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BMC Urol. 2019 Jan 24;19(1):10. doi: 10.1186/s12894-019-0439-7.

Association between De Ritis ratio (aspartate aminotransferase/alanine aminotransferase) and oncological outcomes in bladder cancer patients after radical cystectomy.

Ha YS1,2, Kim SW1,2, Chun SY1,2, Chung JW1,2, Choi SH1,2, Lee JN1,2, Kim BS1,2, Kim HT1,2, Yoo ES1,2, Kwon TG1,2, Kim WT3, Kim WJ3, Kim TH4,5.

Author information

1
Department of Urology, School of Medicine, Kyungpook National University, Daegu, South Korea.
2
Department of Urology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
3
Department of Urology, Chungbuk National University College of Medicine, Cheongju, South Korea.
4
Department of Urology, School of Medicine, Kyungpook National University, Daegu, South Korea. doctork@knu.ac.kr.
5
Department of Urology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea. doctork@knu.ac.kr.

Abstract

BACKGROUND:

New biological prognostic predictors have been studied; however, some factors have limited clinical application due to tissue-specific expression and high cost. There is the need for a promising predictive factor that is simple to detect and that is closely linked to oncological outcomes in patients with urothelial bladder cancer (BC) who have undergone radical cystectomy (RC). Therefore, we investigated the clinical prognostic value of the preoperative De Ritis ratio (aspartate aminotransferase/alanine aminotransferase) on oncological outcomes in patients with urothelial BC after RC.

METHODS:

We retrospectively evaluated clinicopathological data of 118 patients with non-metastatic urothelial BC after RC between 2008 and 2013 at a single center. The association between the De Ritis ratio and clinicopathological findings was assessed. The potential prognostic value of the De Ritis ratio was analyzed using the Kaplan-Meier method, and multivariate Cox analyses were performed to identify the independent predictors of metastasis-free survival, cancer-specific survival, and overall survival.

RESULTS:

According to the receiver operating curve of the De Ritis ratio for metastasis, we stratified the patients into 2 groups using a threshold of 1.3. A high De Ritis ratio was more likely to be associated with old age and the female sex. Kaplan-Meier estimates revealed that patients with a high De Ritis ratio had inferior metastasis-free survival, cancer-specific survival, and overall survival outcomes (P = 0.012, 0.024, and 0.022, respectively). Multivariate analysis revealed that a high De Ritis ratio was an independent prognostic factor for metastasis (hazard ratio [HR], 2.389; 95% confidence interval [CI], 1.161-4.914; P = 0.018), cancer-related death (HR, 2.755; 95% CI, 1.214-6.249; P = 0.015), and overall death (HR, 2.761; 95% CI, 1.257-6.067; P = 0.011).

CONCLUSIONS:

An elevated De Ritis ratio was significantly associated with worse prognosis in patients who underwent RC for urothelial BC. This ratio might further improve the predictive accuracy for prognosis in BC.

KEYWORDS:

Bladder cancer; De Ritis ratio; Prognosis; Survival

PMID:
30678673
PMCID:
PMC6345026
DOI:
10.1186/s12894-019-0439-7
[Indexed for MEDLINE]
Free PMC Article

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