Prognostic Value of Pretreatment Albumin-to-Alkaline Phosphatase Ratio in Cancer: A Meta-Analysis

Abstract

Background. Recently, it has been reported that the pretreatment albumin-to-alkaline phosphatase ratio (AAPR) is related to the prognosis of various cancers. The purpose of this systematic review and meta-analysis was to explore the prognostic value of pretreatment AAPR on clinical outcomes in cancer. Methods. PubMed, Web of Science, Cochrane Library, and Embase were systematically searched for relevant research before May 2020. Stata 12 was utilized to extract the data and the characteristics of each study and to generate a pooled hazard ratio (HR) and 95% confidence interval (CI) to assess the relationship between pretreatment AAPR and survival outcomes. Results. We included 16 eligible published articles involving 5,716 patients. We found that low pretreatment AAPR was associated with poor overall survival ( HR = 2.12 , 95% CI: 1.80–2.50, P < 0.001 ), cancer-specific survival ( HR = 2.89 , 95% CI: 1.46–5.71, P < 0.001 ), disease-free survival ( HR = 1.91 , 95% CI: 1.43–2.53, P < 0.001 ), and progression-free survival ( HR = 1.93 , 95% CI: 1.49–2.52, P < 0.001 ). However, there was no statistical relationship between pretreatment AAPR and recurrence-free survival, distant-metastasis-free survival, or locoregional relapse-free survival. The correlation between pretreatment AAPR and overall survival did not change significantly when possible confounders were stratified. The sensitivity analysis showed that this study was reliable. Conclusions. Low pretreatment AAPR was significantly associated with adverse clinical outcomes of cancer. Pretreatment AAPR could be a valuable noninvasive prognostic indicator for cancer.

Association between pre‐diagnostic serum albumin and cancer risk: Results from a prospective population‐based study

“…First, albumin is one of the various inflammation-related markers. In previous studies, pooled analyses of inflammationrelated markers including the ratio of albumin to globulin, 37 C-reactive protein to albumin, 38 albumin-to-alkaline phosphatase, 39 and albumin to fibrinogen 40 were conducted concerning cancer prognosis. For these indexes, the prognostic value of clinical significance has already been proved.…”

Nomograms based on lactate dehydrogenase to albumin ratio for predicting survival in colorectal cancer

“…Lactate dehydrogenase (LDH) is a considerable indicator for liver in clinical practice and has been advocated to play a momentous role in immune condition in several cancers so as to CRC (8)(9)(10)(11)(12)(13). Serum albumin is also a readily accostable element for nutrition and proposed to have prognostic importance for different tumor patients (14,15). Therefore, the combination of them, LDH to serum albumin ratio (LAR), was recommended to be a good prognostic ratio for patients with cancers (16)(17)(18).…”

Evaluation of the Prognostic Capacity of a Novel Survival Marker in Patients with Sinonasal Squamous Cell Carcinoma

“…Specifically for albumin, the reduced intake of proteins ultimately results in lowered albumin synthesis. Notably, the prognostic relevance of BMI and albumin has already been shown for different malignancies [ 34 , 35 , 36 , 37 , 38 ]. The prognostic relevance of both of these has been shown for head and neck malignancies as well.…”