Albumin-To-Alkaline Phosphatase Ratio as a Novel and Promising Prognostic Biomarker in Patients Undergoing Esophagectomy for Carcinoma: A Propensity Score Matching Study

Zhu, Xianying; Chen, Dongni; Li, Shuangjiang; Zhang, Wenbiao; Li, Yongjiang; Wang, Xiaoyu; Zhou, Jian; Wen, Zhesheng

doi:10.3389/fonc.2021.764076

Cited by 4 publications

(3 citation statements)

References 33 publications

(56 reference statements)

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“…Additionally, a study conducted by Liu et al demonstrated that APAR was independently associated with mortality in patients with sepsis [14]. Moreover, higher APAR levels were independently associated to increased cancer mortality as reported, including lung cancer [7,8,11], hepatocellular carcinoma [6], pancreatic ductal adenocarcinoma [9,20], nasopharyngeal carcinoma [12], urothelial carcinoma [13], and some other types [22][23][24][25][26][27][28][29]. However, there is limited evidence from large-scale general populations, making direct comparisons with our study challenging due to the heterogeneity of the study populations.…”

Section: Discussionmentioning

confidence: 99%

Non-linear Association of Alkaline Phosphatase-to-Albumin Ratio with All-Cause and Cancer Mortality: Evidence from NHANES 2005-2016

Wang,

Yuan

et al. 2024

Preprint

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Background The relationship between the alkaline phosphatase-to-albumin ratio (APAR) and mortality remains unclear. This research looked into the association between APAR levels and cause-specific mortality in US adults. Methods A cohort of 7561 participants from NHANES (2005-2016) was analyzed, with mortality outcomes collected from National Death Index (NDI) records. Cox proportional hazards models and restricted cubic spline (RCS) analysis were utilized to determine hazard ratio (HR) and reveal the non-linear relationship between APAR levels and mortality. Inflection points were calculated using a recursive algorithm. Results Followed for an average 99.41 months, a total of 1048 deaths occurred, including 200 cancer deaths and 348 cardiovascular disease (CVD)-related deaths. Following multivariate adjustment, significant associations were observed between APAR levels and increased all-cause and CVD mortality. Furthermore, non-linear correlations between APAR levels and all-cause and cancer mortality were revealed, characterized by an L-shaped pattern, with mortality rates stabilizing at 1.289 and 2.167, respectively. Participants with APAR levels above the inflection point exhibited a 29.2% increase in all-cause mortality risk per unit increase in APAR levels (HR 1.292, 95% CI 1.217-1.372), and a 38.3% increase in cancer mortality risk (HR 1.383, 95% CI 1.199-1.596). Conclusion This study demonstrated non-linear associations between APAR levels and all-cause and cancer mortality. Thresholds of 1.289 and 2.167 might serve as potential targets for APAR to reduce all-cause and cancer mortality, respectively. Nevertheless, these findings necessitate validation through large-scale clinical trials for further substantiation.

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Section: Discussionmentioning

confidence: 99%

Non-linear Association of Alkaline Phosphatase-to-Albumin Ratio with All-Cause and Cancer Mortality: Evidence from NHANES 2005-2016

Wang,

Yuan

et al. 2024

Preprint

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“…We speculate that cancer progression is affected by both cancer cells and the immune system. First, albumin can protect cells against tumorigenesis by helping stabilize cell growth and DNA replication ( 25 ) and is an independent prognostic factor in ESCC patients ( 26 ). Second, lymphocytes inhibit tumor cell proliferation and invasion through cytokine-mediated cytotoxicity ( 27 ), in which neutrophils can promote tumor angiogenesis and metastasis, and promote tumor progression by inhibiting T cells ( 28 ), with an increase in neutrophils associated with poor cancer prognosis ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Value of a preoperative prognostic nutritional index for the prognostic evaluation of gastric neuroendocrine carcinoma patients

Wei¹,

Ju²,

Jia³

et al. 2023

Front. Nutr.

