Prognostic value of preoperative albumin-to-alkaline phosphatase ratio in patients with surgically treated urological cancer: a systematic review and meta-analysis

Shangqing Ren; Han Wang; Bo Yang; Yang Zheng; Yong Ou; Yige Bao; Yu Mao; Yunlin Feng

doi:10.3389/fonc.2023.1236167

Prognostic value of preoperative albumin-to-alkaline phosphatase ratio in patients with surgically treated urological cancer: a systematic review and meta-analysis

Front Oncol. 2023 Nov 9:13:1236167. doi: 10.3389/fonc.2023.1236167. eCollection 2023.

Authors

Shangqing Ren^#¹, Han Wang^#², Bo Yang³, Yang Zheng^{1

4}, Yong Ou^{1

4}, Yige Bao⁵, Yu Mao³, Yunlin Feng⁶

Affiliations

¹ Robotic Minimally Invasive Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
² Department of Gastroenterology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
³ Department of Pediatric Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
⁴ School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
⁵ Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
⁶ Department of Nephrology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

^# Contributed equally.

Abstract

Objective: A novel albumin-to-alkaline phosphatase ratio (AAPR) is associated with the prognosis of several cancers. In the present study, we evaluate the prognostic significance of perioperative AAPR in urological cancers.

Method: Relevant studies were searched comprehensively from CNKI, PubMed, Embase and Web of Science up to March 2023. The pooled hazard ratio (HR) and 95% confidence interval (CI) were extracted from each study to evaluate the prognostic value of perioperative AAPR in patients with surgically treated urological cancers.

Results: A total of 8 studies consisting of 3,271 patients were included in the final results. A low AAPR was significantly associated with a worse OS (HR=2.21; P<0.001), CSS (HR=2.61; P<0.001) and RFS/DFS (HR=2.87; P=0.001). Stratified by disease, a low AAPR was also associated with worse OS in renal cell carcinoma (HR=2.01; P<0.001), bladder cancer (HR=3.37; P<0.001) and upper tract urothelial carcinoma (HR=1.59; P=0.002).

Conclusion: In conclusion, low AAPR could serve as an unfavorable factor in patients with surgically treated urological cancers. Stratified by tumor type, the low AAPR was also associated with inferior survival. While more prospective and large-scale studies are warranted to validate our findings.

Keywords: albumin-to-alkaline phosphatase ratio; meta-analysis; prognostic value; surgical; urological cancer.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study is supported by 2022YFS0135, 2023YFS0173, 2023YFSY0027 and SCR2023-210.