Journal Article

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

Passaro, Francesco, Pezone, Gabriele, Alvino, Pierluigi, Perdonà, Sisto, Napolitano, Luigi, Buonerba, Carlo, Cilio, Simone, Canciello, Giuseppina, Tufano, Antonio, Barone, Biagio

2024

Overview

Background and Objectives: 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). Materials and Methods: 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 p value < 0.05 was considered to be as statistically significant. Results: 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, p = 0.022), clinical node-positive disease (OR = 13.68; 95% CI: 4.37–43.90, p < 0.009), and albumin-to-alkaline phosphatase ratio ≤ 0.53 (OR = 3.61; 95% CI: 1.23–12.71, p = 0.032) were predictors of pN+ involvement. Conclusions: Preoperative AAPR may be a potentially valuable prognostic marker of pN+ disease in patients who underwent surgery for PC.

• Publisher: MDPI AG,MDPI
• Subject: 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