The prognostic significance of preoperatively assessed AST/ALT (De Ritis) ratio on survival in patients underwent radical cystectomy: Beyond the Abstract

Radical cystectomy (RC) is the standard surgical treatment for localized muscle-invasive bladder cancer [1,2]. Traditionally, RC is recommended for patients with muscle-invasive bladder cancer (BC) T2–T4a, N0–Nx, M0 [1]. It is reasonable to propose immediate RC to those patients with non-muscleinvasive BC who are at highest risk of progression [3].

The ratio of the serum activities of AST and ALT was first described by Fernando De Ritis in 1957 and has been known ever since as the De Ritis ratio. ALT and AST are commonly requested blood tests for liver disease [4].

In recent years, there have been several studies showing that different levels of aminotransaminases, including the De Ritis ratio, could be useful prognostic biomarkers in patients with certain types of malignant tumour [5,6].

In this study, we aimed to evaluate the prognostic signifcance of preoperative assessed De Ritis (AST/ALT) ratio on survival in BC patients underwent radical cystectomy

We found statistical and clinical impact of preoperative De Ritis ratio in bladder cancer patients who underwent radical cystectomy, in the present study. In this study, we found the threshold De Ritis value as 1.3. If the preoperative De Ritis ratio is less than 1.3 that could be an indicator of elevated disease spesific survival and overall spesific survival.

Written By: Yigit AKIN, MD

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References

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2- World Health Organization (WHO) Consensus Conference on Bladder Cancer, Hautmann RE, Abol-Enein H, Hafez K, Haro I, Mansson W, Mills RD, Montie JD, Sagalowsky AI, Stein JP, Stenzl A, Studer UE, Volkmer BG. Urinary diversion. Urology 2007; 69(1 Suppl):17–49

3-  Palou J, Sylvester RJ, Faba OR, Parada R, Peña JA, Algaba F, Villavicencio H. Female gender and carcinoma in situ in the prostatic urethra are prognostic factors for recurrence, progression, and disease-specifc mortality in T1G3 bladder cancer patients treated with bacillus Calmette–Guérin. Eur Urol.2012; 62:118–125

4- De Ritis F, Coltorti M, Giusti G. An enzymic test for the diagnosis of viral hepatitis; the transaminase serum activities. Clin Chim Acta. 1957;2:70–4

5- Rawson NS, Peto J. An overview of prognostic factors in small cell lung cancer. A report from the Subcommittee for the Management of Lung Cancer of the United Kingdom Coordinating Committee on Cancer Research. Br J Cancer 1990; 61:597–604

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