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