Preoperative Albumin-to-Alkaline Phosphatase Ratio as an Independent Predictor of Lymph Node Involvement in Penile Cancer

• Published in: Medicina (Kaunas, Lithuania) Lithuania), 2024-02, Vol.60 (3), p.414
• Main Authors: Tufano, Antonio, Napolitano, Luigi, Barone, Biagio, Pezone, Gabriele, Alvino, Pierluigi, Cilio, Simone, Buonerba, Carlo, Canciello, Giuseppina, Passaro, Francesco, Perdonà, Sisto
• Format: Article
• Language: English
• Subjects: Aged; Albumin; albumin-to-alkaline phosphatase ratio; Albumins; Alkaline Phosphatase; Biomarkers; Blood; Cancer therapies; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Cell growth; Chemotherapy; Clinical medicine; Development and progression; Disease; Genital cancers; Histology; Humans; Inflammation; Kidney cancer; Liver cancer; Lung cancer; Lymph Node Excision; Lymph Nodes - pathology; Lymphatic system; Lymphocytes; Male; Medical examination; Medical prognosis; Medical research; Medicine, Experimental; Metastasis; Middle Aged; penile cancer; penile neoplasms; Penile Neoplasms - pathology; Penile Neoplasms - surgery; penile surgery; Penis; Phosphatase; Phosphatases; Prognosis; Proteins; Regression analysis; Retrospective Studies; serological markers; Squamous cell carcinoma; Statistical analysis; Surgery
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina60030414

To investigate the role of preoperative albumin-to-alkaline phosphatase ratio (AAPR) in predicting pathologic node-positive (pN+) disease in penile cancer (PC) patients undergoing inguinal lymph node dissection (ILND). : Clinical data of patients with squamous cell carcinoma (SCC) PC + ILND at a single high-volume institution between 2016 and 2021 were collected and retrospectively analyzed. An AAPR was obtained from preoperative blood analyses performed within 30 days from their scheduled surgery. A ROC curve analysis was used to assess AAPR cutoff, in addition to the Youden Index. Logistic regression analysis was utilized for an odds ratio (OR), 95% confidence interval (CI) calculations, and an estimate of pN+ disease. A value < 0.05 was considered to be as statistically significant. : Overall, 42 PC patients were included in the study, with a mean age of 63.6 ± 12.9 years. The AAPR cut-off point value was determined to be 0.53. The ROC curve analysis reported an AUC of 0.698. On multivariable logistic regression analysis lymphovascular invasion (OR = 5.38; 95% CI: 1.47-9.93, = 0.022), clinical node-positive disease (OR = 13.68; 95% CI: 4.37-43.90, < 0.009), and albumin-to-alkaline phosphatase ratio ≤ 0.53 (OR = 3.61; 95% CI: 1.23-12.71, = 0.032) were predictors of pN+ involvement. : Preoperative AAPR may be a potentially valuable prognostic marker of pN+ disease in patients who underwent surgery for PC.