Abstract
Background
Radical cystectomy in combination with neoadjuvant chemotherapy is the standard of
care for muscle invasive bladder cancer (BC). However, response to treatment varies
between patients. Considering the role of hepatic glucose metabolism in urothelial
cancer, AST/ALT ratio (De Ritis ratio) has the potential to serve as a prognostic
factor for bladder cancer and a predictor for treatment outcome.
Materials and Methods
We retrospectively analyzed patients who underwent radical cystectomy between March
2016 - March 2019. Patients were classified into 2 groups based on De Ritis ratio
(< 1.3 [normal] vs. ≥ 1.3 [high]). Demographics, disease severity, treatment status,
and disease outcome (90-day mortality and overall survival [OS]) were compared between
2 groups.
Results
A total of 89 patients were included, 62.9% of them having a De Ritis ratio of < 1.3
and 37.1% with a De Ritis ratio of ≥ 1.3. Mean OS was significantly higher in patients
with normal De Ritis ratio (40.84 vs. 18.28 months, P < .001), and 90-day mortality rate was lower in these patients (8.9% vs. 36.4%, P = .001). Moreover, De Ritis ratio was the sole independent predictor of OS in multivariable
regression analysis.
Conclusion
De Ritis ratio is an independent prognostic factor in BC patients who underwent radical
cystectomy. Furthermore, higher De Ritis ratio is associated with worse OS and a higher
90-day mortality rate after surgery, and therefore, has the potential to serve as
a predictor of treatment outcome in BC patients.
Keywords
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Article info
Publication history
Published online: October 25, 2021
Accepted:
October 20,
2021
Received in revised form:
October 12,
2021
Received:
June 22,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
