Preoperative AST/ALT (De Ritis) Ratio as a Prognostic Factor in a Cohort of Patients who underwent radical cystectomy

Kaan Gökçen; Emre Kıraç; Pınar Gökçen; Resul Çiçek; Gökhan Gökçe

doi:10.7197/223.vi.459106

EN

Preoperative AST/ALT (De Ritis) Ratio as a Prognostic Factor in a Cohort of Patients who underwent radical cystectomy

Abstract

Aim: This study aims to evaluate the prognostic significance of the preoperative aspartate aminotransferase (AST) / alanine aminotransferase (ALT) (De Ritis) ratio in bladder cancer (BC) patients who underwent radical cystectomy (RC).

Materials-Method: We evaluated the clinical and histopathological data of 58 patients who had undergone RC between January 2008-August 2018 at our tertiary hospital. The potential prognostic value of the De Ritis ratio with regard to BC was evaluated using ROC curve analysis. The effect of the De Ritis ratio on disease specific survival (DSS) and overall survival (OS) was analyzed using the Kaplan-Meier method and multivariate Cox regression models.

Results: A total of fifty-eight patients underwent RC and 95.6% were male (M/F:56/2). Mean age of the patients was 68.6± 11,56. The cut-off value of the De Ritis ratio for DSS was calculated as 1.417 in the ROC analysis. In Kaplan-Meier analyses, the group with a higher De Ritis ratio presented a more unfavorable progression in terms of DSS and OS (p=0.004). Based on the Cox regression models adjusted for clinical and pathological parameters, for DSS, the De Ritis ratio (HR 2.70, 95% CI 2.34-3.05 p=0.005), pathological T stage (HR 3.36, 95% CI 2.91-3.82, p =0.007), and age (HR 1,038 95% CI 1,02-1,05; p=0.015) were determined as independent prognostic factors; and for OS, the De Ritis ratio (HR 2.71, 95% CI 2.33 -3.09; p =0.005), pathological T stage (HR 4.36, 95% CI 3.87–4.85; p=0.007) and age (HR 1.04, 95% CI 1.03-1.06; p = 0.015) were determined as independent prognostic factors.

Türkçe özet

Amaç: Radikal sistektomi (RC) uygulanan mesane kanseri (BC) hastalarında preoperatif olarak değerlendirilen aspartat aminotransaminaz (AST) / alanin aminotransferaz (ALT) (De Ritis) oranının prognostik önemini değerlendirmeyi amaçladık.

Materyal-Metod: Ocak 2008 ile Ağustos 2018 tarihleri arasında üçüncü basamak hastanemizde RS uygulanan 58 hastanın klinik ve histopatolojik verilerini inceledik. De Ritis oranının BC üzerindeki potansiyel prognostik değeri ROC eğrisi analizi kullanılarak değerlendirildi. Hastalığa bağlı sağ kalım (DSS) ve genel sağ kalım (OAS) da De Ritis oranının etkisi, Kaplan-Meier yöntemi ve multivariate Cox regresyon modelleri ile analiz edildi.

Bulgular: RC uygulanan toplamda ellisekiz hastanın 95.6% erkek (E/K:56/2) idi. Hastaların yaş ortalaması 68.6± 11,56 idi. ROC analizine göre DSS için De Ritis oranının cut-off değeri 1.417 olarak saptandı. Kaplan-Meier analizlerinde yüksek De Ritis oranı görülen grupta DSS ve OAS için daha kötü progresyon gösterdi (p =0.004). Klinik ve patolojik parametrelerin Cox regresyon modellerinde DSS için De Ritis oranı (HR 2.70, 95% CI 2.34-3.05 p=0.005), patolojik T evresi (HR 3.36, 95% CI 2.91-3.82, p =0.007) ve yaş (HR 1,038 95% CI 1,02-1,05; p=0.015) iken OAS için De Ritis oranı (HR 2.71, 95% CI 2.33 -3.09; p =0.005), patolojik T evresi (HR 4.36, 95% CI 3.87–4.85; p=0.007) ve yaş (HR 1.04, 95% CI 1.03-1.06; p = 0.015) bağımsız prognostik faktörler olarak belirlendi.

Sonuç: Preoperatif artmış De Ritis oranı; RC uygulanan BC hastalarında bağımsız bir prognostik faktör olarak değerlendirilebilir. Sonuçlarımızın geniş ve uygun şekilde tasarlanmış prospektif, randomize çalışmalarla doğrulanması ve desteklenmesi gerekmektedir

Keywords

Cystectomy,bladder,cancer,Deritis

References

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Kaan Gökçen ^*
Türkiye

Emre Kıraç
0000-0002-4466-1615
Türkiye

Pınar Gökçen
0000-0002-6742-6976
Türkiye

Resul Çiçek
0000-0003-2622-681X
Türkiye

Gökhan Gökçe
0000-0002-7344-2008
Türkiye

Publication Date

September 30, 2018

Submission Date

September 11, 2018

Acceptance Date

September 30, 2018

Published in Issue

Year 1970 Volume: 40 Number: 3

DOI

https://doi.org/10.7197/223.vi.459106

IZ

https://izlik.org/JA59MK37DH

Cite

RIS / Bibtex

AMA

1.Gökçen K, Kıraç E, Gökçen P, Çiçek R, Gökçe G. Preoperative AST/ALT (De Ritis) Ratio as a Prognostic Factor in a Cohort of Patients who underwent radical cystectomy. CMJ. 2018;40(3):299-307. doi:10.7197/223.vi.459106

Preoperative AST/ALT (De Ritis) Ratio as a Prognostic Factor in a Cohort of Patients who underwent radical cystectomy

Abstract

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