1Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
3Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
4Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
5Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
Copyright © 2019 by the Korean Cancer Association
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Values are presented as median (range) or number (%). PSM, propensity score matching; AAPR, albumin-to-alkaline phosphatase ratio; ECOG PS, Eastern Cooperative Oncology Group performance status; WHO, World Health Organization; EBV, Epstein-Barr virus; IHC, immunohistochemistry; AJCC, American Joint Committee on Cancer; CCRT, concurrent chemoradiotherapy; NCT, neoadjuvant chemotherapy; ACT, adjuvant chemotherapy.
PSM, propensity score matching; OS, overall survival; PFS, progression-free survival; LRRFS, locoregional relapse–free survival; DMFS, distant metastasis–free survival; HR, hazard ratio; CI, confidence interval; WHO, World Health Organization; inf, infinity; AJCC, American Joint Committee on Cancer; AAPR, albumin-to-alkaline phosphatase ratio; ALB, albumin; ALP, alkaline phosphatase.
Values are presented as median (range) or number (%). PSM, propensity score matching; AAPR, albumin-to-alkaline phosphatase ratio; ECOG PS, Eastern Cooperative Oncology Group performance status; WHO, World Health Organization; EBV, Epstein-Barr virus; IHC, immunohistochemistry; AJCC, American Joint Committee on Cancer; CCRT, concurrent chemoradiotherapy; NCT, neoadjuvant chemotherapy; ACT, adjuvant chemotherapy.
PSM, propensity score matching; OS, overall survival; PFS, progression-free survival; LRRFS, locoregional relapse–free survival; DMFS, distant metastasis–free survival; HR, hazard ratio; CI, confidence interval; WHO, World Health Organization; inf, infinity; AJCC, American Joint Committee on Cancer; AAPR, albumin-to-alkaline phosphatase ratio; ALB, albumin; ALP, alkaline phosphatase.
Prognostic Value of Pretreatment Albumin-to-Alkaline Phosphatase Ratio in Extensive-Disease Small-Cell Lung Cancer: A Retrospective Cohort Study
Characteristic | Before PSM |
After PSM |
||||
---|---|---|---|---|---|---|
AAPR < 0.4876 (n=25) | AAPR ≥ 0.4876 (n=145) | p-value | AAPR < 0.4876 (n=20) | AAPR ≥ 0.4876 (n=80) | p-value | |
Age (yr) | 55 (32-75) | 49 (16-80) | 0.022 | 55 (34-75) | 51 (16-73) | 0.158 |
Sex | ||||||
Male | 20 (80.0) | 103 (71.0) | 0.494 | 17 (85.0) | 61 (76.2) | 0.587 |
Female | 5 (20.0) | 42 (29.0) | 3 (15.0) | 19 (23.8) | ||
ECOG PS | ||||||
0-1 | 21 (84.0) | 136 (93.8) | 0.032 | 18 (90.0) | 74 (92.5) | 0.747 |
2 | 2 (8.0) | 1 (0.7) | 0 | 1 (1.2) | ||
