A retrospective study of 327 completely treated oral squamous-cell carcinoma patients from 2008-2018 evaluated pretreatment albumin-to-alkaline phosphatase ratio. A cutoff of 0.52 did not significantly distinguish overall or disease-free survival and was not an independent prognostic factor.
Key findings
- Reported overall and disease-free survival rates were 84.76% and 55.33%. AAPR at or above 0.52 versus below it did not differ for OS (86.32% vs 81.03%, p=0.275) or DFS (55.18% vs 55.65%, p=0.539). Older age and extranodal extension independently predicted worse OS and DFS.
Why this matters globally
Routine-blood biomarkers are attractive because they are accessible, but they must add value beyond stage and pathology. This study underscores the importance of publishing negative results and validating prognostic scores within each cancer type before adoption.
Thai researcher contribution
Prince of Songkla University's otolaryngology and head-and-neck surgery team analyzed long-term Thai clinical data and transparently reported a result that did not support the biomarker hypothesis.
Limitations to consider
This was a single-center retrospective cohort spanning a decade during which treatment and follow-up may have changed. Restricting analysis to completely treated patients may introduce selection bias, and deriving a cutoff in the same dataset risks overfitting. A null result does not exclude utility in every subgroup.