Research Article

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.  ≤1.95Univariate analysisMultivariate analysis
HR (95% CI)HR (95% CI)

Gender
 Male (n = 71)6.767 (1.130–40.518)0.036NS
 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)0.018NS
Nonfunctioning
 No (n = 116)5.326 (1.541–18.407)0.008NS
 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)0.032NS
Cystic component
 No (n = 129)4.438 (1.354–14.547)0.014NS
 Yes (n = 22)
No. of primary lesions
 Single (n = 144)4.205 (1.217–14.529)0.023NS
 Multiple (n = 7)0.594
Necrosis
 No (n = 147)5.009 (1.528–16.415)0.008NS
 Yes (n = 4)
Nerve invasion
 No (n = 134)11.466 (2.224–59.130)0.0047.685 (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)0.0154.789 (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)0.012NS
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.