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Bezan, A; Mrsic, E; Krieger, D; Stojakovic, T; Pummer, K; Zigeuner, R; Hutterer, GC; Pichler, M.
The Preoperative AST/ALT (De Ritis) Ratio Represents a Poor Prognostic Factor in a Cohort of Patients with Nonmetastatic Renal Cell Carcinoma.
J Urol. 2015; 194(1):30-35
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Autor/innen der Med Uni Graz:
Hutterer Georg C.
Pichler Martin
Pummer Karl
Stojakovic Tatjana
Terbuch Angelika
Zigeuner Richard
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Abstract:
Aminotransaminases, which are strongly involved in cellular metabolism and cancer cell turnover, represent easily measureable, potential blood based biomarkers. We evaluated the prognostic value of the preoperatively assessed AST/ALT (De Ritis) ratio on clinically meaningful end points in a large European cohort of patients with nonmetastatic renal cell carcinoma. We retrospectively evaluated clinicopathological data on 698 patients with nonmetastatic renal cell carcinoma operated on between 2005 and 2013 at a single tertiary academic center. The potential prognostic value of the AST/ALT ratio was analyzed using the Kaplan-Meier method, and univariate and multivariate Cox proportional regression models. The impact of the ratio on the predictive accuracy of the Leibovich prognosis score was determined by the Harrell c-index. An increased (1.26 or greater) preoperative AST/ALT ratio was statistically significantly associated with several well established prognostic factors, including pathological T stage, as well as with histological tumor necrosis (p <0.05). On multivariate analysis an increased preoperative AST/ALT ratio was an independent prognostic factor for metastasis-free survival (HR 1.61, 95% CI 1.25-2.07, p <0.001) and overall survival (HR 1.76, 95% CI 1.34-2.32, p <0.001). The Harrell c-index was 0.77 using the Leibovich prognosis score and 0.81 when AST/ALT was added. In our study cohort with nonmetastatic renal cell carcinoma the preoperatively assessed AST/ALT ratio represented an independent prognostic factor. This ratio might further improve the predictive accuracy of well established prognosis scores. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
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Aged -
Alanine Transaminase - blood
Aspartate Aminotransferases - blood
Carcinoma, Renal Cell - blood
Carcinoma, Renal Cell - surgery
Cohort Studies -
Female -
Humans -
Kidney Neoplasms - blood
Kidney Neoplasms - surgery
Male -
Middle Aged -
Preoperative Period -
Prognosis -
Retrospective Studies -

Find related publications in this database (Keywords)
kidney
carcinoma, renal cell
transaminases
prognosis
biological markers
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