Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. May 15, 2022; 14(5): 1002-1013
Published online May 15, 2022. doi: 10.4251/wjgo.v14.i5.1002
Pretreatment serum albumin-to-alkaline phosphatase ratio is an independent prognosticator of survival in patients with metastatic gastric cancer
Yu-Ting Li, Xiao-Shu Zhou, Xiao-Ming Han, Jing Tian, You Qin, Tao Zhang, Jun-Li Liu
Yu-Ting Li, Xiao-Shu Zhou, You Qin, Tao Zhang, Jun-Li Liu, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Xiao-Ming Han, Department of Ultrasound Medicine, Jingmen Second People’s Hospital, Jingchu University of Technology Affiliated Central Hospital, Jingmen 448000, Hubei Province, China
Jing Tian, Department of Oncology, Hubei Cancer Hospital, The Seventh Clinical School Affiliated of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
Author contributions: Liu JL, Tian J, Zhang T, and Li YT contributed to the study conception and design and data analysis; Zhou XS and Han XM collected the data; Li YT drafted the first version of the manuscript; Qin Y and Liu JL verified the data and edited the manuscript; The revision of the manuscript was performed by Zhang T and Tian J; The final version submitted for publication was critically reviewed and approved by all the authors.
Institutional review board statement: The study was approved by the Institutional Ethical Board of Wuhan Union Hospital of Tongji Medical College, Huazhong University of Science and Technology.
Informed consent statement: A waiver of informed consent was obtained for the study because this was a retrospective study, and anonymous analyses were employed in place to protect patient confidentiality, meaning there was minimal risk to the patients.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Li Liu, MD, PhD, Associate Chief Physician, Associate Professor, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jianghan Road, Wuhan 430022, Hubei Province, China. junli78@foxmail.com
Received: November 9, 2021
Peer-review started: November 9, 2021
First decision: December 12, 2021
Revised: December 26, 2021
Accepted: April 21, 2022
Article in press: April 21, 2022
Published online: May 15, 2022
Processing time: 182 Days and 4.7 Hours
ARTICLE HIGHLIGHTS
Research background

Previous studies have suggested that a low albumin-to-alkaline phosphatase ratio (AAPR) is associated with a lower survival rate in patients with various malignancies.

Research motivation

The predictive ability had been established in several malignancies, however, the relationship between pretreatment AAPR and the prognosis of patients with gastric cancer (GC) remains unclear.

Research objectives

To investigate the prognostic value of AAPR in distant metastatic GC.

Research methods

From May 2011 to September 2018, we retrospectively enrolled 191 patients who were diagnosed with distant metastatic GC.

Research results

Patients with high levels of AAPR had better survival in terms of overall survival (OS) and progression-free survival (PFS), regardless of the presence of liver/bone metastasis. Pretreatment AAPR was found to be a favorable predictor of OS and PFS based on a multivariate cox regression model. AAPR-M system, constructed based on AAPR and number of metastatic sites, showed superior predictive ability relative to the number of metastatic sites for predicting survival.

Research conclusions

Patients with high levels of pretreatment AAPR showed better survival compared with those with low levels.

Research perspectives

Prospective studies are needed to verify the prognostic efficacy of AAPR.