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Association of De Ritis ratio with oncological outcomes in patients with non-muscle invasive bladder cancer (NMIBC)
PURPOSE: 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 bl...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217037/ https://www.ncbi.nlm.nih.gov/pubmed/32808107 http://dx.doi.org/10.1007/s00345-020-03384-9 |
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author | Laukhtina, Ekaterina Mostafaei, Hadi D’Andrea, David Pradere, Benjamin Quhal, Fahad Mori, Keiichiro Miura, Noriyoshi Schuettfort, Victor M. Sari Motlagh, Reza Aydh, Abdulmajeed Abufaraj, Mohammad Karakiewicz, Pierre I. Enikeev, Dmitry Kimura, Shoji Shariat, Shahrokh F. |
author_facet | Laukhtina, Ekaterina Mostafaei, Hadi D’Andrea, David Pradere, Benjamin Quhal, Fahad Mori, Keiichiro Miura, Noriyoshi Schuettfort, Victor M. Sari Motlagh, Reza Aydh, Abdulmajeed Abufaraj, Mohammad Karakiewicz, Pierre I. Enikeev, Dmitry Kimura, Shoji Shariat, Shahrokh F. |
author_sort | Laukhtina, Ekaterina |
collection | PubMed |
description | PURPOSE: 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). METHODS: 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). RESULTS: 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. CONCLUSION: 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. |
format | Online Article Text |
id | pubmed-8217037 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-82170372021-07-09 Association of De Ritis ratio with oncological outcomes in patients with non-muscle invasive bladder cancer (NMIBC) Laukhtina, Ekaterina Mostafaei, Hadi D’Andrea, David Pradere, Benjamin Quhal, Fahad Mori, Keiichiro Miura, Noriyoshi Schuettfort, Victor M. Sari Motlagh, Reza Aydh, Abdulmajeed Abufaraj, Mohammad Karakiewicz, Pierre I. Enikeev, Dmitry Kimura, Shoji Shariat, Shahrokh F. World J Urol Original Article PURPOSE: 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). METHODS: 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). RESULTS: 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. CONCLUSION: 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. Springer Berlin Heidelberg 2020-08-17 2021 /pmc/articles/PMC8217037/ /pubmed/32808107 http://dx.doi.org/10.1007/s00345-020-03384-9 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Laukhtina, Ekaterina Mostafaei, Hadi D’Andrea, David Pradere, Benjamin Quhal, Fahad Mori, Keiichiro Miura, Noriyoshi Schuettfort, Victor M. Sari Motlagh, Reza Aydh, Abdulmajeed Abufaraj, Mohammad Karakiewicz, Pierre I. Enikeev, Dmitry Kimura, Shoji Shariat, Shahrokh F. Association of De Ritis ratio with oncological outcomes in patients with non-muscle invasive bladder cancer (NMIBC) |
title | Association of De Ritis ratio with oncological outcomes in patients with non-muscle invasive bladder cancer (NMIBC) |
title_full | Association of De Ritis ratio with oncological outcomes in patients with non-muscle invasive bladder cancer (NMIBC) |
title_fullStr | Association of De Ritis ratio with oncological outcomes in patients with non-muscle invasive bladder cancer (NMIBC) |
title_full_unstemmed | Association of De Ritis ratio with oncological outcomes in patients with non-muscle invasive bladder cancer (NMIBC) |
title_short | Association of De Ritis ratio with oncological outcomes in patients with non-muscle invasive bladder cancer (NMIBC) |
title_sort | association of de ritis ratio with oncological outcomes in patients with non-muscle invasive bladder cancer (nmibc) |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217037/ https://www.ncbi.nlm.nih.gov/pubmed/32808107 http://dx.doi.org/10.1007/s00345-020-03384-9 |
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