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Bao Z, Li G, He F, Xu X, Liu Z, Wang J. The prognostic value of preoperative plasma fibrinogen in Asian patients with urothelial cancer: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1360595. [PMID: 39268235 PMCID: PMC11390423 DOI: 10.3389/fendo.2024.1360595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 08/14/2024] [Indexed: 09/15/2024] Open
Abstract
Objective We conducted this meta-analysis to comprehensively explore the prognostic value of the preoperative plasma fibrinogen in Asian patients diagnosed with urothelial cancer (UC). Methods After a systematic search of Web of Science, PubMed, and Embase before May 2024, we included 10 studies in our meta-analysis. The hazard ratios (HRs) with 95% confidence interval (CI) for overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and progression free survival (PFS) were estimated using fixed effect model. Results This meta-analysis included a total of 2875 patients. UC patients with an elevated preoperative plasma fibrinogen had worse OS (pooled HR: 2.13, 95% CI: 1.81-2.51; P<0.001), CSS (pooled HR: 2.22, 95% CI: 1.83-2.70; P<0.001), RFS (pooled HR: 1.90, 95% CI: 1.59-2.27; P<0.001), and PFS (pooled HR: 2.12, 95% CI: 1.36-3.29, P=0.001). No significant heterogeneity or publication bias was found. Additionally, statistically significant pooled HRs were also calculated in subgroup analysis when stratified by cancer type, country, and cut-off value. Conclusions The presence of elevated preoperative plasma fibrinogen levels is significantly correlated with unfavorable tumor outcomes in UCs.
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Affiliation(s)
- Zhengqing Bao
- Department of Urology Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Guizhong Li
- Department of Urology Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Feng He
- Department of Urology Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Xiao Xu
- Department of Urology Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Zhenhua Liu
- Department of Urology Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Jianwei Wang
- Department of Urology Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
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Zou JF, Li ST, Wang LP, Zhou NL, Ran JJ, Yang X, Tian CH, Liu YT, Liu Y, Peng W. Diagnostic Value of Nutritional Risk Index and Other Indices for Predicting Sarcopenia in the Middle-Aged and Elderly Population of China Without Cancer: A ROC Curve Analysis. Int J Gen Med 2024; 17:2527-2538. [PMID: 38841128 PMCID: PMC11152168 DOI: 10.2147/ijgm.s457252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024] Open
Abstract
Background Emerging evidence suggests that systemic inflammatory and nutritional biomarkers, along with derived indices, could serve as predictors for sarcopenia in cancer population. This study aimed to compare these predictors, focusing on the nutritional risk index (NRI) and evaluate its diagnostic value, for sarcopenic patients without cancer. Methods This cross-sectional retrospective study included 1674 participants. Sarcopenia is defined by skeletal muscle mass index (SMI). Laboratory data reflected the values of systemic inflammatory and nutritional biomarkers, from which the derived indices were calculated. Multiple logistic regression analysis, ROC curve analysis, and the Youden index were utilized to assess the association between these markers and sarcopenia and determine the cutoff value for predicting sarcopenia. Results Among all participants (1110 men and 564 women, mean age 61.97 ± 9.83 years), 398 individuals were diagnosed with sarcopenia, indicating a prevalence of 23.78% in China's middle-aged and elderly population without cancer. Logistic regression analysis revealed significant associations between all biomarkers and derived indices with sarcopenia. Following adjustment for potential confounders, lower NRI values were significantly associated with a higher incidence of sarcopenia. For sarcopenia diagnosis, the area under the curve (AUC) for NRI was 0.769 ([95% CI, 0.742, 0.796], P < 0.001), with a cutoff value of 106.016, sensitivity of 75.6% and specificity of 66.1%. NRI demonstrated greater predictive advantage for sarcopenia incidence in men compared to women. Conclusion A lower NRI value was associated with a higher prevalence of sarcopenia. NRI shows promise for early, rapid, and effective sarcopenia screening, particularly in China's middle-aged and elderly male population without cancer.
