Effectiveness of De Ritis (AST/ALT) Ratio in Predicting Biochemical Recurrence in Patients Underwent Radical Prostatectomy for Localized Prostate Cancer


Abstract views: 80 / PDF downloads: 58

Authors

DOI:

https://doi.org/10.54614/eurjther.2022.0038

Keywords:

Biochemical recurrence, De Ritis ratio, prostate cancer

Abstract

Objective: Several studies have shown that the De Ritis (aspartate aminotransferase/alanine aminotransferase) ratio is a prognostic biochemical biomarker in many cancers, including urological cancers. Biochemical recurrence is a well-known indicator of the biological aggressiveness of the tumor. In our study, we aimed to evaluate the predictability of the De Ritis ratio for biochemical recurrence in patients who underwent radical prostatectomy due to localized prostate cancer. Methods: This study included 198 patients who underwent radical prostatectomy for localized prostate cancer between 2008 and 2015 in our clinic. Preoperative data of the patients included age, prostate-specific antigen level, post-biopsy Gleason score, De Ritis ratio, neutrophil/lymphocyte ratio, and platelet count. Among the postoperative data, the Gleason score, extracapsular invasion, positive surgical margin, seminal vesicle invasion, perineural invasion, lymph node invasion, and pathological tumor stage data were evaluated retrospectively. The relationship of these parameters was examined in patients who developed biochemical recurrence during the follow-up period. Results: The mean follow-up period of the patients was 56.7 ± 23.6 months and biochemical recurrence occurred in 10.1% of all patients. In the receiver-operating characteristic analysis, the cut-off value for biochemical recurrence was 1.184, and the patients with a ratio below this value were grouped as the low De Ritis group and the patients with higher rates were grouped as the high De Ritis group. According to multivariate logistic regression analysis, high De Ritis ratio, Gleason score >8 of radical prostatectomy specimen, positive surgical margin, and the presence of seminal vesicle invasion were detected as independent risk factors for biochemical recurrence after radical prostatectomy.

Conclusion: De Ritis ratio is an independent risk factor for predicting biochemical recurrence in patients who underwent radical prostatectomy due to localized prostate cancer.

Metrics

Metrics Loading ...

References

Mottet N. (Chair), Cornford P (Vice-Chair). Van Der Berg RCN. EAU Guidelines on Prostate Cancer. EAU guidelines; 2020.

May EJ, Viers LD, Viers BR, et al. Prostate cancer post-treatment follow-up and recurrence evaluation. Abdom Radiol (NY). 2016;41(5):862-876.

Hamada R, Nakashima J, Ohori M, et al. Preoperative predictive factors and further risk stratification of biochemical recurrence in clinically localized highrisk prostate cancer. Int J Clin Oncol. 2016;21(3):595-600.

Wu J, Chen L, Wang Y, Tan W, Huang Z. Prognostic value of aspartate transaminase to alanine transaminase (De Ritis) ratio in solid tumors: a pooled analysis of 9,400 patients [De Ritis]. Onco Targets Ther. 2019;12:5201-5213.

Laukhtina E, Pradere B, Andrea D, et al. Association of preoperative serum De Ritis ratio with oncological outcomes in patients treated with cytoreductive nephrectomy for metastatic renal cell carcinoma. Urol Oncol. 2020;38(12):936.e7-14.

Kantoff PW, Higano CS, Shore ND, et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med. 2010;363(5):411-422.

Hu X, Yang WX, Wang Y, Shao YX, Xiong SC, Li X. The prognostic value of de Ritis (AST/ALT) ratio in patients after surgery for urothelial carcinoma: a systematic review and meta-analysis. Cancer Cell Int. 2020;20:39.

Bezan A, Mrsic E, Krieger D, et al. The preoperative AST/ALT (De Ritis) ratio represents a poor prognostic factor in a cohort of patients with Nonmetastatic Renal Cell Carcinoma [De Ritis]. J Urol. 2015;194(1):30-35.

Botros M, Sikaris KA. The De Ritis ratio: the test of time. Clin Biochem Rev. 2013;34(3):117-130.

De Ritis F, Coltorti M, Giusti G. An enzymic test for the diagnosis of viral hepatitis; the transaminase serum activities. Clin Chimi Acta. 1957;2(1):70-74.

Ha H, Chung JW, Ha YS, et al. Clinical significance of the De Ritis ratio for detecting prostate cancer in a repeat prostate biopsy. Investig Clin Urol. 2019;60(6):447-453.

Warburg O. On the origin of cancer cells. Science. 1956;123(3191):309-314.

Su S, Liu L, Li C, Zhang J, Li S. Prognostic role of pretreatment De Ritis ratio (aspartate transaminase/alanine transaminase ratio) in urological cancers: a systematic review and meta-analysis. Front Oncol. 2020;10:1650.

Bañez LL, Loftis RM, Freedland SJ, et al. The infuence of hepatic function on prostate cancer outcomes after radical prostatectomy. Prostate Cancer Prostatic Dis. 2010;13(2):173-177.

Wang H, Fang K, Zhang J, et al. The significance of de Ritis (aspartate transaminase/alanine transaminase) ratio in predicting pathological outcomes and prognosis in localized prostate cancer patients. Int Urol Nephrol. 2017;49(8):1391-1398.

Quhal F, Abufaraj M, Janisch F, et al. The significance of de Ritis ratio in patients with radiation-recurrent prostate cancer undergoing salvage radical prostatectomy. Arab J Urol. 2020;18(4):213-218.

Lee H, Jeong SJ, Hong SK, Byun SS, Lee SE, Oh JJ. High preoperative neutrophil-lymphocyte ratio predicts biochemical recurrence in patients with localized prostate cancer after radical prostatectomy. World J Urol. 2016;34(6):821-827.

Gu X, Gao X, Li X, et al. Prognostic Signifcance of Neutrophil-toLymphocyte Ratio in Prostate Cancer: Evidence from 16,266 patients. Sci Rep. 2016;6:22089

Downloads

Published

2023-01-19

How to Cite

Taştemur, S., Şenel, S., Kasap, Y., & Odabaş, Öner. (2023). Effectiveness of De Ritis (AST/ALT) Ratio in Predicting Biochemical Recurrence in Patients Underwent Radical Prostatectomy for Localized Prostate Cancer. European Journal of Therapeutics, 28(1), 8–13. https://doi.org/10.54614/eurjther.2022.0038

Issue

Section

Original Articles