MP73-18 EXTERNAL VALIDATION OF PREOPERATIVE AST/ALT (DE-RITIS) RATIO AS A PROGNOSTIC INDICATOR IN LOCALIZED AND METASTATIC RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging I1 Apr 2016MP73-18 EXTERNAL VALIDATION OF PREOPERATIVE AST/ALT (DE-RITIS) RATIO AS A PROGNOSTIC INDICATOR IN LOCALIZED AND METASTATIC RENAL CELL CARCINOMA Dattatraya Patil, Rishi Sekar, Jeff Pearl, Yoram baum, Kathryn Wehrmeyer, Mersiha Torlak, Mehrdad Alemozaffar, Christopher Filson, Kenneth Ogan, and Viraj Master Dattatraya PatilDattatraya Patil More articles by this author , Rishi SekarRishi Sekar More articles by this author , Jeff PearlJeff Pearl More articles by this author , Yoram baumYoram baum More articles by this author , Kathryn WehrmeyerKathryn Wehrmeyer More articles by this author , Mersiha TorlakMersiha Torlak More articles by this author , Mehrdad AlemozaffarMehrdad Alemozaffar More articles by this author , Christopher FilsonChristopher Filson More articles by this author , Kenneth OganKenneth Ogan More articles by this author , and Viraj MasterViraj Master More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1673AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A recent European cohort study showed the De-Ritis ratio, defined as the ratio of preoperative aspartate aminotransferase (AST) to alanine aminotransferase (ALT), as an independent predictor of overall and recurrence-free survival in localized renal cell carcinoma (RCC). In this study, we perform an external validation of the De-Ritis ratio as a prognostic indicator in a distinct cohort of patients with localized as well as metastatic RCC. METHODS Patients that underwent nephrectomy for localized and metastatic RCC between 2001 and 2014 with available laboratory values within one week prior to the surgery were queried from the Emory Nephrectomy Database. After sensitivity-specificity trade-off analysis, De-Ritis ratio of 1.2 was used as an optimal threshold to divide subjects into high and low subgroups. Prognostic value of the De-Ritis ratio was used for further analysis with Kaplan-Meier and Cox proportional survival regression models. RESULTS In a cohort of 451 patients, an elevated DeRitis ratio (AST/ALT≥1.2) was associated with statistically significant reduction in overall survival (log-rank, p=0.0023) and recurrence-free survival (log-rank, p=0.0395). On multivariate survival analysis, De-Ritis ratio was shown to be an independent and significant predictor of overall survival (HR=1.91, p=0.002) and recurrence-free survival (HR=2.13, p=0.014) as seen in Table 1. CONCLUSIONS Elevated De-Ritis ratio (AST/ALT≥1.2) is an independent and significant predictor of overall and recurrence-free survival and is capable of differentiating high-risk disease in patients with localized as well as metastatic RCC. These findings are consistent with a previous study investigating the De-Ritis ratio in a European cohort, and further validates its prognostic ability in a geographically distinct cohort including patients who presented with metastatic disease. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e967 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Dattatraya Patil More articles by this author Rishi Sekar More articles by this author Jeff Pearl More articles by this author Yoram baum More articles by this author Kathryn Wehrmeyer More articles by this author Mersiha Torlak More articles by this author Mehrdad Alemozaffar More articles by this author Christopher Filson More articles by this author Kenneth Ogan More articles by this author Viraj Master More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...