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Affiliation(s)
- Jing-Feng Zou
- Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, People’s Republic of China
| | - Shao-Tian Li
- Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, People’s Republic of China
| | - Li-Ping Wang
- Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, People’s Republic of China
| | - Nian-Li Zhou
- Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, People’s Republic of China
| | - Jia-Jia Ran
- Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, People’s Republic of China
| | - Xin Yang
- Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, People’s Republic of China
| | - Chun-Hui Tian
- Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, People’s Republic of China
| | - Yi-Ting Liu
- Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, People’s Republic of China
| | - Yun Liu
- Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, People’s Republic of China
| | - Wen Peng
- Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, People’s Republic of China
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Wang Q, Ye J, Chen Z, Liao X, Wang X, Zhang C, Zheng L, Han P, Wei Q, Bao Y. Preoperative Systemic Inflammation Score Predicts the Prognosis of Patients with Upper Tract Urothelial Carcinoma Undergoing Radical Nephroureterectomy. J Clin Med 2024; 13:791. [PMID: 38337485 PMCID: PMC10856497 DOI: 10.3390/jcm13030791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Background: To investigate the prognostic significance of systemic inflammation score (SIS) in upper tract urothelial carcinoma (UTUC) in patients undergoing radical nephroureterectomy (RNU). Methods: A total of 313 UTUC patients who underwent RNU at West China Hospital from May 2014 to June 2019 were retrospectively analyzed. The predictive value of SIS for relevant endpoints, including overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS), was assessed by Kaplan-Meier curves and the Cox proportional hazards model. Results: According to inclusion and exclusion criteria, 218 UTUC patients were ultimately included in this cohort study. Statistical analysis shows that increased SIS was significantly associated with higher TNM stage (p = 0.017), lower BMI (p = 0.037), absence of hemoglobin (p < 0.001), and pathologic necrosis (p = 0.007). Kaplan-Meier survival curves clearly visually stratified survival for the three outcomes. After adjusting for tumor grade, the multivariate Cox proportional hazards model results showed that SIS was an independent risk factor for poor OS and CSS (HR = 1.89, 95% CI: 1.11-3.21, p = 0.0183, HR = 1.89, 95% CI: 1.07-3.33, p = 0.0285) in the advanced group. Conclusions: SIS was an independent risk factor for OS and CSS after RNU in patients with high-grade UTUC. It may be a novel and conducive tool for preoperative risk stratification and guiding individualized therapy for high-risk UTUC patients.
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Affiliation(s)
- Qihao Wang
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Q.W.); (J.Y.); (Z.C.); (X.L.); (X.W.); (C.Z.); (L.Z.); (P.H.)
- West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - Jianjun Ye
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Q.W.); (J.Y.); (Z.C.); (X.L.); (X.W.); (C.Z.); (L.Z.); (P.H.)
- West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - Zeyu Chen
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Q.W.); (J.Y.); (Z.C.); (X.L.); (X.W.); (C.Z.); (L.Z.); (P.H.)
- West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - Xinyang Liao
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Q.W.); (J.Y.); (Z.C.); (X.L.); (X.W.); (C.Z.); (L.Z.); (P.H.)
| | - Xingyuan Wang
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Q.W.); (J.Y.); (Z.C.); (X.L.); (X.W.); (C.Z.); (L.Z.); (P.H.)
- West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - Chichen Zhang
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Q.W.); (J.Y.); (Z.C.); (X.L.); (X.W.); (C.Z.); (L.Z.); (P.H.)
- West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - Lei Zheng
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Q.W.); (J.Y.); (Z.C.); (X.L.); (X.W.); (C.Z.); (L.Z.); (P.H.)
- West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - Ping Han
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Q.W.); (J.Y.); (Z.C.); (X.L.); (X.W.); (C.Z.); (L.Z.); (P.H.)
| | - Qiang Wei
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Q.W.); (J.Y.); (Z.C.); (X.L.); (X.W.); (C.Z.); (L.Z.); (P.H.)
| | - Yige Bao
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Q.W.); (J.Y.); (Z.C.); (X.L.); (X.W.); (C.Z.); (L.Z.); (P.H.)
