OncoTargets and Therapy (Nov 2019)
The Prognostic Significance Of Pretreatment Albumin/alkaline Phosphatase Ratio In Patients With Stage IB-IIA Cervical Cancer
Abstract
Can Zhang,1,* Yong Li,1,* Rui Ji,1 Weiling Zhang,1 Chenfei Zhang,2 Youli Dan,3 Hongyan Qian,4 Aiqin He1 1Department of Gynecology Oncology, Tumor Hospital Affiliated to Nantong University, Nantong, People’s Republic of China; 2Department of Medical Oncology, Tumor Hospital Affiliated to Nantong University, Nantong, People’s Republic of China; 3Department of Oncology, Medical College of Nantong University, Nantong, People’s Republic of China; 4Cancer Research Centre Nantong, Tumor Hospital Affiliated to Nantong University, Nantong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Aiqin HeDepartment of Gynecology Oncology, Tumor Hospital Affiliated to Nantong University, 30 Tongyang North Road, Nantong 226300, People’s Republic of ChinaTel +86 139 6293 1600Fax +86 513 8671 2287Email [email protected] QianCancer Research Centre Nantong, Tumor Hospital Affiliated to Nantong University, 30 Tongyang North Road, Nantong 226300, People’s Republic of ChinaTel/Fax +86 513 8671 2287Email [email protected]: Pretreatment albumin/alkaline phosphatase ratio (AAPR) has been discussed about its prognostic value in several malignancies, whereas its role in cervical cancer remains unclear. In this study, we attempt to explore the prognostic significance of the AAPR in stage IB-IIA cervical cancer patients who underwent a radical hysterectomy.Patients and methods: A total of 230 cervical cancer patients were enrolled in this retrospective study. The threshold value of AAPR was determined by receiver operating characteristic (ROC) curve. Kaplan-Meier survival analysis and multivariate analysis were performed to identify independent prognostic predictors of disease-free survival (DFS) and overall survival (OS).Results: The optimal cut-off value of the preoperative AAPR was 0.68. Patients with AAPR<0.68 showed obviously inferior OS and DFS than those with AAPR>0.68 according to Kaplan-Meier curves (DFS: P = 0.011; OS: P = 0.017). In multivariate analysis, the preoperative AAPR showed to be an independent predictive factor for disease-free survival (DFS: P = 0.015) and overall survival (OS: P = 0.019). Moreover, subgroup analysis revealed that the lower AAPR was correlated with worse prognosis in patients with histologic grade I-II; but in those with histologic grade III, there was no significant difference between the two groups.Conclusion: Preoperative AAPR was a potentially valuable prognostic index in stage IB-IIA cervical cancer patients. Further prospective studies are required to validate its prognostic value.Keywords: albumin-to-alkaline phosphatase ratio, uterine cervical neoplasms, prognosis, survival analysis
