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KOBAYASHI Hirohito
Department School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine Position Associate Professor |
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| Article types | Original article |
| Language | English |
| Peer review | Peer reviewed |
| Title | The de ritis (aspartate transaminase/alanine transaminase) ratio as a prognosticator in patients with end-stage renal disease-associated renal cell carcinoma. |
| Journal | Formal name：Clinical genitourinary cancer Abbreviation：Clin Genitourin Cancer ISSN code：15587673/19380682 |
| Domestic / Foregin | Foregin |
| Volume, Issue, Page | 18(3),pp.236-240.e1 |
| Author and coauthor | IKEDA Takashi†, ISHIHARA Hiroki*, TAKAGI Toshio, FUKUDA Hironori, YOSHIDA Kazuhiko, IIZUKA Junpei, KOBAYASHI Hirohito, OKUMI Masayoshi, ISHIDA Hideki, KONDO Tsunenori*, TANABE Kazunari |
| Publication date | 2020/06 |
| Summary | BACKGROUND:The aspartate transaminase (AST)/alanine transaminase (ALT) ratio (ie, the De Ritis ratio) is associated with prognosis in some types of cancers including renal cell carcinoma (RCC). Meanwhile, an effective prognosticator for end-stage renal disease (ESRD)-associated RCC remains unknown. Thus, we investigated the prognostic impact of the AST/ALT ratio in patients with ESRD-associated RCC.PATIENTS AND METHODS:We retrospectively evaluated 243 patients receiving radical nephrectomy for nonmetastatic ESRD-associated RCC. The patients were divided according to the cutoff value of preoperative AST/ALT ratio. Prognostic factors associated with cancer-specific survival (CSS) after radical nephrectomy were analyzed.RESULTS:The maximum Youden index showed that the cutoff value of the AST/ALT ratio was 1.42. The high AST/ALT ratio group (≥ 1.42; n = 88) had a significantly shorter 10-year CSS than the low AST/ALT ratio group (64.3% vs. 87.2%; P = .0027). Multivariate analysis revealed that the AST/ALT ratio was an independent prognostic factor of CSS (hazard ratio [HR], 3.03; P = .0020), together with serum C-reactive protein level (HR, 4.84; P < .0001), pathologic stage (HR, 2.79; P = .0030), and tumor grade (HR, 7.08; P = .0087). Based on these independent factors, the patients were further classified into 3 groups: low (0-1 factor), intermediate (2 factors), and high risk (3-4 factors). The 10-year CSS in the high-risk group was significantly shorter than that of the other groups (68.9% vs. 70.9% vs. 94.4%; P < .0001).CONCLUSION:The AST/ALT ratio can aid in the risk classification of patients with ESRD-associated RCC. |
| DOI | 10.1016/j.clgc.2019.12.012 |
| PMID | 31917171 |