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Wei L, Wu Y, Bo J, Fu B, Sun M, Zhang Y, Xiong B, Dong J. Dual-Energy Computed Tomography Parameters Combined With Inflammatory Indicators Predict Cervical Lymph Node Metastasis in Papillary Thyroid Cancer. Cancer Control 2024; 31:10732748241262177. [PMID: 38881040 PMCID: PMC11181884 DOI: 10.1177/10732748241262177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 05/26/2024] [Accepted: 05/30/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Cervical lymph node metastasis (CLNM) is considered a marker of papillar Fethicy thyroid cancer (PTC) progression and has a potential impact on the prognosis of PTC. The purpose of this study was to screen for predictors of CLNM in PTC and to construct a predictive model to guide the surgical approach in patients with PTC. METHODS This is a retrospective study. Preoperative dual-energy computed tomography images of 114 patients with pathologically confirmed PTC between July 2019 and April 2023 were retrospectively analyzed. The dual-energy computed tomography parameters [iodine concentration (IC), normalized iodine concentration (NIC), the slope of energy spectrum curve (λHU)] of the venous stage cancer foci were measured and calculated. The independent influencing factors for predicting CLNM were determined by univariate and multivariate logistic regression analysis, and the prediction models were constructed. The clinical benefits of the model were evaluated using decision curves, calibration curves, and receiver operating characteristic curves. RESULTS The statistical results show that NIC, derived neutrophil-to-lymphocyte ratio (dNLR), prognostic nutritional index (PNI), gender, and tumor diameter were independent predictors of CLNM in PTC. The AUC of the nomogram was .898 (95% CI: .829-.966), and the calibration curve and decision curve showed that the prediction model had good predictive effect and clinical benefit, respectively. CONCLUSION The nomogram constructed based on dual-energy CT parameters and inflammatory prognostic indicators has high clinical value in predicting CLNM in PTC patients.
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Affiliation(s)
- Longyu Wei
- Department of Graduate, Bengbu Medical University, Bengbu, China
| | - Yaoyuan Wu
- Department of Radiology, Anhui Provincial Cancer Hospital, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Juan Bo
- Department of Radiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Baoyue Fu
- Department of Graduate, Bengbu Medical University, Bengbu, China
| | - Mingjie Sun
- Department of Radiology, Wannan Medical College, Wuhu, China
| | - Yu Zhang
- Department of Radiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Baizhu Xiong
- Department of Graduate, Bengbu Medical University, Bengbu, China
| | - Jiangning Dong
- Department of Graduate, Bengbu Medical University, Bengbu, China
- Department of Radiology, Anhui Provincial Cancer Hospital, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
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Luo Z, Jiao B, Yan Y, Su C, Pan Y, Zhao H, Bo Y, Zhang G, Ding Z. Risk factors for extraurothelial recurrence in upper tract urothelial carcinoma after radical nephroureterectomy: a retrospective study based on a Chinese population. Front Oncol 2023; 13:1164464. [PMID: 37621681 PMCID: PMC10445394 DOI: 10.3389/fonc.2023.1164464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 07/20/2023] [Indexed: 08/26/2023] Open
Abstract
Objectives The risk factors for extraurothelial recurrence (EUR) after radical nephroureterectomy (RNU) in patients with upper urinary tract urothelial carcinoma (UTUC) are currently inconsistent and unclear. In this study, we aimed to identify these risk factors and develop a grading system for EUR. Methods We retrospectively analyzed 220 patients who underwent RNU for UTUC in our center from January 2009 to December 2020. Overall survival (OS) and extraurothelial recurrence-free survival (EURFS) were compared using the Kaplan-Meier curve with a log-rank test. Univariate and multivariate Cox regression models were applied to identify the independent risk factors related to EUR. Results The median follow-up period was 42 (range: 2-143) months. Of the 220 patients, 61 patients developed EUR in our cohort, which had worse survival outcome. Multivariate Cox regression analysis showed pathologic stage, lymph node (LN) status, lymphovascular invasion (LVI), Ki-67, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were independent risk factors for EUR. The Kaplan-Meier curves revealed a significant difference in EUR among the three risk groups. Conclusion Our study suggests that pathologic stage, LN status, LVI, Ki-67, NLR, and PLR are independent risk factors for EUR in UTUC patients after RNU. The development of a grading system for EUR risk stratification may assist urologists in making clinical decisions regarding the management of UTUC.
