ALKALINE PHOSPHATASE-TO-ALBUMIN RATIO (APAR) AS A PROGNOSTIC BIOMARKER IN METASTATIC HORMONE-SENSITIVE PROSTATE CANCER

Creative Commons License

ÖZALP F. R., ARSLAN A. M., YETGİNOĞLU Ö., Semiz H. S.

Journal of Basic and Clinical Health Sciences, cilt.10, sa.2, ss.222-228, 2026 (ESCI, TRDizin)

Özet

Purpose: Metastatic hormone-sensitive prostate cancer requires accessible biomarkers for better prognostication. This study investigated the prognostic value of the alkaline phosphatase-to-albumin ratio (APAR) in metastatic hormone-sensitive prostate cancer survival risk stratification. Methods: We retrospectively analyzed 128 metastatic hormone-sensitive prostate cancer patients treated at a single institution between January 2015 and January 2025. A cut-off of 2.92 for the alkaline phosphatase-to-albumin ratio was determined via receiver operating characteristic analysis. Overall survival was assessed using Kaplan–Meier methods and multivariable Cox regression adjusting for standard prognostic factors, including tumor volume and Gleason score. Results: Patients with an alkaline phosphatase-to-albumin ratio of 2.92 or higher had significantly shorter overall survival compared to those with a ratio lower than 2.92 (log-rank p<0.001). In multivariable analysis, an alkaline phosphatase-to-albumin ratio of 2.92 or higher remained an independent predictor of poor overall survival (Hazard Ratio 3.26, 95% Confidence Interval 1.76–5.97; p<0.001), alongside Eastern Cooperative Oncology Group performance status (ECOG PS). Conclusion: The alkaline phosphatase-to-albumin ratio is an inexpensive, accessible marker that independently predicts survival in metastatic hormone-sensitive prostate cancer. APAR should be interpreted as a supportive, complementary marker alongside established clinical parameters such as ECOG PS, Gleason grade, and metastatic burden rather than as a standalone determinant. It holds promise for early risk stratification, though prospective validation is warranted