SIU 2017: The Predictive Value of Preoperative AST/ALT Ratio in Renal Cell Carcinoma Patients – A Multicenter Study

Lisbon, Portugal ( There is some controversial evidence suggesting that the AST/ALT ratio, performed prior to surgery, in patients with renal cell carcinoma (RCC), has some correlation to prognosis. In this study the authors analyzed the value of this preoperative ratio as a possible predictive factor in RCC.

From 1988 to 2015, data on 7,271 patients surgically treated for non-metastatic RCC from 8 different centers was retrospectively collected and analyzed. The ROC curve was analyzed to calculate the cut-off value of AST/ALT ratio as a predictive factor of RCC. A propensity score was calculated, and patients were matched according to it. Kaplan Meyer analysis and multivariable Cox regression analysis were performed to identify overall survival (OS), cancer specific survival (CSS), and recurrence free survival (RFS).

In the propensity score matched cohort, there were no statistical difference in age, gender, diabetes, hypertension, ECOG score, tumor size, and symptoms. Results demonstrated no statistical different in OS, CSS, and RFS between the two groups (p=0.119, 0.228, and 0.389 respectively). A subgroup analysis was performed with Kaplan Meier survival analysis based on T stage. This demonstrated that in patients with T1 disease high AST/ALT ratio was correlated with poor OS, and CSS in a statistically significant manner. On the other hand, in patients with T2, T3, and T4 disease, this ratio did no show statistical significance as a predictive factor.

The authors therefore concluded that the preoperative AST/ALT ratio in RCC patients Is strongly correlated to OS and CSS only in T1 patients.

Presented by: Sung Hoo Hong
Affiliation:  St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre.Twitter: @GoldbergHanan at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal