Association between alkaline phosphatase levels and mortality in Chinese patients with colorectal cancer with liver metastases: a retrospective cohort study

Background: Alkaline phosphatase (ALP) is a potential cancer biomarker. However, its prognostic value in patients with colorectal liver metastasis remains unclear. Objectives: This study aimed to investigate the association between ALP levels and mortality risk in patients with colorectal liver meta...

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Main Authors: ZhaoXi Liu, ZiQing Zhang, GuoFang Yu, MingJiang Mo, ChuanYu Xie, DangHan Xu, JieTao Lin, YuChen Zhang, Li Deng, YiChang Luo, YingFeng Huang, Cui Shao
Format: Article
Language:English
Published: SAGE Publishing 2025-01-01
Series:Therapeutic Advances in Gastroenterology
Online Access:https://doi.org/10.1177/17562848241311114
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author ZhaoXi Liu
ZiQing Zhang
GuoFang Yu
MingJiang Mo
ChuanYu Xie
DangHan Xu
JieTao Lin
YuChen Zhang
Li Deng
YiChang Luo
YingFeng Huang
Cui Shao
author_facet ZhaoXi Liu
ZiQing Zhang
GuoFang Yu
MingJiang Mo
ChuanYu Xie
DangHan Xu
JieTao Lin
YuChen Zhang
Li Deng
YiChang Luo
YingFeng Huang
Cui Shao
author_sort ZhaoXi Liu
collection DOAJ
description Background: Alkaline phosphatase (ALP) is a potential cancer biomarker. However, its prognostic value in patients with colorectal liver metastasis remains unclear. Objectives: This study aimed to investigate the association between ALP levels and mortality risk in patients with colorectal liver metastases (CRLM), providing insights for enhancing prognostic assessments. Design: Retrospective cohort study. Methods: This study included 195 patients with CRLM from a single centre in China. ALP level was the primary exposure variable, with demographic, clinical and pathological factors serving as covariates. Multivariate Cox regression analyses were used to evaluate the impact of ALP on mortality over a 4-year follow-up period. Covariates included the number of liver metastases, T stage, N stage, chemotherapy, tumour location, primary surgery, topical treatment, apolipoprotein A1, targeted therapy, tumour type, CA-199 levels, metastatic surgery, sex, Karnofsky Performance Status and age. Results: Of 195 enrolled patients, 134 (68.72%) were male, and 61 (31.28%) were female, with ages ranging from January 2008 to December 2019. A total of 147 patients (76.96%) were diagnosed with left hemicolon cancer and 44 (23.04%) with right hemicolon cancer. After adjusting for the covariates, elevated ALP levels were significantly associated with an increased risk of mortality (hazard ratio = 1.24, 95% confidence interval: 1.08–1.43, p  = 0.0029). Sensitivity analyses confirmed the robustness of these findings, reinforcing the association across different analytical approaches. Conclusion: ALP level is a valuable prognostic indicator in patients with CRLM. Integrating ALP measurement into clinical practice may enhance risk stratification and patient management. Future research should explore the role of ALP in broader populations and explore its implications for treatment strategies.
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spelling doaj-art-dfa2a4ddd3b640c09795455e8a520d912025-01-22T13:03:27ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482025-01-011810.1177/17562848241311114Association between alkaline phosphatase levels and mortality in Chinese patients with colorectal cancer with liver metastases: a retrospective cohort studyZhaoXi LiuZiQing ZhangGuoFang YuMingJiang MoChuanYu XieDangHan XuJieTao LinYuChen ZhangLi DengYiChang LuoYingFeng HuangCui ShaoBackground: Alkaline phosphatase (ALP) is a potential cancer biomarker. However, its prognostic value in patients with colorectal liver metastasis remains unclear. Objectives: This study aimed to investigate the association between ALP levels and mortality risk in patients with colorectal liver metastases (CRLM), providing insights for enhancing prognostic assessments. Design: Retrospective cohort study. Methods: This study included 195 patients with CRLM from a single centre in China. ALP level was the primary exposure variable, with demographic, clinical and pathological factors serving as covariates. Multivariate Cox regression analyses were used to evaluate the impact of ALP on mortality over a 4-year follow-up period. Covariates included the number of liver metastases, T stage, N stage, chemotherapy, tumour location, primary surgery, topical treatment, apolipoprotein A1, targeted therapy, tumour type, CA-199 levels, metastatic surgery, sex, Karnofsky Performance Status and age. Results: Of 195 enrolled patients, 134 (68.72%) were male, and 61 (31.28%) were female, with ages ranging from January 2008 to December 2019. A total of 147 patients (76.96%) were diagnosed with left hemicolon cancer and 44 (23.04%) with right hemicolon cancer. After adjusting for the covariates, elevated ALP levels were significantly associated with an increased risk of mortality (hazard ratio = 1.24, 95% confidence interval: 1.08–1.43, p  = 0.0029). Sensitivity analyses confirmed the robustness of these findings, reinforcing the association across different analytical approaches. Conclusion: ALP level is a valuable prognostic indicator in patients with CRLM. Integrating ALP measurement into clinical practice may enhance risk stratification and patient management. Future research should explore the role of ALP in broader populations and explore its implications for treatment strategies.https://doi.org/10.1177/17562848241311114
spellingShingle ZhaoXi Liu
ZiQing Zhang
GuoFang Yu
MingJiang Mo
ChuanYu Xie
DangHan Xu
JieTao Lin
YuChen Zhang
Li Deng
YiChang Luo
YingFeng Huang
Cui Shao
Association between alkaline phosphatase levels and mortality in Chinese patients with colorectal cancer with liver metastases: a retrospective cohort study
Therapeutic Advances in Gastroenterology
title Association between alkaline phosphatase levels and mortality in Chinese patients with colorectal cancer with liver metastases: a retrospective cohort study
title_full Association between alkaline phosphatase levels and mortality in Chinese patients with colorectal cancer with liver metastases: a retrospective cohort study
title_fullStr Association between alkaline phosphatase levels and mortality in Chinese patients with colorectal cancer with liver metastases: a retrospective cohort study
title_full_unstemmed Association between alkaline phosphatase levels and mortality in Chinese patients with colorectal cancer with liver metastases: a retrospective cohort study
title_short Association between alkaline phosphatase levels and mortality in Chinese patients with colorectal cancer with liver metastases: a retrospective cohort study
title_sort association between alkaline phosphatase levels and mortality in chinese patients with colorectal cancer with liver metastases a retrospective cohort study
url https://doi.org/10.1177/17562848241311114
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