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

<i>Background and Objectives:</i> 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). <i>Materials and Methods</...

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Main Authors: Antonio Tufano, Luigi Napolitano, Biagio Barone, Gabriele Pezone, Pierluigi Alvino, Simone Cilio, Carlo Buonerba, Giuseppina Canciello, Francesco Passaro, Sisto Perdonà
Format: Article
Language:English
Published: MDPI AG 2024-02-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/60/3/414
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author Antonio Tufano
Luigi Napolitano
Biagio Barone
Gabriele Pezone
Pierluigi Alvino
Simone Cilio
Carlo Buonerba
Giuseppina Canciello
Francesco Passaro
Sisto Perdonà
author_facet Antonio Tufano
Luigi Napolitano
Biagio Barone
Gabriele Pezone
Pierluigi Alvino
Simone Cilio
Carlo Buonerba
Giuseppina Canciello
Francesco Passaro
Sisto Perdonà
author_sort Antonio Tufano
collection DOAJ
description <i>Background and Objectives:</i> 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). <i>Materials and Methods</i>: 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 <i>p</i> value < 0.05 was considered to be as statistically significant. <i>Results</i>: 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, <i>p</i> = 0.022), clinical node-positive disease (OR = 13.68; 95% CI: 4.37–43.90, <i>p</i> < 0.009), and albumin-to-alkaline phosphatase ratio ≤ 0.53 (OR = 3.61; 95% CI: 1.23–12.71, <i>p</i> = 0.032) were predictors of pN+ involvement. <i>Conclusions</i>: Preoperative AAPR may be a potentially valuable prognostic marker of pN+ disease in patients who underwent surgery for PC.
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spelling doaj.art-1546797f3e044c7694058fbadc3f2e612024-03-27T13:53:33ZengMDPI AGMedicina1010-660X1648-91442024-02-0160341410.3390/medicina60030414Preoperative Albumin-to-Alkaline Phosphatase Ratio as an Independent Predictor of Lymph Node Involvement in Penile CancerAntonio Tufano0Luigi Napolitano1Biagio Barone2Gabriele Pezone3Pierluigi Alvino4Simone Cilio5Carlo Buonerba6Giuseppina Canciello7Francesco Passaro8Sisto Perdonà9Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, “Sapienza” Rome University, 00161 Rome, ItalyUrology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, ItalyUrology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, ItalyUrology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, ItalyUrology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, ItalyUrology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, ItalyDepartment of Public Health, University of Naples “Federico II”, 80131 Naples, ItalyDepartment of Urology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Naples, ItalyUrology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, ItalyDepartment of Urology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy<i>Background and Objectives:</i> 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). <i>Materials and Methods</i>: 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 <i>p</i> value < 0.05 was considered to be as statistically significant. <i>Results</i>: 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, <i>p</i> = 0.022), clinical node-positive disease (OR = 13.68; 95% CI: 4.37–43.90, <i>p</i> < 0.009), and albumin-to-alkaline phosphatase ratio ≤ 0.53 (OR = 3.61; 95% CI: 1.23–12.71, <i>p</i> = 0.032) were predictors of pN+ involvement. <i>Conclusions</i>: Preoperative AAPR may be a potentially valuable prognostic marker of pN+ disease in patients who underwent surgery for PC.https://www.mdpi.com/1648-9144/60/3/414penile cancerpenile neoplasmspenile surgeryalbumin-to-alkaline phosphatase ratiobiomarkersserological markers
spellingShingle Antonio Tufano
Luigi Napolitano
Biagio Barone
Gabriele Pezone
Pierluigi Alvino
Simone Cilio
Carlo Buonerba
Giuseppina Canciello
Francesco Passaro
Sisto Perdonà
Preoperative Albumin-to-Alkaline Phosphatase Ratio as an Independent Predictor of Lymph Node Involvement in Penile Cancer
Medicina
penile cancer
penile neoplasms
penile surgery
albumin-to-alkaline phosphatase ratio
biomarkers
serological markers
title Preoperative Albumin-to-Alkaline Phosphatase Ratio as an Independent Predictor of Lymph Node Involvement in Penile Cancer
title_full Preoperative Albumin-to-Alkaline Phosphatase Ratio as an Independent Predictor of Lymph Node Involvement in Penile Cancer
title_fullStr Preoperative Albumin-to-Alkaline Phosphatase Ratio as an Independent Predictor of Lymph Node Involvement in Penile Cancer
title_full_unstemmed Preoperative Albumin-to-Alkaline Phosphatase Ratio as an Independent Predictor of Lymph Node Involvement in Penile Cancer
title_short Preoperative Albumin-to-Alkaline Phosphatase Ratio as an Independent Predictor of Lymph Node Involvement in Penile Cancer
title_sort preoperative albumin to alkaline phosphatase ratio as an independent predictor of lymph node involvement in penile cancer
topic penile cancer
penile neoplasms
penile surgery
albumin-to-alkaline phosphatase ratio
biomarkers
serological markers
url https://www.mdpi.com/1648-9144/60/3/414
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