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    Preoperative AST/ALT (De Ritis) Ratio as a Prognostic Factor in a Cohort of Patients who underwent radical cystectomy
    (2018) Gökçen, Kaan; Kıraç, Emre; Gökçen, Pınar; Çiçek, Resul; Gökçe, Gökhan
    Objective: This study aims to evaluate the prognostic significance of the preoperative aspartate aminotransferase (AST)/ alanine aminotransferase (ALT) (De Ritis) ratio in bladder cancer (BC) patients who underwent radical cystectomy(RC).Method: We evaluated the clinical and histopathological data of 58 patients who had undergone RC between January2008-August 2018 at our tertiary hospital. The potential prognostic value of the De Ritis ratio with regard to BC wasevaluated using ROC curve analysis. The effect of the De Ritis ratio on disease specific survival (DSS) and overallsurvival (OS) was analyzed using the Kaplan-Meier method and multivariate Cox regression models.Results: A total of fifty-eight patients underwent RC and 95.6% were male (M/F:56/2). Mean age of the patients was68.6± 11,56. The cut-off value of the De Ritis ratio for DSS was calculated as 1.417 in the ROC analysis. In Kaplan-Meier analyses, the group with a higher De Ritis ratio presented a more unfavorable progression in terms of DSS andOS (p=0.004). Based on the Cox regression models adjusted for clinical and pathological parameters, for DSS, the DeRitis ratio (HR 2.70, 95% CI 2.34-3.05 p=0.005), pathological T stage (HR 3.36, 95% CI 2.91-3.82, p =0.007), and age(HR 1,038 95% CI 1,02-1,05; p=0.015) were determined as independent prognostic factors; and for OS, the De Ritisratio (HR 2.71, 95% CI 2.33 -3.09; p =0.005), pathological T stage (HR 4.36, 95% CI 3.87–4.85; p=0.007) and age (HR1.04, 95% CI 1.03-1.06; p = 0.015) were determined as independent prognostic factors.Conclusions: A higher preoperative De Ritis ratio can be considered as an independent prognostic factor in BC patientswho underwent RC. Our results need to be confirmed and corroborated by comprehensive prospective randomizedstudies with an appropriate design.