Unknown | 2 (8.0) | 8 (5.5) | 2 (10.0) | 5 (6.2) | ||
Pathology (WHO) | ||||||
Type I | 2 (8.0) | 11 (7.6) | 0.655 | 0 | 5 (6.2) | 0.319 |
Type II | 13 (52.0) | 89 (61.4) | 11 (55.0) | 50 (62.5) | ||
Type III | 10 (40.0) | 45 (31.0) | 9 (45.0) | 25 (31.2) | ||
EBV IHC | ||||||
Positive | 14 (56.0) | 85 (58.6) | 0.462 | 13 (65.0) | 49 (61.2) | 0.959 |
Negative | 0 | 7 (4.8) | 0 | 0 | ||
Unknown | 11 (44.0) | 53 (36.6) | 7 (35.0) | 31 (38.8) | ||
T category | ||||||
T1 | 6 (24.0) | 45 (31.0) | 0.002 | 5 (25.0) | 26 (32.5) | 0.649 |
T2 | 0 | 35 (24.1) | 0 | 0 | ||
T3 | 5 (20.0) | 32 (22.1) | 5 (25.0) | 23 (28.8) | ||
T4 | 14 (56.0) | 33 (22.8) | 10 (50.0) | 31 (38.8) | ||
N category | ||||||
N0 | 3 (12.0) | 16 (11.0) | 0.829 | 3 (15.0) | 9 (11.2) | 0.915 |
N1 | 11 (44.0) | 51 (35.2) | 8 (40.0) | 30 (37.5) | ||
N2 | 8 (32.0) | 55 (37.9) | 8 (40.0) | 34 (42.5) | ||
N3 | 3 (12.0) | 23 (15.9) | 1 (5.0) | 7 (8.8) | ||
AJCC stage | ||||||
I | 0 | 3 (2.1) | 0.224 | 0 | 0 | 0.711 |
II | 4 (16.0) | 29 (20.0) | 3 (15.0) | 10 (12.5) | ||
III | 6 (24.0) | 57 (39.3) | 6 (30.0) | 32 (40.0) | ||
IV | 15 (60.0) | 56 (38.6) | 11 (55.0) | 38 (47.5) | ||
CCRT | ||||||
No | 3 (12.0) | 10 (6.9) | 0.632 | 2 (10.0) | 5 (6.2) | 0.922 |
Yes | 22 (88.0) | 135 (93.1) | 18 (90.0) | 75 (93.8) | ||
NCT | ||||||
No | 11 (44.0) | 84 (57.9) | 0.281 | 9 (45.0) | 41 (51.2) | 0.803 |
Yes | 14 (56.0) | 61 (42.1) | 11 (55.0) | 39 (48.8) | ||
ACT | ||||||
No | 21 (84.0) | 127 (87.6) | 0.864 | 18 (90.0) | 72 (90.0) | 1.000 |
Yes | 4 (16.0) | 18 (12.4) | 2 (10.0) | 8 (10.0) |
Variable | OS |
PFS |
LRRFS |
DMFS |
||||
---|---|---|---|---|---|---|---|---|
p-value | HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | |
Age (< 50 yr/≥ 50 yr) | 0.242 | 1.633 (0.719-3.711) | 0.851 | 1.068 (0.535-2.134) | 0.555 | 1.448 (0.423-4.954) | 0.081 | 0.384 (0.131-1.125) |
Pathology (WHO I/II-III) | 0.522 | 0.622 (0.145-2.662) | 0.827 | 0.853 (0.203-3.574) | 0.998 | 25,973,937 (0-inf) | 0.998 | 25,903,022 (0-inf) |
T category (1-2/3-4) | 0.425 | 1.454 (0.580-3.645) | 0.299 | 1.671 (0.723-3.861) | 0.155 | 4.444 (0.569-34.730) | 0.744 | 0.836 (0.286-2.448) |
N category (0-1/2-3) | 0.369 | 1.443 (0.648-3.215) | 0.151 | 1.670 (0.830-3.361) | 0.696 | 1.267 (0.386-4.155) | 0.172 | 2.113 (0.722-6.185) |
AJCC stage (I-II/III-IV) | 0.561 | 1.535 (0.362-6.518) | 0.588 | 1.389 (0.424-4.552) | 0.736 | 1.425 (0.182-11.140) | 0.886 | 0.897 (0.202-3.976) |
AAPR (< 0.4876/≥ 0.4876) | 0.202 | 0.566 (0.236-1.356) | 0.410 | 0.715 (0.322-1.587) | 0.116 | 0.374 (0.109-1.277) | 0.534 | 1.603 (0.362-7.106) |
