regression. Results: During a median follow-up of 68.2 months, recurrence occurred in 64 patients (33.7%). The ROC-derived AGR cut-off was 1.22, with an area under the curve of 0.69, sensitivity of 68%, and specificity of 66%. Patients with low AGR had significantly shorter RFS than those with high AGR (64.4 vs. 117.7 months, p<0.001). In multivariate analysis, low AGR remained independently associated with increased risk of relapse or death (2.66, 95% CI: 1.48–4.79, p=0.001). Conclusion: Preoperative low AGR was independently associated with poorer RFS and may support recurrence risk assessment in high-risk resected melanoma. Keywords: Albumin-to-globulin ratio, cutaneous melanoma, recurrence-free survival
Cite This Article
Erkin Ö. Association Between Preoperative Albumin-to-Globulin Ratio (AGR) and Recurrence-Free Survival in High-Risk Resected Cutaneous Melanoma. EJMI. 2026; 10(4): 540-549
Corresponding Author: