Alkaline Phosphatase-To-Albumin Ratio (APAR) As A Prognostıc Biomarker in Metastatic Hormone-Sensitive Prostate Cancer

Abstract

Here is the revised abstract, shortened by approximately 20% while retaining critical statistical data (HR, p-values) and adhering to medical journal standards. English Abstract Background: Metastatic hormone-sensitive prostate cancer (mHSPC) requires accessible biomarkers for better prognostication. This study investigated the prognostic value of the alkaline phosphatase-to-albumin ratio (APAR) in mHSPC survival risk stratification. Methods: We retrospectively analyzed 128 mHSPC patients. A cut-off of 2.92 for APAR was determined via ROC analysis. Overall survival (OS) was assessed using Kaplan–Meier methods and multivariable Cox regression adjusting for standard prognostic factors, including tumor volume and Gleason score. Results: Patients with APAR ≥2.92 had significantly shorter OS compared to those with APAR <2.92 (log-rank p<0.001). In multivariable analysis, APAR ≥2.92 remained an independent predictor of poor OS (HR 3.26, 95% CI 1.76–5.97; p<0.001), alongside ECOG status. Conclusions: APAR is an inexpensive, accessible marker that independently predicts survival in mHSPC. It holds promise for early risk stratification, though prospective validation is warranted. Türkçe Özet (Turkish Abstract) Amaç: Metastatik hormona duyarlı prostat kanserinde (mHSPC) daha iyi prognoz tayini için erişilebilir biyobelirteçlere ihtiyaç duyulmaktadır. Bu çalışma, mHSPC sağkalım risk katmanlandırmasında alkalen fosfataz/albümin oranının (APAR) prognostik değerini araştırmayı amaçlamıştır. Yöntemler: Geriye dönük olarak 128 mHSPC hastası analiz edildi. ROC analizi ile APAR için 2.92 kesme değeri belirlendi. Genel sağkalım (OS), Kaplan-Meier yöntemi ve standart prognostik faktörlere (tümör volümü, Gleason skoru vb.) göre düzeltilmiş çok değişkenli Cox regresyonu ile değerlendirildi. Bulgular: APAR ≥2.92 olan hastalarda OS, APAR <2.92 olanlara kıyasla anlamlı derecede daha kısaydı (log-rank p<0.001). Çok değişkenli analizde, yüksek APAR (HR 3.26, %95 GA 1.76–5.97; p<0.001) ve ECOG performansı, kötü sağkalımın bağımsız öngörücüleri olarak saptandı. Sonuç: APAR, mHSPC'de sağkalımı bağımsız olarak öngören, düşük maliyetli ve ulaşılabilir bir belirteçtir. Erken risk katmanlandırması için umut vadetmekle birlikte ileriye dönük validasyon çalışmaları gereklidir.

Keywords

• Alkalen fosfataz-albümin oranı (APAR)
• Metastatik hormona duyarlı prostat kanseri (mHSPC)
• Prognostik biyobelirteç
• Risk sınıflandırması

Alkaline Phosphatase-To-Albumin Ratio (APAR) As A Prognostıc Biomarker in Metastatic Hormone-Sensitive Prostate Cancer

Abstract

Background: Metastatic hormone-sensitive prostate cancer (mHSPC) requires accessible biomarkers for better prognostication. This study investigated the prognostic value of the alkaline phosphatase-to-albumin ratio (APAR) in mHSPC survival risk stratification. Methods: We retrospectively analyzed 128 mHSPC patients. A cut-off of 2.92 for APAR was determined via ROC analysis. Overall survival (OS) was assessed using Kaplan–Meier methods and multivariable Cox regression adjusting for standard prognostic factors, including tumor volume and Gleason score. Results: Patients with APAR ≥2.92 had significantly shorter OS compared to those with APAR <2.92 (log-rank p<0.001). In multivariable analysis, APAR ≥2.92 remained an independent predictor of poor OS (HR 3.26, 95% CI 1.76–5.97; p<0.001), alongside ECOG status. Conclusions: APAR is an inexpensive, accessible marker that independently predicts survival in mHSPC. It holds promise for early risk stratification, though prospective validation is warranted.

Keywords

• Alkaline phosphatase-to-albumin ratio (APAR)
• Metastatic hormone-sensitive prostate cancer (mHSPC)
• Prognostic biomarker
• Risk stratification

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