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A retrospective analysis of the de ritis ratio in muscle invasive bladder cancer, with focus on tumor response and long-term survival in patients receiving neoadjuvant chemotherapy and in chemo naïve cystectomy patients : a study of a clinical multicentre database

Eriksson, Victoria (author)
Umeå universitet,Urologi och andrologi,Umea Univ, Sweden
Holmkvist, Oscar (author)
Umeå universitet,Urologi och andrologi,Umea Univ, Sweden
Huge, Ylva (author)
Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland
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Johansson, Markus (author)
Department of Surgery, Division of Urology, Sundsvall-Härnösand County Hospital, Sundsvall, Sweden,Sundsvall Harnosand Cty Hosp, Sweden
Alamdari, Farhood (author)
Department of Urology, Västmanland Hospital, Västerås, Sweden,Vastmanland Hosp, Sweden
Svensson, Johan, 1978- (author)
Umeå universitet,Statistik,Umea Univ, Sweden
Aljabery, Firas (author)
Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland
Sherif, Amir (author)
Umeå universitet,Urologi och andrologi,Umea Univ, Sweden
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 (creator_code:org_t)
2022-10-27
2022
English.
In: Journal of Personalized Medicine. - : MDPI. - 2075-4426. ; 12:11
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background: A high pre-treatment De Ritis ratio, the aspartate transaminase/alanine aminotransferase ratio, has been suggested to be of prognostic value for mortality in muscle-invasive bladder cancer (MIBC). Our purpose was to evaluate if a high ratio was associated with mortality and downstaging. Methods: A total of 347 Swedish patients with clinically staged T2-T4aN0M0, with administered neoadjuvant chemotherapy (NAC) or eligible for NAC and undergoing radical cystectomy (RC) 2009–2021, were retrospectively evaluated with a low ratio < 1.3 vs. high ratio > 1.3, by Log Rank test, Cox regression and Mann–Whitney U-test (MWU), SPSS 27. Results: Patients with a high ratio had a decrease of up to 3 years in disease-free survival (DFS), cancer-specific survival (CSS) and overall survival (OS) (p = 0.009, p = 0.004 and p = 0.009) and 5 years in CSS and OS (p = 0.019 and p = 0.046). A high ratio was associated with increased risk of mortality, highest in DFS (HR, 1.909; 95% CI, 1.265–2.880; p = 0.002). No significant relationship between downstaging and a high ratio existed (p = 0.564 MWU). Conclusion: A high pre-treatment De Ritis ratio is on a population level, associated with increased mortality post-RC in endpoints DFS, CSS and OS. Associations decrease over time and require further investigations to determine how strong the associations are as meaningful prognostic markers for long-term mortality in MIBC. The ratio is not suitable for downstaging-prediction.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Keyword

clinical decision rules
cystectomy
neoadjuvant therapy
prognosis
urinary bladder neoplasms

Publication and Content Type

ref (subject category)
art (subject category)

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