The influence of the preoperative albumin to alkaline phosphatase ratio on OS in postradical colorectal cancer and the construction of a nomogram prediction model

Abstract Objective The albumin to alkaline phosphatase ratio (AAPR) is a newly developed blood biomarker that has been reported to have prognostic value in several types of cancers. The aim of this study was to investigate the predictive value of AAPR in overall survival after radical colon cancer surgery in patients with stage I-III colorectal cancer (CRC). Methods The clinical data of 221 eligible patients with stage I ~ III CRC were retrospectively analysed. A series of survival analyses were performed to assess the prognostic value of AAPR. Univariate and multifactorial Cox analyses were performed to identify independent risk factors. Columnar graph prediction models were further constructed based on independent risk factors such as AAPR, and their predictive properties were validated. Results The optimal cutoff value of preoperative AAPR for postoperative OS in patients undergoing laparoscopic radical CRC was 0.495 as shown by univariate and multifactorial Cox regression analysis. The factors of age ≤ 65 years, TNM stage I-II, tumour grading (high/medium differentiation), CEA ≤ 5 and AAPR ≥ 0.495 were associated with better OS (P < 0.05). Conclusions Preoperative AAPR level was a good predictor of postoperative survival in patients undergoing laparoscopic radical CRC surgery, and AAPR < 0.495 was an independent risk factor for decreased postoperative OS.