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. 2019 Aug 27:2019:6702964.
doi: 10.1155/2019/6702964. eCollection 2019.

De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase) as a Significant Prognostic Factor in Patients Undergoing Radical Cystectomy with Bladder Urothelial Carcinoma: A Propensity Score-Matched Study

Hyeong Dong Yuk  1 , Chang Wook Jeong  2 , Cheol Kwak  2 , Hyeon Hoe Kim  2 , Ja Hyeon Ku  2
Affiliations

De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase) as a Significant Prognostic Factor in Patients Undergoing Radical Cystectomy with Bladder Urothelial Carcinoma: A Propensity Score-Matched Study

Hyeong Dong Yuk et al. Dis Markers. .

Abstract

Introduction: To investigate the correlation between preoperative De Ritis ratio (aspartate transaminase (AST)/alanine transaminase (ALT)) and postoperative outcome in patients with urothelial cell carcinoma (UC) treated with radical cystectomy.

Materials and methods: We analyzed the clinical and pathological data of 771 patients who underwent radical cystectomy for bladder UC. Patients were divided into two groups according to the optimal value of AST/ALT ratio. The effect of the AST/ALT ratio was analyzed using the Kaplan-Meier method and Cox regression hazard models for patients' cancer-specific survival (CSS), overall survival (OS), and recurrence-free survival (RFS). In addition, propensity score matching of 1 : 1 was performed between the two groups.

Results: Median follow-up was 84.0 (36-275) months. Mean age was 64.8 ± 10.0 years. According to the receiver operating characteristic (ROC) analysis, the optimal threshold of the AST/ALT ratio was 1.1. In Kaplan-Meier analyses, the high AST/ALT group showed worse outcomes in CSS and OS (all P < 0.001). Also, RFS (P = 0.001) in the Cox regression models of clinical and pathological parameters was used to predict CSS, OS, and AST/ALT ratio (HR 2.15, 95% CI 1.23-3.73, P = 0.007) and pathological T stage (HR 4.80, 95% CI 1.19-19.28, P = 0.003). To predict OS and AST/ALT ratio (HR 2.05, 95% CI 1.65-2.56, P < 0.001), pathological T stage (HR 2.96, 95% CI 0.57-17.09, P = 0.037) and positive lymph node (HR 1.71, 95% CI 1.50-1.91, P = 0.021) were determined as independent prognostic factors.

Conclusion: Preoperative AST/ALT ratio could be an independent prognostic factor in patients with UC treated with radical cystectomy.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier survival curves of overall survival, cancer-specific survival, and recurrence-free survival according to the preoperative aspartate transaminase (AST)/alanine transaminase (ALT) ratio before (a–c) and after (d–f) propensity score matching.
See this image and copyright information in PMC

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