ALB (< 44.5 g/L/≥ 44.5 g/L) | 0.686 | 1.198 (0.499-2.874) | 0.769 | 0.887 (0.399-1.971) | 0.567 | 0.639 (0.138-2.963) | 0.934 | 0.953 (0.303-2.994) |
ALP (< 89.5 IU/L/≥ 89.5 IU/L) | 0.071 | 2.239 (0.932-5.376) | 0.383 | 1.452 (0.628-3.357) | 0.299 | 2.020 (0.536-7.618) | 0.697 | 0.744 (0.168-3.297) |
Characteristic | Before PSM |
After PSM |
||||
---|---|---|---|---|---|---|
AAPR < 0.4876 (n=21) | AAPR ≥ 0.4876 (n=113) | p-value | AAPR < 0.4876 (n=17) | AAPR ≥ 0.4876 (n=68) | p-value | |
Age (yr) | 55 (32-75) | 49 (16-73) | 0.023 | 55 (34-75) | 52.5 (21-73) | 0.206 |
Sex | ||||||
Male | 16 (76.2) | 81 (71.7) | 0.874 | 14 (82.4) | 53 (77.9) | 0.947 |
Female | 5 (23.8) | 32 (28.3) | 3 (17.6) | 15 (22.1) | ||
ECOG PS | ||||||
0-1 | 17 (81.0) | 106 (93.8) | 0.034 | 15 (88.2) | 62 (91.2) | 0.747 |
2 | 2 (9.5) | 1 (0.9) | 0 | 1 (1.5) | ||
Unknown | 2 (9.5) | 6 (5.3) | 2 (11.8) | 5 (7.4) | ||
Pathology (WHO) | ||||||
Type I | 2 (9.5) | 10 (8.8) | 0.790 | 1 (5.9) | 5 (7.4) | 0.888 |
Type II | 11 (52.4) | 68 (60.2) | 10 (58.8) | 43 (63.2) | ||
Type III | 8 (38.1) | 35 (31.0) | 6 (35.3) | 20 (29.4) | ||
EBV IHC | ||||||
Positive | 12 (57.1) | 64 (56.6) | 0.484 | 11 (64.7) | 41 (60.3) | 0.956 |
Negative | 0 | 7 (6.2) | 0 | 0 | ||
Unknown | 9 (42.9) | 42 (37.2) | 6 (35.3) | 27 (39.7) | ||
T category | ||||||
T1 | 2 (9.5) | 30 (26.5) | 0.005 | 2 (11.8) | 15 (22.1) | 0.490 |
T2 | 0 | 18 (15.9) | 0 | 0 | ||
T3 | 5 (23.8) | 32 (28.3) | 5 (29.4) | 23 (33.8) | ||
T4 | 14 (66.7) | 33 (29.2) | 10 (58.8) | 30 (44.1) | ||
N category | ||||||
N0 | 3 (14.3) | 10 (8.8) | 0.526 | 3 (17.6) | 9 (13.2) | 0.894 |
N1 | 7 (33.3) | 25 (22.1) | 6 (35.3) | 21 (30.9) | ||
N2 | 8 (38.1) | 55 (48.7) | 7 (41.2) | 31 (45.6) | ||
N3 | 3 (14.3) | 23 (20.4) | 1 (5.9) | 7 (10.3) | ||
AJCC stage | ||||||
III | 6 (28.6) | 57 (50.4) | 0.108 | 6 (35.3) | 31 (45.6) | 0.623 |
IV | 15 (71.4) | 56 (49.6) | 11 (64.7) | 37 (54.4) | ||
CCRT | ||||||
No | 3 (14.3) | 8 (7.1) | 0.502 | 2 (11.8) | 5 (7.4) | 0.921 |
Yes | 18 (85.7) | 105 (92.9) | 15 (88.2) | 63 (92.6) | ||
NCT | ||||||
No | 9 (42.9) | 59 (52.2) | 0.582 | 8 (47.1) | 32 (47.1) | 1.000 |
Yes | 12 (57.1) | 54 (47.8) | 9 (52.9) | 36 (52.9) | ||
ACT | ||||||
No | 19 (90.5) | 98 (86.7) | 0.907 | 15 (88.2) | 61 (89.7) | 1.000 |
Yes | 2 (9.5) | 15 (13.3) | 2 (11.8) | 7 (10.3) |
Variable | OS |
PFS |
LRRFS |
DMFS |
||||
---|---|---|---|---|---|---|---|---|
p-value | HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | |
Age (< 50 yr/≥ 50 yr) | 0.095 | 2.122 (0.877-5.139) | 0.277 | 1.524 (0.713-3.258) | 0.462 | 1.571 (0.472-5.228) | 0.644 | 0.766 (0.247-2.377) |
