Prognostic importance of preoperative albumin-to--alkaline phosphatase ratio in colorectal cancer patients

Introduction: Colorectal cancer (CRC) prognosis is typically determined based on clinical stage and histopathological findings,yet patients with the same stage and histological structure can exhibit varyingsurvival outcomes. This highlights the need for additional prognostic biomarkers. Serum biomarkers are gaining increasing significance due to their affordability and accessibility. The albumin-alkaline phosphatase ratio (AAPR) has been associated with prognosis in hepatocellular and gastric cancers, but its role in CRC remains underexplored. Aim: This study aimed to evaluate the effect ofthe albumin-alkaline phosphatase ratio (AAPR) on the prognosis of patients with colorectal cancer (CRC). Material and method: Data from 358 patients who had undergone surgery for CRC were analyzed retrospectively to identify factors that could predict overall survival (OS). The Roc-Curve test was applied to determine the power of the preoperative AAPR in predicting mortality. Kaplan Meier and log-rank tests were used to examine the survival times of the patients. Results: Our findings revealed that an albumin-alkaline phosphatase cut-off ratio above 0.67 predicted mortality with a sensitivity of 17.54% and a specificity of 92.22%. Although patients with a lower AAPR exhibited a slightly shorter mean survival time compared to those above the cut-off value, this difference did not reach statistical significance (P = .112). Conclusions: The results ofthis study did not provide evidence to support the AAPR asa potential prognostic factor in patients with colorectal cancer.