ALB and neoplasm: It remains unclear why lower AAPR increases the risk of tumor relapses and mortality; however there is one possibility that should be addressed: AAPR is calculated from serum ALB concentration divided by serum ALP concentration, indicating that nutritional deficiency and systemic inflammatory response might be involved in the development and progress of RCC when AAPR performed for its prognostic impact on tumor recurrence and metastasis.