Wen-Zhe Xu,1,2 Feng Li,1,2 Zhen-Kuan Xu,1,2 Xuan Chen,3 Bin Sun,1,2 Jing-Wei Cao,1,2 Yu-Guang Liu1,2 1Department of Neurosurgery, Qilu Hospital, 2Brain Science Research Institute, 3Department of Radiation Oncology, Qilu Hospital, Shandong University, Jinan, People’s Republic of China Objective: Impaired immunonutritional status has disadvantageous effects on outcomes for cancer patients. Preoperative albumin-to-globulin ratio (AGR) and the prognostic nutrition index (PNI) have been used as prognostic factors in various cancers. We aimed to evaluate the clinical significance of the AGR and PNI in glioblastoma.Materials and methods: This retrospective analysis involved 166 patients. Demographic, clinical, and laboratory data were collected. AGR and the PNI were calculated as AGR = albumin/(total serum protein – albumin) and PNI = albumin (g/L) + 5 × total lymphocyte count (109/L). Overall survival (OS) was estimated by Kaplan–Meier analysis. Receiver-operating characteristic analysis was used to assess the predictive ability of AGR and the PNI. Cox proportional-hazard models estimating hazard ratios (HRs) and 95% confidence intervals (CIs) were used for univariable and multivariable survival analyses.Results: The cutoff values of AGR and PNI were 1.75 and 48. OS was enhanced, with high AGR (>1.75) and the PNI (>48) (P