The De Ritis (aspartate transaminase/alanine transaminase) ratio as a predictor of oncological outcomes in patients after surgery for upper urinary tract urothelial carcinoma

Yang Hyun Cho, Jun Eul Hwang, Ho Seok Chung, Myung Soo Kim, Eu Chang Hwang, Seung Il Jung, Taek Won Kang, Dong Deuk Kwon, Seock Hwan Choi, Hyun Tae Kim, Tae Hwan Kim, Tae Gyun Kwon, Joon Hwa Noh, Myung Ki Kim, Chul Sung Kim, Sung-Gu Kang, Seok Ho Kang, Jun Cheon, Chan Ho Lee, Ja Yoon KuHong Koo Ha, Bum Sik Tae, Chang Wook Jeong, Ja Hyeon Ku, Cheol Kwak, Hyeon Hoe Kim

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

Purpose: Recently, several studies have shown that the De Ritis ratio (aspartate transaminase/alanine transaminase) can be a useful prognostic biomarker for certain types of malignant tumors. However, the prognostic value of the De Ritis ratio in patients with upper tract urothelial carcinoma remains largely unknown. The aim of the present study was to evaluate the prognostic significance of the De Ritis ratio in patients who had undergone radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma. Methods: In total, 1049 patients who underwent RNU at eight institutions from 2004 to 2015 were reviewed retrospectively. The De Ritis ratio and conventional clinicopathological parameters were analyzed. Survival analysis was performed using the Kaplan–Meier method and log-rank test. Multivariate analysis was carried out using the Cox proportional hazards regression model. De Ritis ratio cutoff values were derived from receiver operating characteristic (ROC) curves. Results: ROC analysis showed the cutoff De Ritis ratio for overall death to be 1.6 (p = 0.002). The cancer-specific survival (CSS) and overall survival (OS) were significantly shorter for patients with a high De Ritis ratio (>1.6). Multivariate analysis revealed an independent relationship between an increased De Ritis ratio (>1.6) and shorter CSS (hazard ratio, HR 2.49, 95% confidence interval, CI 1.70–3.64; p = 0.001) and OS (HR 1.84, 95% CI 1.34–2.52; p = 0.001). Conclusion: The De Ritis ratio can be a significant predictor of oncological outcomes in patients with upper urinary tract urothelial carcinoma after surgery.

Original languageEnglish
Pages (from-to)1383-1390
Number of pages8
JournalInternational Urology and Nephrology
Volume49
Issue number8
DOIs
Publication statusPublished - 2017 Aug 1

Keywords

  • Alanine transaminase
  • Aspartate aminotransferase
  • Prognosis
  • Survival
  • Transitional cell carcinoma

ASJC Scopus subject areas

  • Nephrology
  • Urology

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