| Summary: | Jiayuan Wu,1,* Shasha Li,2,* Yufeng Wang,2 Liren Hu2 1Department of Clinical Research, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People’s Republic of China; 2Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, Zhanjiang, Guangdong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jiayuan WuDepartment of Clinical Research, Affiliated Hospital of Guangdong Medical University, No. 57, South of Renmin Avenue, Zhanjiang, Guangdong 524001, People’s Republic of ChinaEmail 87537665@qq.comLiren HuDepartment of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, No. 2, Wenmin East Road, Zhanjiang 524023, People’s Republic ChinaEmail fox833@163.comBackground: The pretreatment aspartate aminotransferase-to-alanine aminotransferase (De Ritis) ratio is reportedly valuable in prognosis prediction of various malignancies. However, its value in the prognosis of nasopharyngeal carcinoma (NPC) has not yet been reported. This study aimed to evaluate the effect of the De Ritis ratio on the survival outcomes of patients with nonmetastatic NPC.Methods: We retrospectively reviewed the medical data of 1023 patients with nonmetastatic NPC admitted between 2009 and 2013 at a single center. The Fine and Gray competing risk regression model was used to analyze the associations between the De Ritis ratio and the survival outcomes of cancer-specific survival (CSS) and progression-free survival (PFS) by using the subdistribution hazard ratio (SHR) and 95% confidence interval (CI) as size effects. The Cox proportional hazard model was used to evaluate the correlation between the De Ritis ratio and overall survival (OS) by using hazard ratio (HR) and 95% CI as size effects.Results: Patients were divided into two groups in accordance with the pretreatment De Ritis ratio by using an optimal cutoff value of 1.65. Compared with the patients with low De Ritis ratio (< 1.65), those with elevated De Ritis ratio (≥ 1.65) had poorer prognosis with regard to CSS, PFS, and OS. Notably, multivariate analyses showed that high De Ritis ratio was independently associated with poor CSS (SHR = 1.64, 95% CI: 1.25–2.16), PFS (SHR = 1.69, 95% CI: 1.30–2.19), and OS (HR = 1.81, 95% CI: 1.39–2.40).Conclusion: Pretreatment De Ritis ratio can be an independent prognostic predictor for patients with nonmetastatic NPC.Keywords: aspartate aminotransferase-to-alanine aminotransferase ratio, nasopharyngeal carcinoma, prognosis, competing risk model
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