Pathology (WHO I/II-III) | 0.311 | 0.533 (0.158-1.801) | 0.512 | 0.670 (0.202-2.221) | 0.674 | 0.644 (0.083-5.002) | 0.998 | 26674545 (0-inf) |
T category (1-2/3-4) | 0.464 | 1.494 (0.510-4.384) | 0.300 | 1.747 (0.608-5.024) | 0.310 | 2.886 (0.372-22.360) | 0.677 | 0.757 (0.205-2.801) |
N category (0-1/2-3) | 0.463 | 1.363 (0.596-3.117) | 0.187 | 1.650 (0.784-3.470) | 0.681 | 1.272 (0.403-4.013) | 0.129 | 2.752 (0.745-10.170) |
AJCC stage (III/IV) | 0.886 | 1.061 (0.474-2.376) | 0.694 | 1.158 (0.558-2.402) | 0.423 | 1.633 (0.491-5.430) | 0.906 | 1.072 (0.340-3.380) |
AAPR (< 0.4876/≥ 0.4876) | 0.014 | 0.341 (0.144-0.805) | 0.029 | 0.416 (0.189-0.914) | 0.016 | 0.243 (0.077-0.769) | 0.943 | 1.057 (0.231-4.841) |
ALB (< 44.5 g/L/≥ 44.5 g/L) | 0.734 | 1.174 (0.464-2.974) | 0.891 | 0.942 (0.401-2.213) | 0.545 | 0.626 (0.137-2.860) | 0.912 | 0.929 (0.251-3.434) |
ALP (< 89.5 IU/L/≥ 89.5 IU/L) | 0.015 | 2.909 (1.234-6.857) | 0.116 | 1.919 (0.851-4.332) | 0.112 | 2.652 (0.797-8.821) | 0.931 | 0.935 (0.205-4.276) |
Values are presented as median (range) or number (%). PSM, propensity score matching; AAPR, albumin-to-alkaline phosphatase ratio; ECOG PS, Eastern Cooperative Oncology Group performance status; WHO, World Health Organization; EBV, Epstein-Barr virus; IHC, immunohistochemistry; AJCC, American Joint Committee on Cancer; CCRT, concurrent chemoradiotherapy; NCT, neoadjuvant chemotherapy; ACT, adjuvant chemotherapy.
PSM, propensity score matching; OS, overall survival; PFS, progression-free survival; LRRFS, locoregional relapse–free survival; DMFS, distant metastasis–free survival; HR, hazard ratio; CI, confidence interval; WHO, World Health Organization; inf, infinity; AJCC, American Joint Committee on Cancer; AAPR, albumin-to-alkaline phosphatase ratio; ALB, albumin; ALP, alkaline phosphatase.
Values are presented as median (range) or number (%). PSM, propensity score matching; AAPR, albumin-to-alkaline phosphatase ratio; ECOG PS, Eastern Cooperative Oncology Group performance status; WHO, World Health Organization; EBV, Epstein-Barr virus; IHC, immunohistochemistry; AJCC, American Joint Committee on Cancer; CCRT, concurrent chemoradiotherapy; NCT, neoadjuvant chemotherapy; ACT, adjuvant chemotherapy.
PSM, propensity score matching; OS, overall survival; PFS, progression-free survival; LRRFS, locoregional relapse–free survival; DMFS, distant metastasis–free survival; HR, hazard ratio; CI, confidence interval; WHO, World Health Organization; inf, infinity; AJCC, American Joint Committee on Cancer; AAPR, albumin-to-alkaline phosphatase ratio; ALB, albumin; ALP, alkaline phosphatase.