Prognostic Significance of Preoperative Albumin to Alkaline Phosphatase Ratio in Patients with Glioblastoma

Abstract

Objective: To explore the prognostic value of preoperative albumin to alkaline phosphatase ratio (AAPR) in patients with newly-diagnosed glioblastoma (GBM) and its association with clinical characteristics. Patients and methods: A retrospective analysis was carried out on patients with newly diagnosed GBM who had undergone operation at the Department of Neurosurgery at West China Hospital between June 1st 2016 to December 31st 2018. X-tile software was applied to determine the optimal cut-off values for AAPR, neutrophil to lymphocyte ratio (NLR), and albumin. Cox regression analyses were applied to evaluate the prognostic value of AAPR in GBM. PSM analysis was conducted to verify the results. Results: A total of 197 and 154 GBM patients were included in original cohort and PSM cohort respectively. The optimal cut-off value for AAPR, NLR, and albumin were 0.56, 4.55 and 42.2 g/L respectively. High AAPR was only significantly related to longer overall survival (OS) (p=0.010) in original cohort. In PSM cohort, no clinical variable was evidently related to the level of AAPR. AAPR was determined to be an independent prognostic indicator in both original cohort (HR=0.599, 95%CI 0.437-0.822, p=0.001) and PSM cohort (HR=0.649, 95%CI 0.459-0.918, p=0.015). Prognostic models including AAPR had better prognostic accuracy than that including albumin. Conclusion: Preoperative AAPR was determined to be an independent risk factor of prognosis in newly-diagnosed GBM patients, and its prognostic ability was stronger than albumin. And PSM analysis also validated the results.

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

“…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.…”

Albumin-to-alkaline phosphatase ratio as a novel prognostic indicator in patients undergoing peritoneal dialysis: a propensity score matching analysis

“…We also established a novel nomogram that incorporated AAPR to improve the prediction of mortality in patients undergoing PD. Links between AAPR and cancer were first introduced for hepatocellular carcinoma patients undergoing curative surgery (13), and subsequent studies showed that, in general, the AAPR can be utilized as a simple indicator in various diseases, such as glioblastoma (14), coronary artery disease (15), non-alcoholic fatty liver disease (16), and renal cell carcinoma (17). In particular, we recently evaluated the AAPR in critically ill patients with acute kidney injury (AKI) and concluded that AAPR independently predicted OS (18).…”

Albumin-to-Alkaline Phosphatase Ratio as a Prognostic Biomarker for Spinal Fusion in Lumbar Degenerative Diseases Patients Undergoing Lumbar Spinal Fusion

“…AAPR was applied in patients undergoing surgery for hepatocellular carcinoma for the first time by Chan et al; this conclusion has been confirmed in the following studies [ 35 , 36 ]. Furthermore, previous research has shown that low levels of this indicator are associated with poor outcomes [ 37 , 38 ]. Despite varying cutoff values, these studies confirm that patients with high AAPR have a better prognosis than those with low AAPR.…”