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Affiliation(s)
- Zhenkai Luo
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Binbin Jiao
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yangxuanyu Yan
- Peking University, China-Japan Friendship School Clinical Medicine, Beijing, China
- Department of Urology, China-Japan Friendship Hospital, Beijing, China
| | - Caixia Su
- School of Public Health, Peking University, Beijing, China
| | - Yijin Pan
- Peking University, China-Japan Friendship School Clinical Medicine, Beijing, China
- Department of Urology, China-Japan Friendship Hospital, Beijing, China
| | - Hang Zhao
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yuxuan Bo
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guan Zhang
- Department of Urology, China-Japan Friendship Hospital, Beijing, China
| | - Zhenshan Ding
- Department of Urology, China-Japan Friendship Hospital, Beijing, China
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Chen H, Liu S, Li X, Wang Z, Zhang C. Prognostic analysis of inflammatory response-related genes and biomarkers in patients with urothelial carcinoma of ureter. Front Genet 2023; 14:1139412. [PMID: 36936427 PMCID: PMC10017875 DOI: 10.3389/fgene.2023.1139412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Ureteral urothelial carcinoma is a common urinary system tumor, accounting for 40% to 60% of all ureteral diseases. This study attempted to analyze the prognosis of patients with urothelial carcinoma, judging ureteral urothelial carcinoma by genes and biomarkers of inflammatory response. In this paper, co-expression network analysis and gene-based image fusion evaluation methods were proposed to obtain the prognosis results of patients with ureteral urothelial carcinoma. The experimental results showed that the levels of PLR and NLR increased, and the levels of HGB and HCT decreased; high PLR and high NLR levels, low HGB and low HCT levels were all risk factors affecting bladder urothelial carcinoma, and their ratios (OR) were 1.023, 1.611, 0.961, 0.859, 1.015, 1.072, 0.979, and 0.951, respectively. However, high PLR and high NLR levels were independent risk factors for bladder urothelial carcinoma, and their OR values were 1.497 and 1.071, respectively. Through biomarker diagnosis, the area under the curve, sensitivity, specificity and Youden index of hsa-mir-17, hsa-mir-93, hsa-mir-429 and hsa-mir-20a all exceeded 0.9, indicating that this is a potential diagnostic indicators. All in all, during the treatment of ureteral cancer, in order to reduce tumor recurrence, systemic therapy should be combined with ureteral cancer. In addition, this study also analyzed the prognosis of chemotherapy patients, and the results showed that immunotherapy may increase the risk of tumor cell reperfusion during chemotherapy.
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Tan D, Li J, Lin T, Tan P, Zhang J, Xiong Q, Jiang J, Li Y, Zhang P, Wei Q. Prognostic Utility of the Modified Glasgow Prognostic Score in Urothelial Carcinoma: Outcomes from a Pooled Analysis. J Clin Med 2022; 11:jcm11216261. [PMID: 36362488 PMCID: PMC9655933 DOI: 10.3390/jcm11216261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/16/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Many studies explored the prognostic value of the modified Glasgow Prognostic Score (mGPS) in urothelial carcinoma (UC), but the results are controversial. This study aimed to quantify the relationship between pretreatment mGPS and survival in patients with UC. Methods: A systematic literature search was conducted using Embase, PubMed, and Web of Science to identify eligible studies published before August 2022. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the association between pretreatment mGPS and the prognosis of UC. Results: Thirteen eligible studies involving 12,524 patients were included. A high mGPS was significantly associated with poor overall survival (mGPS 1/0: HR = 1.33, 95% CI 1.12−1.58, p = 0.001; mGPS 2/0: HR = 2.02, 95% CI 1.43−2.84, p < 0.0001), progression-free survival (mGPS 1/0: HR = 1.26, 95% CI 1.03−1.53, p = 0.021; mGPS 2/0: HR = 1.76, 95% CI 1.12−2.77, p = 0.013), recurrence-free survival (mGPS 1/0: HR = 1.36, 95% CI 1.18−1.56, p < 0.0001; mGPS 2/0: HR = 1.70, 95% CI 1.44−2.000, p < 0.0001), and cancer-specific survival (mGPS 2/0: HR = 1.81, 95% CI 1.30−2.52, p < 0.0001). A subgroup analysis of OS also yielded similar results. Conclusions: Evidence suggests that high pretreatment mGPS in UC is closely related to poor survival. Pre-treatment mGPS is a powerful independent prognostic factor in patients with UC.
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Affiliation(s)
- Daqing Tan
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
- Department of Urology, Minda Hospital of Hubei Minzu University, Enshi 445000, China
| | - Jinze Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Tianhai Lin
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ping Tan
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jiapeng Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiao Xiong
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jinjiang Jiang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yifan Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Peng Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence: (P.Z.); (Q.W.)
| | - Qiang Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence: (P.Z.); (Q.W.)
