TY  - EJOU
AU  - Lyu, Jingcheng 
AU  - Yue, Ruiyu 
AU  - Zhu, Yichen 
AU  - Tian, Ye 
AU  - Hu, Xinyi 

TI  - Association of urinary tract infection and low albumin/globulin ratio with chemoresistance to gemcitabine-cisplatin in advanced urothelial carcinoma
T2  - Canadian Journal of Urology

PY  - 2025
VL  - 32
IS  - 5
SN  - 1488-5581

AB  -  <b>Objective:</b> Urothelial 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. <b>Method:</b> A 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 <i>t</i>-tests and chi-square tests. Kaplan-Meier assessed overall survival (OS), and binary logistic regression identified independent predictors of chemoresistance. <b>Result:</b> Overall 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. <b>Conclusion:</b> Multifocality, 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.
KW  - urothelial carcinoma; chemotherapy resistance; urinary tract infection; albumin/globulin ratio

DO  - 10.32604/cju.2025.066758