The prognostic significance of preoperatively assessed AST/ALT (De Ritis) ratio on survival in patients underwent radical cystectomy

Görgel, Sacit Nuri; Köse, Osman; Koç, Esra Meltem; Ateş, Erhan; Akın, Yiğit; Yılmaz, Yüksel

doi:10.1007/s11255-017-1648-1

Cited by 27 publications

(37 citation statements)

References 28 publications

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“…De Ritis ratio was found associated with worse diseasespecific and overall survival. The optimal De Ritis ratio threshold according to ROC analyses was 1.30 in this study [7]. ▶ Given the lack of an established threshold for De Ritis ratio in the testicular tumor, in the present study, the optimal threshold of De Ritis ratio was calculated as 1.35 with similar AUC compared to aforementioned studies.…”

Section: Discussionmentioning

confidence: 58%

The utility of De Ritis Ratio in predicting prognosis in testicular cancer

et al. 2020

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Objective We aimed to investigate the possible association between testicular cancer prognosis and De Ritis ratio (AST/ALT). Methods The medical records of all patients who underwent radical inguinal orchiectomy at a single tertiary in Istanbul, Turkey between 2006 and 2017 were retrospectively analyzed. Investigated parameters included patients’ demographics, complete blood count and blood biochemistry results, pathology results, treatment schemes, imaging results, and survival. De Ritis ratio was calculated as follows: AST/ALT. Results A total of 171 patients with a mean age of 32.6 ± 10.1 years were included in the study. 73 patients had T1, 83 had T2, 13 had T3 and 2 had T4 disease. Rete testis invasion was detected in 74 patients (43.3 %) as well as lymphovascular invasion in 93 (54.4 %) and tunica albuginea invasion in 80 (46.8 %) patients. The cut-off value for AST/ALT was set at 1.35 [Area Under Curve (AUC): 0.791 with a sensitivity of 80 % and specificity of 73 %]. No statistically significance was observed between patients with and without elevated AST/ALT according to rete testis invasion, lymphovascular invasion, tunica albuginea invasion, and tunica vaginalis invasion (p = .25, p = .63, p = 1.0 and p = 1.0, respectively). 28.2 % of patients with seminoma had AST/ALT > 1.35 however 41.9 % of patients with non-seminoma pathology had AST/ALT > 1.35 (p = .078). Mean estimated survival time of patients with AST/ALT > 1.35 was higher than those with AST/ALT < 1.35, 91.8 versus 70.4 months, p < .001). As seen in Kaplan-Meier analysis elevated AST/ALT is associated with early-term mortality. Conclusion De Ritis ratio was shown to be significantly associated with unfavorable prognosis. De Ritis ratio might serve as a prognostic biomarker in testicular tumor besides well-known tumor markers such as beta-human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH).

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Section: Discussionmentioning

confidence: 58%

The utility of De Ritis Ratio in predicting prognosis in testicular cancer

et al. 2020

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“…After screening titles and abstracts of the remaining 299 studies, 20 studies were reviewed comprehensively. Finally, a total of 8 studies incorporating 3949 patients were included in the quantitative synthesis [15,16,[19][20][21][22][23][24]. The flow diagram of the study search and selection is presented in Fig.…”

Section: Study Searchmentioning

confidence: 99%

“…Of the enrolled 8 studies, all are published in recent 3 years and are retrospective. Five studies involved the patients with UTUC and underwent RUN [15,16,20], 3 studies involved patients with BC and treated by RC [19,21,22]. The median ages of patients were similar, ranging from 61 to 69.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…All studies defined the De Ritis ratio as a dichotomous variable, which was measured before surgery. Most studies had a relatively long follow-up, and median follow-up ranged from 33.3 months to 84 months, while one study did not report the duration of the follow-up [22]. Seven studies observed the OS and CSS, 3 studies revealed the clinical outcome of RFS and PFS, and only one study involves the MFS.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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The prognostic value of De Ritis (AST/ALT) ratio in patients after surgery for urothelial carcinoma: a systematic review and meta-analysis

Yang

Wang

et al. 2020

Cancer Cell Int

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Background: Recently, the De Ritis (AST/ALT) ratio has been considered as a prognostic biomarker for various malignancies. We conducted this systematic review and meta-analysis to explore the prognostic value of preoperative De Ritis ratio in patients after surgery for urothelial carcinoma. Methods:We searched the online database Embase, PubMed and Cochrane Library up to October 2019. The hazard ratio (HR) and 95% confidence interval (CI) were extracted from the studies. Results:A total of 8 studies incorporating 3949 patients were included in the quantitative synthesis. We observed that elevated preoperative De Ritis ratio is associated with inferior OS (HR = 1.97; 95% CI 1.70-2.28; P < 0.001), CSS (HR = 2.40; 95% CI 2.02-2.86; P < 0.001), RFS (HR = 1.31; 95% CI 1.11-1.54; P = 0.001), PFS (HR = 2.07; 95% CI 1.68-2.56; P < 0.001) and MFS (HR = 2.39; 95% CI 1.16-4.91; P = 0.018). Stratified by diseases, the elevated De Ritis ratio also served as an unfavorable factor. Conclusion:The elevated preoperative De Ritis ratio is an unfavorable factor for patients with urothelial carcinoma. In patients with BC and UTUC, the elevated preoperative De Ritis ratio is also associated with poor prognosis. But De Ritis ratio must be validated in large, independent cohorts before it can be applied widely.

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“…Nineteen studies were evaluated for eligibility with full-text, three of them were got rid of because of continuous or three categorial variable, one of them was excluded due to duplicated study. Lastly, 15 studies (5,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) were included for extracting data.…”

Section: Searching Process and Characteristics Of Studiesmentioning

confidence: 99%

Prognostic Role of Pretreatment De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase Ratio) in Urological Cancers: A Systematic Review and Meta-Analysis

Liu

et al. 2020

Front. Oncol.

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Background: To examine the potential prognostic significance of pretreatment De Ritis ratio (aspartate transaminase/alanine transaminase ratio) in urological cancers, including upper tract urothelial cancer (UTUC), renal cell carcinoma (RCC), prostate cancer (PCa), bladder cancer (BCa). Methods: Potential literatures were searched with PubMed, Embase, Cochrane Library, and Web of Science in December 2019. Merged hazard ratios (HRs) and 95% confidence intervals (CIs) were used to evaluate the associations. Results: Totally, 15 studies with 8,565 patients were included. Merged results showed that an elevated pretreatment De Ritis ratio was correlated with poorer OS (HR 1.80, 95% CI 1.61-2.01), CSS (HR 2.15, 95% CI 1.80-2.56), PFS (HR 1.57, 95% CI 1.34-1.85), BRFS (HR 1.67, 95% CI 1.11-2.53) for urological cancers. Subgroup analyses by cancer type for OS found that De Ritis ratio can be a predictor in UTUC (

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The prognostic significance of preoperatively assessed AST/ALT (De Ritis) ratio on survival in patients underwent radical cystectomy

Abstract: Preoperative elevated De Ritis ratio could be an independent prognostic factor in BC patients underwent RC. Our results should be confirmed by large and properly designed prospective, randomized trials.

Cited by 27 publications

References 28 publications

The utility of De Ritis Ratio in predicting prognosis in testicular cancer

The utility of De Ritis Ratio in predicting prognosis in testicular cancer

The prognostic value of De Ritis (AST/ALT) ratio in patients after surgery for urothelial carcinoma: a systematic review and meta-analysis

Prognostic Role of Pretreatment De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase Ratio) in Urological Cancers: A Systematic Review and Meta-Analysis

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