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Meng C, Gan L, Li K, Yi F, Peng L, Li J, Li Y. Prognostic nutritional index before surgical treatment may serve as a prognostic biomarker for patients with upper tract urothelial carcinoma: A systematic review and meta-analysis. Front Nutr 2022; 9:972034. [PMID: 36211527 PMCID: PMC9538959 DOI: 10.3389/fnut.2022.972034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThis meta-analysis aims to assess whether the prognostic nutritional index (PNI) score before treatment can be an independent biomarker of the prognosis of patients with upper tract urothelial carcinoma (UTUC).Materials and methodsWe systematically search PubMed, Embase, Scopus database, and Cochrane Library, and the search time is up to April 2021. Use STATA 16.0 software for data processing and statistical analysis.ResultsSix studies, including seven cohorts, were eventually included in our meta-analysis. The meta-analysis results showed that low PNI scores are associated with worse OS (HR: 1.92; 95% CI 1.60 to 2.30; P < 0.01), DFS/RFS/PFS (HR: 1.57; 95% CI 1.33 to 1.85; P < 0.01), and CSS/DSS (HR: 1.79; 95% CI 1.49 to 2.16; P < 0.01), which supported the PNI score as an independent prognostic biomarker for survival outcomes. The subgroup analysis and Begg’s test showed that the results were stable.ConclusionBased on current evidence, this meta-analysis proves that the PNI score of UTUC patients before treatment is an independent prognostic biomarker. It performs well on OS, DFS/RFS/PFS, and CSS/DSS. This conclusion needs to be verified by a prospective cohort study with larger sample size and a more rigorous design.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022338503], identifier [CRD42022338503].
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Affiliation(s)
- Chunyang Meng
- Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China
| | - Lijian Gan
- Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China
| | - Kangsen Li
- Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China
| | - Fulin Yi
- Department of Anesthesiology, North Sichuan Medical College (University), Nanchong, China
| | - Lei Peng
- Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China
| | - Jinze Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yunxiang Li
- Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China
- *Correspondence: Yunxiang Li,
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The prognostic value of the Controlling Nutritional Status score on patients undergoing nephrectomy for upper tract urothelial carcinoma or renal cell carcinoma: a systematic review and meta-analysis. Br J Nutr 2022; 128:217-224. [PMID: 34338171 DOI: 10.1017/s0007114521002889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In recent years, the controlling nutritional status (CONUT) score has increasingly became an effective indicator associated with tumor prognosis. This study was conducted to synthesise data on the prognostic value of CONUT score on patients with upper tract urothelial carcinoma (UTUC) or renal cell carcinoma (RCC) undergoing nephrectomy. We designed and performed a systematic analysis of studies that verified the correlation between preoperative CONUT score and prognosis for UTUC and RCC using PubMed, Web of Science and Embase. The conclusion was clarified by pooled hazard ratios (HR) and 95% confidence intervals (95% CI). Subgroup analysis were further conducted in accordance with different primary tumor. Six studies involving 3529 patients were included in this evidence synthesis, which revealed that the CONUT score had a potential role to predict the survival of UTUC and RCC patients accepting surgery. Pooled analysis showed that the overall survival (OS, HR 2·32, p < 0·0001), cancer-specific survival (CSS, HR 2·68, p < 0·0001) and disease-free survival (DFS, HR 1·62, p < 0·00001) were inferior in the high CONUT score group when compared with low score group. Subgroup analysis revealed that this result was in line with UTUC (OS: HR 1·86, p = 0·02; CSS: HR 2·24, p = 0·01; DFS: HR 1·54, p < 0·00001) and RCC (OS: HR 3·05, p < 0·00001; CSS: HR 3·47, p < 0·00001; DFS: HR 2·21, p = 0·0005) patients respectively. Consequently, the CONUT score is a valuable preoperative index to predict the survival of patients with UTUC or RCC undergoing nephrectomy.
