J Cancer 2017; 8(5):809-815. doi:10.7150/jca.17536

Research Paper

Albumin-to-Alkaline Phosphatase Ratio: A Novel Prognostic Index of Overall Survival in Cisplatin-based Chemotherapy-treated Patients with Metastatic Nasopharyngeal Carcinoma

Man Nie1,2,3*, Peng Sun1,2,3*, Cui Chen4, Xiwen Bi1,2,3, Yu Wang1,2,3, Hang Yang1,2,3, Panpan Liu1,2,3, Zhiming Li1,2,3, Yi Xia1,2,3✉, Wenqi Jiang1,2,3✉

1. Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, People's Republic of China;
2. State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong, People's Republic of China;
3. Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, People's Republic of China;
4. Department of Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510060, Guangdong, People's Republic of China.
* Man Nie and Peng Sun contributed equally to this work.

Abstract

The Albumin-to-Alkaline Phosphatase Ratio (AAPR) has been recently revealed as a prognostic index for hepatocellular carcinoma, whereas its role in metastatic nasopharyngeal cancer (NPC) remains unclear. The aim of this study was to evaluate the clinical value of AAPR in patients with metastatic NPC. We retrospectively reviewed 209 metastatic NPC patients treated with cisplatin-based regimens. Survival data were calculated using the Kaplan-Meier method and were compared using the log-rank test. Univariate and multivariate survival analyses were conducted using the Cox proportional hazards regression methodology. The optimal cutoff level of AAPR for assessing overall survival (OS) was 0.447, which was determined by R software. An AAPR less than 0.447 was significantly associated with a higher lactate dehydrogenase (LDH) level (273 vs. 185 U/L, P = 0.004), a higher EBV DNA viral load (5.59×105 vs. 3.49×104 copies/ml, P = 0.001), and more liver and bone metastases (P = 0.005 and P = 0.001, respectively). Additionally, patients with an AAPR < 0.447 had a shorter overall survival and progression-free survival (hazard ratio: 3.269, 95% confidence interval: 1.710-6.248; HR: 2.295, 95% confidence interval: 1.217-4.331, respectively) than those with an AAPR ≥ 0.447. Our study suggested that the AAPR might be a novel prognostic factor in metastatic NPC patients treated with cisplatin-based regimens. However, a prospective study to validate its prognostic value is needed, and the mechanisms underlying the low AAPR and poor survival in metastatic NPC need to be further investigated.

Keywords: Albumin-to-alkaline phosphatase ratio, cisplatin-based regimens, metastatic nasopharyngeal carcinoma.

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How to cite this article:
Nie M, Sun P, Chen C, Bi X, Wang Y, Yang H, Liu P, Li Z, Xia Y, Jiang W. Albumin-to-Alkaline Phosphatase Ratio: A Novel Prognostic Index of Overall Survival in Cisplatin-based Chemotherapy-treated Patients with Metastatic Nasopharyngeal Carcinoma. J Cancer 2017; 8(5):809-815. doi:10.7150/jca.17536. Available from http://www.jcancer.org/v08p0809.htm