Metastatik kemik sarkomlu hastalarda albumin-alkalen fosfataz oranının sağ kalıma etkisi

Yıl 2024, Cilt: 6 Sayı: 1, 71 - 78, 26.02.2024

Emel Mutlu , Oktay Bozkurt , Mevlüde İnanç , Metin Ozkan , Sedat Tarık Fırat , Ramazan Coşar , İrfan Buğday , Muhammet Cengiz , Ahmet Kürşad Dişli , Murat Eser

https://doi.org/10.52827/hititmedj.1389249

Öz

Amaç: Metastatik kemik sarkomu hastalarında albümin-alkalen fosfataz oranının (AALPO) sağ kalıma etkisini araştırmak.
Hasta ve Yöntem: Çalışmaya metastatik evrede olan 60 kemik sarkomu hastası dahil edildi. Kemoterapi öncesi bakılan AALPO ile genel sağkalım (GS) ve progresyonsuz sağkalım (PS) arasındaki ilişki Cox regresyonu multivariate analizi ile değerlendirildi.
Bulgular: Çalışmaya alınan hastaların 25 (%58.3)’i osteosarkom, 16 (%26.7)’si Ewing sarkomu, 5(%8.3)’ü kondrosarkom ve 4 (%6.7)’ü dev hücreli kemik tümörüydü. ROC analizi ile elde edilen AALPO değeri 0.039 olarak bulundu. AALPO ≥ 0,039 grubundaki medyan PS ve GS, <0,039 olan gruba göre istatistiksel olarak anlamlı derecede yüksekti (p=0.006, p=0.003). AALPO <0.039 (HR=1.778, %95 Cl, 1.211-1.912, p=0.023) olması düşük genel GS ile ilişkili ve (HR=4.782, %95 Cl, 1.963-11.647, p=0.001) olması düşük PS ile ilişkili bulundu.
Sonuç: Çalışmamızda metastatik kemik sarkomlu hastalarda kemoterapi öncesi düşük AALPO değeri, kötü GS ve PS ile ilişkili bulunmuştur. Daha önce birçok kanser türünde düşük AALPO kötü GS ve PS ile ilişkili bulunmuştur ancak daha önce kemik kanseri hastalarında AALPO’nun sağ kalım ile ilişkisi değerlendirilmemiştir. Çalışmamız literatürde bu konuyu araştıran ilk çalışmadır. AALPO, hastaların prognozunu değerlendirmede ucuz ve basit bir belirteç olarak kullanılabilir. Ancak daha kesin sonuçlar söylemek için daha fazla hasta sayısı ile yapılacak çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

kemik kanseri, osteosarkom, nötrofil lenfosit oranı, albumin alkalen fosfataz oranı

The effect of albumin to alkaline phosphatase ratio on survival in patients with metastatic bone sarcomas

Öz

Objective: To investigate the effect of albumin to alkaline phosphatase ratio (AALPR) at survival in patients with metastatic bone sarcomas.
Patients and Methods: 60 patients with metastatic bone sarcomas were included in the study. The relationship between AALPR before chemotherapy and overal survival (OS) and progression free survival (PFS) was evaluated with Cox regression multivariate analysis.
Results: Of the patients in the study, 25 (58.3%) were osteosarcoma, 16 (26.7%) Ewing's sarcoma, 5 (8.3%) chondrosarcoma and 4 (6.7%) giant cell bone tumor. AALPR was 0.039 obtained in ROC analysis. The median PFS and OS at AALPR ≥ 0.039 group was statistically significantly higher than the group with <0.039 (p=0.006, p=0.003). AALPR <0.039 was found to be associated with poor OS and PFS (OS, HR=1.778, 95% CI, 1.211-1.912, p=0.023 - PFS, HR=4.782, 95% CI, 1.963-11,647, p=0.001 ).
Conclusion: In our study, low AALPR value before chemotherapy was associated with poor OS and PFS in patients with metastatic bone sarcoma. Low AALPR has been associated with poor OS and PFS in many cancer types, but the association of AALPR with survival at bone sarcoma patients has not been evaluated previously. Our study is the first in the literature to investigate this issue. AALPR can be used as an inexpensive and simple marker to evaluate the prognosis of patients. However, studies with larger number of patients are needed to give more precise results.

