Masatomo Nishikawa1, Hideaki Miyake2, Masato Fujisawa1. 1. Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan. 2. Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: hideakimiyake@hotmail.com.
Abstract
BACKGROUND: To evaluate the prognostic significance of preoperatively assessed aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), and the AST/ALT (De Ritis) ratio in patients with upper urinary tract urothelial carcinoma (UUTUC). METHODS: This study included a total of 109 consecutive patients with clinically localized UUTUC who underwent nephroureterectomy. Effects of preoperative levels of AST, ALT, and the De Ritis ratio in addition to conventional clinicopathological parameters on the extravesical recurrence-free survival (eRFS) in these 109 patients were retrospectively analyzed. RESULTS: Despite the lack of a significant correlation of AST or ALT with any of the factors examined in this study, the elevation of the De Ritis ratio was significantly correlated with several unfavorable parameters, including elderly age, high pathological stage, high tumor grade, and lymphovascular invasion. During the observation period of this series (median = 40.8mo), extravesical disease recurrence developed in 39 (35.8%) of the 109 patients, with a 5-year eRFS rate of 56.8%. Of several factors examined, the tumor location, De Ritis ratio, pathological stage, lymph node metastasis, tumor grade, lymphovascular invasion, surgical margin status, and adjuvant chemotherapy were shown to be significantly correlated with eRFS by univariate analysis. Of these, the De Ritis ratio, pathological stage, lymph node metastasis, and tumor grade were identified as independent predictors of eRFS on multivariate analysis. CONCLUSIONS: These findings suggest that preoperative assessment of the De Ritis ratio may provide useful information with respect to the clinical course of patients with clinically localized UUTUC who are scheduled to be treated with nephroureterectomy.
BACKGROUND: To evaluate the prognostic significance of preoperatively assessed aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), and the AST/ALT (De Ritis) ratio in patients with upper urinary tract urothelial carcinoma (UUTUC). METHODS: This study included a total of 109 consecutive patients with clinically localized UUTUC who underwent nephroureterectomy. Effects of preoperative levels of AST, ALT, and the De Ritis ratio in addition to conventional clinicopathological parameters on the extravesical recurrence-free survival (eRFS) in these 109 patients were retrospectively analyzed. RESULTS: Despite the lack of a significant correlation of AST or ALT with any of the factors examined in this study, the elevation of the De Ritis ratio was significantly correlated with several unfavorable parameters, including elderly age, high pathological stage, high tumor grade, and lymphovascular invasion. During the observation period of this series (median = 40.8mo), extravesical disease recurrence developed in 39 (35.8%) of the 109 patients, with a 5-year eRFS rate of 56.8%. Of several factors examined, the tumor location, De Ritis ratio, pathological stage, lymph node metastasis, tumor grade, lymphovascular invasion, surgical margin status, and adjuvant chemotherapy were shown to be significantly correlated with eRFS by univariate analysis. Of these, the De Ritis ratio, pathological stage, lymph node metastasis, and tumor grade were identified as independent predictors of eRFS on multivariate analysis. CONCLUSIONS: These findings suggest that preoperative assessment of the De Ritis ratio may provide useful information with respect to the clinical course of patients with clinically localized UUTUC who are scheduled to be treated with nephroureterectomy.
Authors: Yang Hyun Cho; Jun Eul Hwang; Ho Seok Chung; Myung Soo Kim; Eu Chang Hwang; Seung Il Jung; Taek Won Kang; Dong Deuk Kwon; Seock Hwan Choi; Hyun Tae Kim; Tae-Hwan Kim; Tae Gyun Kwon; Joon Hwa Noh; Myung Ki Kim; Chul-Sung Kim; Sung Gu Kang; Seok Ho Kang; Jun Cheon; Chan Ho Lee; Ja Yoon Ku; Hong Koo Ha; Bum Sik Tae; Chang Wook Jeong; Ja Hyeon Ku; Cheol Kwak; Hyeon Hoe Kim Journal: Int Urol Nephrol Date: 2017-05-08 Impact factor: 2.370
Authors: Jakob Michael Riedl; Florian Posch; Gerald Prager; Wolfgang Eisterer; Leopold Oehler; Thamer Sliwa; Klaus Wilthoner; Andreas Petzer; Petra Pichler; Eva Hubmann; Thomas Winder; Sonja Burgstaller; Markus Korger; Johannes Andel; Richard Greil; Hans-Joerg Neumann; Martin Pecherstorfer; Kathrin Philipp-Abbrederis; Angela Djanani; Birgit Gruenberger; Friedrich Laengle; Ewald Wöll; Armin Gerger Journal: Ther Adv Med Oncol Date: 2020-04-10 Impact factor: 8.168