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ObjectiveTo study the value of Onodera’s prognostic nutrition index (PNI) in patients with gastric neuroendocrine cancer (G-NEC).MethodsThe clinical data on 148 cases of G-NEC presented between March 2010 and April 2022 were retrospectively analyzed. The relationship between the clinical characteristics of the patients and PNI was analyzed. Optimal PNI cutoff values for G-NEC prognosis prediction were calculated using the X-tile software. The survival curves were created using the Kaplan–Meier method. A Cox proportional hazards model was also established to identify independent prognostic factors that impact the prognosis of patients with G-NEC.ResultsThe median overall survival (OS) rate was 30 months (range 6–127 months), and the OS rates at 1, 3 and 5 years were 89.2, 71.6 and 68.2%, respectively. The mean PNI of the 148 patients before the operation was 49.5 ± 8.0. The mean PNI of patients with anemia (p < 0.001) and abnormal carcinoembryonic antigen (p = 0.039) was significantly lower than that of patients without such comorbidities. The mean PNI of patients with Stage III tumors (p < 0.001) and postoperative complications was significantly lower (p = 0.005). PNI optimal cutoff values were 50 (p < 0.001). Based on the cut-off value of the PNI, these patients were divided into a PNI-high group (PNI ≥ 50.0, n = 77) and a PNI-low group (PNI < 50.0, n = 71). The PNI-high group had a significantly better 5-years OS rate compared with the PNI-low group (76.6% vs. 59.2%, χ2 = 14.7, p < 0. 001). Multivariate analysis demonstrated that PNI and pathological stage were independent prognostic factors for patients with G-NEC. In the subgroup analysis, OS rates were significantly lower in the PNI-low group than in the PNI-high group among patients with stage I and stage III of the disease.ConclusionThe PNI is a simple and useful marker for predicting long-term outcomes in G-NEC patients regardless of tumor stage. Based on our results, we suggest that PNI should be included in routine assessments of patients with G-NEC.

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“…PSM is also widely used to assess the effectiveness of a certain treatment on outcomes. [29][30][31][32] Following PSM of the RT and non-RT groups, none of the possible confounding factors, such as lesion location, NLR (>8.9 or ≤8.9), and tumor differentiation, differed significantly. Both PFS and OS in the PSM cohort were significantly longer…”

Section: Discussionmentioning

confidence: 99%

Effects of Radiotherapy on Survival of Esophageal Cancer Patients Receiving Immunotherapy: Propensity Score Analysis and Nomogram Construction

Nie¹,

Yao²,

Li³

et al. 2022

CMAR

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Purpose The present study assessed the effects of radiotherapy on overall survival (OS) and progression-free survival time (PFS) in patients with stage II or higher esophageal cancer receiving immunotherapy; evaluated factors independently prognostic of OS and PFS in these patients; and utilized these factors to establish a prognostic nomogram. Patients and Methods This study enrolled 134 patients with stage II or higher esophageal cancer treated with chemotherapy (platinum-based agents plus paclitaxel or fluorouracil) and immunotherapy. These patients were divided into two groups, a radiotherapy (RT) group (n = 55) and a non-radiotherapy (non-RT) group (n = 79). Following 1:1 propensity score matching, OS and PFS were compared by the Kaplan–Meier method, and factors associated with survival were determined by univariate and multifactorial Cox regression analyses. These factors were used to construct a prognostic nomogram. Results After propensity matching, all covariates were well balanced in the two groups (all P > 0.05). After matching, both median PFS (15.70 months [95% confidence interval (CI) 8.68–22.72 months] vs 5.70 months [95% CI 3.38–8.02 months], P = 0.002) and median OS (15.72 months [95% CI 12.94–18.46 months] vs 12.06 months [95% CI 9.91–14.20 months], P = 0.036) were significantly longer in the RT than in the non-RT group. Univariate and multifactorial analyses showed that RT, neutrophil-lymphocyte ratios, and tumor differentiation were independently prognostic of OS, with all hazard ratios (HRs) <1 and all P-values <0.05. A nomogram based on these factors was constructed, and its accuracy was verified. Conclusion Immunotherapy plus RT resulted in better survival outcomes than immunotherapy alone. A nomogram based on prognostic factors can guide personalized treatment and monitor prognosis.

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Albumin-To-Alkaline Phosphatase Ratio as a Novel and Promising Prognostic Biomarker in Patients Undergoing Esophagectomy for Carcinoma: A Propensity Score Matching Study

Cited by 4 publications

References 33 publications

Non-linear Association of Alkaline Phosphatase-to-Albumin Ratio with All-Cause and Cancer Mortality: Evidence from NHANES 2005-2016

Non-linear Association of Alkaline Phosphatase-to-Albumin Ratio with All-Cause and Cancer Mortality: Evidence from NHANES 2005-2016

Value of a preoperative prognostic nutritional index for the prognostic evaluation of gastric neuroendocrine carcinoma patients

Effects of Radiotherapy on Survival of Esophageal Cancer Patients Receiving Immunotherapy: Propensity Score Analysis and Nomogram Construction

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