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Preoperative Albumin-to-Alkaline Phosphatase Ratio as an Independent Predictor of Lymph Node Involvement in Penile
Antonio Tufano1, Luigi Napolitano2, Biagio Barone2
1Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, 00161 Rome, Italy.
Medicina (Kaunas, Lithuania)
|March 28, 2024
Summary
The preoperative albumin-to-alkaline phosphatase ratio (AAPR) can help predict lymph node involvement in penile cancer patients. A lower AAPR value is associated with a higher risk of positive nodes after surgery.
Area of Science:
- Urology
- Oncology
- Medical Diagnostics
Background:
- Penile cancer (PC) staging relies on accurate assessment of lymph node status.
- Inguinal lymph node dissection (ILND) is a key procedure for staging and treatment.
- Predictive markers for nodal metastasis are crucial for personalized treatment strategies.
Purpose of the Study:
- To evaluate the albumin-to-alkaline phosphatase ratio (AAPR) as a preoperative predictor of pathologic node-positive (pN+) disease in penile cancer.
- To determine the diagnostic accuracy of AAPR for identifying nodal involvement in PC patients undergoing ILND.
Main Methods:
- Retrospective analysis of clinical data from 42 penile cancer patients undergoing ILND.
- Calculation of preoperative albumin-to-alkaline phosphatase ratio (AAPR) from blood tests.
- Receiver Operating Characteristic (ROC) curve analysis to determine AAPR cutoff and logistic regression for predicting pN+ disease.
Main Results:
- The optimal AAPR cutoff value for predicting pN+ disease was determined to be 0.53, with an Area Under the Curve (AUC) of 0.698.
- Multivariable analysis identified lymphovascular invasion, clinical node-positive disease, and AAPR ≤ 0.53 as significant predictors of pN+ disease.
- Patients with AAPR ≤ 0.53 had an Odds Ratio (OR) of 3.61 for pN+ involvement.
Conclusions:
- Preoperative AAPR is a potentially valuable and accessible prognostic marker for predicting pN+ disease in penile cancer patients.
- Incorporating AAPR into preoperative assessments may aid in risk stratification and treatment planning for PC.
- Further prospective studies are warranted to validate the utility of AAPR in clinical practice.
