Association of De Ritis ratio with oncological outcomes in patients with non-muscle invasive bladder cancer (NMIBC).


Journal

World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 11 05 2020
accepted: 22 07 2020
pubmed: 19 8 2020
medline: 28 9 2021
entrez: 19 8 2020
Statut: ppublish

Résumé

The De Ritis ratio (aspartate aminotransferase/alanine aminotransferase, DRR) has been linked to oncological outcomes in several cancers. We aimed to assess the association of DRR with recurrence-free survival (RFS) and progression-free survival (PFS) in patients with non-muscle-invasive bladder cancer (NMIBC). We conducted a retrospective analysis of 1117 patients diagnosed with NMIBC originating from an established multicenter database. To define the optimal pretreatment DRR cut-off value, we determined a value of 1.2 as having a maximum Youden index value. The overall population was therefore divided into two De Ritis ratio groups using this cut-off (lower, < 1.2 vs. higher, ≥ 1.2). Univariable and multivariable Cox regression analyses were used to investigate the association of DRR with RFS and PFS. The discrimination of the model was evaluated with the Harrel's concordance index (C-index). Overall, 405 (36%) patients had a DRR ≥ 1.2. On univariable Cox regression analysis, DRR was significantly associated with RFS (HR: 1.23, 95% CI 1.02-1.47, p = 0.03), but not with PFS (HR: 0.96, 95% CI 0.65-1.44, p = 0.9). On multivariable Cox regression analysis, which adjusted for the effect of established clinicopathologic features, DRR ≥ 1.2 remained significantly associated with worse RFS (HR:1.21, 95% CI 1.00-1.46, p = 0.04). The addition of DRR only minimally improved the discrimination of a base model that included established clinicopathologic features (C-index = 0.683 vs. C-index = 0.681). On DCA the inclusion of DRR did not improve the net-benefit of the prognostic model. Despite the statistically significant association of the DRR with RFS in patients with NMIBC, it does not seem to add any prognostic or clinical benefit beyond that of currently available clinical factors.

Identifiants

pubmed: 32808107
doi: 10.1007/s00345-020-03384-9
pii: 10.1007/s00345-020-03384-9
pmc: PMC8217037
doi:

Substances chimiques

Aspartate Aminotransferases EC 2.6.1.1
Alanine Transaminase EC 2.6.1.2

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1961-1968

Références

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Auteurs

Ekaterina Laukhtina (E)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

Hadi Mostafaei (H)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

David D'Andrea (D)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.

Benjamin Pradere (B)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Department of Urology, University Hospital of Tours, Tours, France.

Fahad Quhal (F)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.

Keiichiro Mori (K)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.

Noriyoshi Miura (N)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Department of Urology, Ehime University Graduate School of Medicine, Ehime, Japan.

Victor M Schuettfort (VM)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Reza Sari Motlagh (R)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.

Abdulmajeed Aydh (A)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
King Faisal Medical City, Abha, Saudi Arabia.

Mohammad Abufaraj (M)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.
The National Center for Diabetes, Endocrinology and Genetics, The University of Jordan, Amman, Jordan.

Pierre I Karakiewicz (PI)

Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada.

Dmitry Enikeev (D)

Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

Shoji Kimura (S)

Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.

Shahrokh F Shariat (SF)

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at.
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. shahrokh.shariat@meduniwien.ac.at.
Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan. shahrokh.shariat@meduniwien.ac.at.
Department of Urology, Weill Cornell Medical College, New York, NY, USA. shahrokh.shariat@meduniwien.ac.at.
Department of Urology, University of Texas Southwestern, Dallas, TX, USA. shahrokh.shariat@meduniwien.ac.at.
Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. shahrokh.shariat@meduniwien.ac.at.
Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at.
European Association of Urology Research Foundation, Arnhem, The Netherlands. shahrokh.shariat@meduniwien.ac.at.

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