Highlights
- •The present study showed that a low AAPR is associated with poor prongosis in patients with non-metastatic RCC treated with radical or partial nephrectomy.
- •Moreover, AAPR increased the accuracy of multivariable base models using standard prognostic factors, and this result remained almost significant after propensity score weighting.
- •AAPR could be used as an adjunct of established prognostic factors and might be a valuable tool for patient counseling and clinical practice in patients with non-metastatic RCC treated with radical or partial nephrectomy
Abstract
Introduction
To evaluate the prognostic value of albumin-to-alkaline phosphatase ratio (AAPR) on
recurrence and survival in patients with non-metastatic renal cell carcinoma (RCC)
treated with radical or partial nephrectomy.
Patients and Methods
Between June 1994 and December 2018, 491 patients with RCC who underwent radical or
partial nephrectomy at 2 institutions were enrolled in this study. Recurrence-free
survival (RFS) and cancer-specific survival (CSS) analyses were performed to distinguish
the differences in postoperative recurrence and survival between patients stratified
by an optimal cut-off value of AAPR. Multivariable Cox proportional hazards regression
models were established to determine the independent prognostic factors after propensity
score weighting.
Results
Of the total 491 patients, 51 patients (10.4%) developed local recurrence or distant
metastasis and 26 patients (5.3%) died of disease during the follow-up period. Patients
with AAPR<0.41 had significantly lower rates of RFS and CSS than those of patients
with AAPR≥0.41 in multivariate analysis (P < .001 and P = .027, respectively). After propensity scroe matching analyses, this difference
was still remained for RFS (P < .001). However, AAPR was not an independent prognostic factor for CSS but the value
was almost pregnant (HR = 2.674; 95%CI = 0.872–8.203; P = .086).
Conclusion
AAPR can serve as a novel and useful tool to refine prognosis in patients with non-metastatic
RCC treated with partial or radical nephrectomy. These findings suggest that AAPR
could be a promising prognostic factor for prediction of recurrence and survival in
patients with non-metastatic RCC who undergo nephrectomy.
Keywords
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Article info
Publication history
Published online: January 27, 2022
Accepted:
January 17,
2022
Received in revised form:
January 11,
2022
Received:
April 29,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