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Miyake M, Iida K, Nishimura N, Inoue T, Matsumoto H, Matsuyama H, Fujiwara Y, Komura K, Inamoto T, Azuma H, Yasumoto H, Shiina H, Yonemori M, Enokida H, Nakagawa M, Fukuhara H, Inoue K, Yoshida T, Kinoshita H, Matsuda T, Fujii T, Fujimoto K. Site-specific Risk Stratification Models for Postoperative Recurrence and Survival Prediction in Patients with Upper Tract Urothelial Carcinoma Undergoing Radical Nephroureterectomy: Better Stratification for Adjuvant Therapy. EUR UROL SUPPL 2022; 41:95-104. [PMID: 35813249 PMCID: PMC9257658 DOI: 10.1016/j.euros.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 11/29/2022] Open
Abstract
Background Site-specific postoperative risk models for localized upper tract urothelial carcinoma (UTUC) are unavailable. Objective To create specific risk models for renal pelvic urothelial carcinoma (RPUC) and ureteral urothelial carcinoma (UUC), and to compare the predictive accuracy with the overall UTUC risk model. Design, setting, and participants A multi-institutional database retrospective study of 1917 UTUC patients who underwent radical nephroureterectomy (RNU) between 2000 and 2018 was conducted. Outcome measurements and statistical analysis A multivariate hazard model was used to identify the prognostic factors for extraurinary tract recurrence (EUTR), cancer-specific death (CSD), and intravesical recurrence (IVR) after RNU. Patients were stratified into low-, intermediate-, high-, and highest-risk groups. External validation was performed to estimate a concordance index of the created risk models. We investigated whether our risk models could aid decision-making regarding adjuvant chemotherapy (AC) after RNU. Results and limitations The UTUC risk models could stratify the risk of cumulative incidence of three endpoints. The RPUC- and UUC-specific risk models showed better stratification than the overall UTUC risk model for all the three endpoints, EUTR, CSD, and IVR (RPUC: concordance index, 0.719 vs 0.770, 0.714 vs 0.794, and 0.538 vs 0.569, respectively; UUC: 0.716 vs 0.767, 0.766 vs 0.809, and 0.553 vs 0.594, respectively). The UUC-specific risk model can identify the high- and highest-risk patients likely to benefit from AC after RNU. A major limitation was the potential selection bias owing to the retrospective nature of this study. Conclusions We recommend using site-specific risk models instead of the overall UTUC risk model for better risk stratification and decision-making for AC after RNU. Patient summary Upper tract urothelial carcinoma comprises renal pelvic and ureteral carcinomas. We recommend using site-specific risk models instead of the overall upper tract urothelial carcinoma risk model in risk prediction and decision-making for adjuvant therapy after radical surgery.
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Affiliation(s)
- Makito Miyake
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
- Corresponding author. Department of Urology, Nara Medical University, 840 Shijo-cho, Nara 634-8522, Japan. Tel. +81 744 22 3051 (ext 2338); Fax: +81 744 22 9282.
| | - Kota Iida
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | | | - Takashi Inoue
- Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Nara, Japan
| | - Hiroaki Matsumoto
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Hideyasu Matsuyama
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Yuya Fujiwara
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Kazumasa Komura
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Teruo Inamoto
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Haruhito Azuma
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Hiroaki Yasumoto
- Department of Urology, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Hiroaki Shiina
- Department of Urology, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Masaya Yonemori
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan
| | - Hideki Enokida
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan
| | - Masayuki Nakagawa
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan
| | - Hideo Fukuhara
- Department of Urology, Kochi Medical School, Kohasu, Oko-cho, Nankoku-shi, Kochi, Japan
| | - Keiji Inoue
- Department of Urology, Kochi Medical School, Kohasu, Oko-cho, Nankoku-shi, Kochi, Japan
| | - Takashi Yoshida
- Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
| | - Hidefumi Kinoshita
- Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
| | - Tadashi Matsuda
- Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
| | - Tomomi Fujii
- Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
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11
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Li S, Chen X, Zheng J, Liu X. Reduced Preoperative Glomerular Filtration Rate Is Associated With Adverse Postoperative Oncological Prognosis in Patients Undergoing Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Retrospective Cohort Study. Front Surg 2022; 9:872273. [PMID: 35548184 PMCID: PMC9082599 DOI: 10.3389/fsurg.2022.872273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To evaluate the association between perioperative estimated glomerular filtration rate (eGFR) and postoperative oncological outcomes in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU),and to evaluate the effect of sex on this association. Methods The medical records of patients with UTUC who underwent RNU between January 2012 and December 2017 at our hospital were retrospectively reviewed. Patients were divided into three groups based on preoperative eGFRs: normal eGFR (>60 mL/min/1.73 m2; n = 179), moderately reduced eGFR (45-60 mL/min/1.73 m2; n = 45), and severely reduced eGFR (≤ 45 mL/min/1.73 m2; n = 36). Statistical analyses were performed to evaluate the prognostic impact of preoperative eGFR on prognosis. Results Patient mean age was 66.7 ± 9.6 years, and 47.9% were female. Multivariate regression analysis based on Cox proportional risk models and Kaplan-Meier survival rates showed that lower preoperative eGFR was associated with decreased OS, PFS, and CSS. In the adjusted Cox regression model, patients with normal and moderately reduced eGFRs had a decreased hazard for mortality, with adjusted hazard ratios of 0.13 [95% confidence interval (CI): 0.07-0.26] and 0.36 (95% CI: 0.18-0.73), respectively (P < 0.001). The smooth fitting curve suggested a linear relationship between eGFR and prognostic survival. Additionally, sensitivity subgroup analyses verified an inverse relationship between the reduced eGFR and OS. Women had a lower eGFR and worse oncological outcomes than men. A nomogram for OS was developed based on multivariate analysis with a C-index of 0.754 (95% CI: 0.728-0.779). Conclusion Preoperative renal insufficiency is strongly associated with a higher risk of cancer progression and a lower survival probability. It is important to identify preoperative renal insufficiency in patients with UTUC, particularly female patients.
