Prognostic Value of Preoperative Albumin-to-Alkaline Phosphatase Ratio for Survival in Colorectal Cancer Patients Undergoing Surgery.

This study aimed to evaluate the prognostic significance of the pre-treatment albumin-to-alkaline phosphatase ratio (AAPR) in early-stage colorectal cancer patients and to compare it with the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) within the same patient cohort. This retrospective study included 540 patients who were followed up after a diagnosis of early-stage colorectal cancer and whose albumin (ALB), alkaline phosphatase (ALP), neutrophil, platelet, and lymphocyte values were measured before treatment. In the receiver operating characteristic (ROC) curve analysis for overall survival (OS), the AAPR index Area Under Curve (AUC):0.560, ( = 0.018), NLR index ( = 0.079), and PLR index ( = 0.692) were evaluated. In the ROC analysis for OS, a cut-off value of the AAPR index of ≤0.423 was found. In the AAPR-low group, the relapse and death rates were higher than in the AAPR-high group ( = 0.004 and = 0.001, respectively). As the AAPR index decreased, the NLR and PLR indexes increased ( = 0.027 and = 0.003, respectively). Median disease-free survival (DFS) was worse in the AAPR-low group (128 versus 156) months ( = 0.015). The AAPR index significantly affected OS with hazard ratio (HR):0.42 (95%CI, 0.18-0.97) ( = 0.044). At 5 years, 68% of the patients in the AAPR-low group and 79% of the patients in the AAPR-high group were alive ( = 0.005). In a multivariate analysis, low AAPR, patient age at diagnosis, TNM stage, and recurrence status were independent factors affecting OS ( = 0.022, < 0.001, = 0.002, and < 0.001, respectively). : In early-stage colorectal cancer patients, the OS was worse in the AAPR-low group than in the AAPR-high group. The AAPR index demonstrated significant prognostic value for OS compared to the NLR and PLR in the same patient cohort.