Cheng X, Zhou X, Yi M, et al. - Among patients with primary non-muscle-invasive bladder cancer (NMIBC), a high preoperative aspartate transaminase/alanine transaminase (AST/ALT) ratio was associated with poorer recurrence-free survival (RFS) and progression-free survival (PFS) than a low AST/ALT ratio. Increased preoperative AST/ALT ratio may be considered as a valuable prognostic biomarker for predicting early recurrence as well as progression in primary NMIBC.

• This study included 314 patients with primary NMIBC who had transurethral resection of bladder tumor.

• Full cohorts were split into a low AST/ALT ratio group and a high AST/ALT ratio group based on the optimal cut-off value which was 1.40.

• Following propensity score matching, poorer RFS and PFS were evident in patients with a high AST/ALT ratio vs those with a low AST/ALT ratio.

• Preoperative AST/ALT ratio was thought to be an independent prognostic factor of RFS (HR 2.865) and PFS (HR 4.771).