The Value of Alkaline Phosphatase-to-Albumin Ratio in Detecting Synchronous Metastases and Predicting Postoperative Relapses among Patients with Well-Differentiated Pancreatic Neuroendocrine Neoplasms
Table 4
Stratification analysis of APAR for recurrence-free survival in resected pNEN patients.
APAR >1.95 vs. ≤1.95
Univariate analysis
Multivariate analysis
HR (95% CI)
HR (95% CI)
Gender
Male (n = 71)
6.767 (1.130–40.518)
0.036
—
NS
Female (n = 80)
4.013 (0.809–19.902)
0.089
Age
≤54 years (n = 87)
2.000 (0.208–19.227)
0.548
>54 years (n = 64)
7.283 (1.411–37.587)
0.018
—
NS
Nonfunctioning
No (n = 116)
5.326 (1.541–18.407)
0.008
—
NS
Yes (n = 35)
—
0.600
Location
Head-neck (n = 62)
4.812 (0.804–28.807)
0.085
Body-tail (n = 87)
3.853 (0.643–23.083)
0.140
Diameter
≤3.6 cm (n = 105)
8.908 (0.807–98.321)
0.074
>3.6 cm (n = 46)
4.614 (1.140–18.670)
0.032
—
NS
Cystic component
No (n = 129)
4.438 (1.354–14.547)
0.014
—
NS
Yes (n = 22)
—
—
No. of primary lesions
Single (n = 144)
4.205 (1.217–14.529)
0.023
—
NS
Multiple (n = 7)
—
0.594
Necrosis
No (n = 147)
5.009 (1.528–16.415)
0.008
—
NS
Yes (n = 4)
—
—
Nerve invasion
No (n = 134)
11.466 (2.224–59.130)
0.004
7.685 (1.433–41.209)
0.017
Yes (n = 17)
1.003 (0.103–9.804)
0.998
Vascular invasion
No (n = 131)
5.136 (1.379–19.131)
0.015
4.789 (1.241–18.473)
0.023
(n = 20)
5.831 (0.347–97.939)
0.221
Lymph node metastasis
No (n = 139)
2.286 (0.418–12.493)
0.340
Yes (n = 12)
6.078 (0.674–54.824)
0.108
Histological grade
G1 (n = 71)
—
0.758
G2 (n = 80)
5.112 (1.442–18.124)
0.012
—
NS
AJCC stage
I (n = 52)
—
0.756
II (n = 86)
3.466 (0.579–20.750)
0.173
III (n = 13)
7.332 (0.813–66.154)
0.076
PNEN, pancreatic neuroendocrine neoplasm; AJCC, American Joint Committee on Cancer; ALB, albumin; ALP, alkaline phosphatase; APAR, alkaline phosphatase-to-albumin ratio; HR, hazard ratio; CI, confidence interval; NS, not significant.