Anahtar Kelimeler

Bone cancer, osteosarcoma, albumin to alkaline phosphatase ratio, neutrophil to lymphocyte ratio

Etik Beyan

The study was carried out with the permission of Erciyes University Medical Faculty Clinical Researches Ethics Committee (Date:28.09.2022 Decision No:2022/675).

Destekleyen Kurum

The authors did not receive support from any organization for the submitted work.

Teşekkür

The authors did not receive support from any organization for the submitted work.

Kaynakça

• Rizk VT, Walko CM, Brohl AS. Precision medicine approaches for the management of Ewing sarcoma: current perspectives. Pharmacogenomics and Personalized Medicine 2019;12:9.
• Atrayee BM, Chawla SP. Giant Cell Tumor of Bone: An Update. Current Oncology Reports 2021;23(5):51
• Hashimoto K, Nishimura S, Oka N, Akagi M. Clinical features and outcomes of primary bone and soft tissue sarcomas in adolescents and young adults. Molecular and clinical oncology 2020;12(4):358-364.
• Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA: a cancer journal for clinicians 2019;69(1):7-34.
• Jagdish RK, Maras JS, Sarin SK. Albumin in advanced liver diseases: The good and bad of a drug! Hepatology 2021;74(5):2848-2862.
• Siller AF, Whyte MP. Alkaline phosphatase: discovery and naming of our favorite enzyme. Journal of Bone and Mineral Research 2018;33(2):362-364.
• An L, Yin W-t, Sun D-w. Albumin-to-alkaline phosphatase ratio as a promising indicator of prognosis in human cancers: is it possible? BMC cancer 2021;21(1):1-18.
• Li W, Luo X, Liu Z, Chen Y, Li ZJPo. Prognostic value of C-reactive protein levels in patients with bone neoplasms: a meta-analysis. PLoS One 2018;13(4):e0195769.
• Li Y-J, Yao K, Lu M-X, Zhang W-B, Xiao C, Tu C-Q. Prognostic value of the C-reactive protein to albumin ratio: a novel inflammation-based prognostic indicator in osteosarcoma. OncoTargets and therapy 2017;10:5255.
• Xin S, Wei G. Prognostic factors in osteosarcoma: A study level meta-analysis and systematic review of current practice. J Bone Oncol 2020;21:100281.
• Zhang X, Xin Y, Chen Y, Zhou XJSR. Prognostic effect of albumin-to-alkaline phosphatase ratio on patients with hepatocellular carcinoma: a systematic review and meta-analysis. Sci Rep 2023;13(1):1808.
• Nie M, Sun P, Chen C, et al. Albumin-to-alkaline phosphatase ratio: a novel prognostic index of overall survival in cisplatin-based chemotherapy-treated patients with metastatic nasopharyngeal carcinoma. Journal of Cancer 2017;8(5):809.
• Kim JS, Keam B, Heo DS, et al. The prognostic value of albumin-to-alkaline phosphatase ratio before radical radiotherapy in patients with non-metastatic nasopharyngeal carcinoma: a propensity score matching analysis. Cancer research and treatment: official journal of Korean Cancer Association 2019;51(4):1313-1323.
• Zeng X, Liu G, Pan Y, Li Y. Prognostic value of clinical biochemistry-based indexes in nasopharyngeal carcinoma. Frontiers in oncology 2020;10:146.
• Li D, Yu H, Li W. Albumin-to-alkaline phosphatase ratio at diagnosis predicts survival in patients with metastatic non-small-cell lung cancer. OncoTargets and therapy 2019;12:5241.
• Strijker M, Chen J, Mungroop T, et al. Systematic review of clinical prediction models for survival after surgery for resectable pancreatic cancer. Br J Surg 2019;106(4):342-354.
• Xiong J-P, Long J-Y, Xu W-Y, et al. Albumin-to-alkaline phosphatase ratio: a novel prognostic index of overall survival in cholangiocarcinoma patients after surgery. World J Gastrointest Oncol 2019;11(1):39.
• Zhang C, Li Y, Ji R, et al. The prognostic significance of pretreatment albumin/alkaline phosphatase ratio in patients with stage IB-IIA cervical Cancer. OncoTargets and therapy 2019;12:9559.