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

Abstract

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.