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Affiliation(s)
| | | | | | - Xuefeng Liu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
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12
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Liu J, Wu P, Lai S, Song X, Wang M, Wang X, Liu S, Hou H, Zhang Y, Wang J. Clinicopathological and Prognostic Significance of Preoperative Prognostic Nutritional Index in Patients with Upper Urinary Tract Urothelial Carcinoma. Nutr Cancer 2022; 74:2964-2974. [PMID: 35297733 DOI: 10.1080/01635581.2022.2049829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To investigate the prognostic value of preoperative prognostic nutritional index (PNI) to predict oncological outcome and intravesical recurrence (IVR) in upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). This study involved the clinical data of 255 patients with UTUC who had undergone RNU from 2004 to 2019 at our institution. Patients were grouped according to an optimal value of preoperative PNI. Kaplan-Meier analyses and Cox proportional hazards models were used to analyze the associations of preoperative PNI with progression-free survival (PFS), cancer-specific survival (CSS), overall survival (OS), and IVR. Patients with low PNI were more likely to be older, have higher tumor stage, higher eGFR, and multifocal lesions. No significant association was found between PNI and CSS, IVR. In subgroup analysis according to the risk stratification, low PNI was associated with worse PFS, CSS, and OS for patients with higher risk. Multivariate analyses showed that elevated PNI was an independent prognostic indicator for PFS (P = 0.014) and OS (P = 0.048). A low PNI is an independent predictor of PFS and OS in patients with UTUC after RNU. By subgroup analysis, the prognostic value of PNI was limited to patients with higher risk. PNI may become a useful biomarker to predict oncological outcomes in patients with UTUC after RNU.
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Affiliation(s)
- Jianyong Liu
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Pengjie Wu
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Shicong Lai
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xinda Song
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Miao Wang
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Xuan Wang
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Shengjie Liu
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Huimin Hou
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Yaoguang Zhang
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Jianye Wang
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
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13
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Yu Q, Cen C, Gao M, Yuan H, Liu J. Combination of early Interleukin-6 and -18 levels predicts postoperative nosocomial infection. Front Endocrinol (Lausanne) 2022; 13:1019667. [PMID: 36299462 PMCID: PMC9589414 DOI: 10.3389/fendo.2022.1019667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/23/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The inflammatory response plays a critical role in postoperative nosocomial infections, which are the most common postoperative complications causing adverse events and poor postoperative outcomes. This study aimed to explore the ability of early inflammation-related factor levels to predict the occurrence of nosocomial infections after abdominal surgery. METHODS The study included 146 patients with open abdominal surgery (a nosocomial infection group (NI group, n=42) and a no-nosocomial infection group (NNI group, n=104)). After 1:1 matching, the patients were divided into a matching nosocomial infection group (M-NI group, n=25) and a matching no-nosocomial infection group (M-NNI group, n=25). Serum levels of interleukin (IL)-6, IL-8, IL-10, IL-12, IL-18, macrophage migration inhibitory factor (MIF), and monocyte chemotactic protein (MCP-1) were tested at three time points (pre-operation, 0-hour post-operation (POD1) and 24-hour post-operation (POD2)). The area under the receiver operating characteristic curve (AUC-ROC) was used to test the predictive abilities. RESULTS There were significant differences in the levels of IL-6, IL-12, and IL-18 between the M-NI and M-NNI groups (p < 0.05), but not in the levels of other inflammatory factors. MIF, IL-8, and MCP-1 levels were higher in the M-NI group than in the M-NNI group at POD2 (p < 0.05). In the ROC analysis, the AUC for prediction of nosocomial infection using a combination of IL-6 and IL-18 at POD1 was 0.9616, while the AUCs for IL-6 alone and IL-12 alone were 0.8584 and 0.8256, respectively. CONCLUSIONS The combination of the levels of inflammatory factors, IL-6 and IL-18, at the 0-hour postoperative time point, significantly improved the predictive ability to the development of postoperative infection during perioperative period. Our study suggests the importance of monitoring postoperative inflammatory markers.
