Background. We investigated the prognostic usefulness of prechemoradiotherapy (CRT) albumin-to-alkaline phosphatase ratio (AAPR) in unresectable locally advanced pancreatic adenocarcinoma (LAPAC) patients managed with definitive concurrent CRT (CCRT). Methods. A sum of 136 LAPAC patients who consecutively underwent definitive CCRT was retrospectively analyzed. The AAPR (serum albumin (g/dL)/serum alkaline phosphatase (IU/L)) was calculated by using the parameters obtained from the routine biochemistry tests on the first day of the CCRT. Ideal AAPR cutoff was sought by utilizing receiver operating characteristic (ROC) curve analysis. The primary and secondary endpoints were the impact of the AAPR on the overall survival (OS) and progression-free survival (PFS) results, respectively. Results. At a median follow-up of 14.8 months (range: 3.2-85.7), the median PFS and OS times were 7.5 (95% confidence interval (CI): 6.0-9.0) and 14.9 months (95% CI: 11.9-17.9), respectively. The ideal common AAPR cutoff was identified at the rounded 0.46 (area under the curve: 72.3%; sensitivity: 71.2%; specificity: 70.3%) point that dichotomized the patients into two groups: low AAPR (L-AAPR; ) and high AAPR (H-AAPR; ) groups, respectively. Comparative survival analyses showed that the L-AAPR cohort had significantly shorter median PFS (6.8 (95% CI: 5.7-7.9) versus 11.3 (95% CI: 9.9-12.7) months; ) and OS (12.8 (95% CI: 10.6-15.0) versus 19.2 (95% CI: 16.9-21.5) months; ) durations than their H-AAPR counterparts, separately. Albeit the N1-2 () and () were also found to be associated with inferior outcomes, yet the results of the multivariate analyses ascertained the L-AAPR as an independent indicator of diminished PFS () and OS () results. Conclusion. The present results proposed that the pretreatment was a novel independent indicator of adverse PFS and OS in unresectable LAPAC patients undergoing definitive CCRT.

中文翻译：

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放化疗前白蛋白与碱性磷酸酶比值在不可切除的局部晚期胰腺癌患者中的预后效用

背景。我们研究了放化疗前 (CRT) 白蛋白与碱性磷酸酶比 (AAPR) 在接受确定性同步 CRT (CCRT) 治疗的不可切除局部晚期胰腺癌 (LAPAC) 患者中的预后价值。方法。回顾性分析了 136 名连续接受明确 CCRT 的 LAPAC 患者。AAPR（血清白蛋白（g/dL）/血清碱性磷酸酶（IU/L））通过使用从CCRT第一天的常规生化测试获得的参数计算。通过利用接收器操作特征 (ROC) 曲线分析寻求理想的 AAPR 截止值。主要和次要终点分别是 AAPR 对总生存期 (OS) 和无进展生存期 (PFS) 结果的影响。结果。在中位随访 14.8 个月（范围：3.2-85.7）时，中位 PFS 和 OS 时间分别为 7.5（95% 置信区间（CI）：6.0-9.0）和 14.9 个月（95% CI：11.9-17.9） ， 分别。理想的共同 AAPR 截止点确定为四舍五入的 0.46（曲线下面积：72.3%；敏感性：71.2%；特异性：70.3%），将患者分为两组：低 AAPR（L-AAPR；)和高 AAPR (H-AAPR;)组，分别。比较生存分析显示，L-AAPR 队列的中位 PFS 显着缩短（6.8（95% CI：5.7-7.9）与 11.3（95% CI：9.9-12.7）个月；)和 OS (12.8 (95% CI: 10.6-15.0) 与 19.2 (95% CI: 16.9-21.5) 个月；)持续时间分别比其 H-AAPR 对应项。尽管是 N1-2 ()和(）也被发现与较差的结果相关，但多变量分析的结果确定 L-AAPR 是 PFS 降低的独立指标（)和操作系统 ()结果。结论。目前的结果表明，预处理是接受明确 CCRT 的不可切除 LAPAC 患者不良 PFS 和 OS 的新的独立指标。