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A retrospective ana...
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
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- Eriksson, Victoria (author)
- Umeå universitet,Urologi och andrologi,Umea Univ, Sweden
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- Holmkvist, Oscar (author)
- Umeå universitet,Urologi och andrologi,Umea Univ, Sweden
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- 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
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- Alamdari, Farhood (author)
- Department of Urology, Västmanland Hospital, Västerås, Sweden,Vastmanland Hosp, Sweden
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- Svensson, Johan, 1978- (author)
- Umeå universitet,Statistik,Umea Univ, Sweden
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- Aljabery, Firas (author)
- Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland
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- Sherif, Amir (author)
- Umeå universitet,Urologi och andrologi,Umea Univ, Sweden
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(creator_code:org_t)
- 2022-10-27
- 2022
- English.
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In: Journal of Personalized Medicine. - : MDPI. - 2075-4426. ; 12:11
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Abstract
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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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