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Affiliation(s)
- Qingwei Yu
- Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chaoqun Cen
- Department of Emergency Medicine, Third Xiangya Hospital, Central South University, Changsha, China
| | - Min Gao
- Department of Intensive Medicine, Third Xiangya Hospital, Central South University, Changsha, China
| | - Hong Yuan
- Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jingjing Liu
- Department of Intensive Medicine, Third Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Jingjing Liu,
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14
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Abe S, Nozawa H, Kawai K, Sasaki K, Murono K, Emoto S, Kishikawa J, Ozawa T, Yokoyama Y, Nagai Y, Anzai H, Sonoda H, Ishihara S. Poor nutrition and sarcopenia are related to systemic inflammatory response in patients with rectal cancer undergoing preoperative chemoradiotherapy. Int J Colorectal Dis 2022; 37:189-200. [PMID: 34633498 DOI: 10.1007/s00384-021-04039-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Preoperative chemoradiotherapy (CRT) is the standard therapy for locally advanced rectal cancer (LARC). However, the changes that the patient's physical status during CRT, such as host systemic inflammatory response, nutritional status, and muscle depletion, are still unclear. We evaluated the clinical significance of malnutrition and sarcopenia for patients with LARC undergoing CRT. PATIENTS AND METHODS Patients with LARC treated with CRT following radical surgery at our institution between 2006 and 2016 (N = 225) were retrospectively analyzed. A new prognostic score (PNSI) was devised based on the prognostic nutritional index (PNI) and the psoas muscle mass index (PMI): patients with malnutrition/sarcopenia were scored 2; patients with one and neither abnormality were scored 1 and 0, respectively. RESULTS Neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, and platelet/lymphocyte ratio increased, whereas PNI and PMI decreased after CRT. There were 130, 73, and 22 patients in the PNSI 0, 1, and 2 groups, respectively. Patients with higher PNSI had higher residual tumor size (p = 0.003), yT stage (p = 0.007), ypStage (p < 0.001), post-CRT platelet/lymphocyte ratio (p = 0.027), and post-CRT C-reactive protein/albumin ratio (p < 0.001). Post-CRT PNSI was associated with overall survival and was an independent poor prognosis factor (PNSI 1 to 0, hazard ratio 2.40, p = 0.034, PNSI 2 to 0, hazard ratio 2.66, p = 0.043) together with mesenteric lymph node metastasis, lateral lymph node metastasis, and histology. CONCLUSION A combined score of post-CRT malnutrition/sarcopenia is promising for predicting overall survival in LARC.
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Affiliation(s)
- Shinya Abe
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Hiroaki Nozawa
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kazushige Kawai
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kazuhito Sasaki
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Koji Murono
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Shigenobu Emoto
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Junko Kishikawa
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Tsuyoshi Ozawa
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yuichiro Yokoyama
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yuzo Nagai
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Hiroyuki Anzai
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Hirofumi Sonoda
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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15
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The prognostic significance of controlling nutritional status (CONUT) score for surgically treated renal cell cancer and upper urinary tract urothelial cancer: a systematic review and meta-analysis. Eur J Clin Nutr 2021; 76:801-810. [PMID: 34815539 DOI: 10.1038/s41430-021-01014-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/11/2021] [Accepted: 09/16/2021] [Indexed: 02/05/2023]
Abstract
In order to evaluate the predictive effect of the controlled nutritional status (CONUT) score on the prognosis of patients with renal cell carcinoma (RCC) and upper urinary tract urothelial carcinoma (UTUC), a meta-analysis was performed. This systematic review has been registered on PROSPERO, the registration ID is CRD42021251879. A systematic search of the published literature using PubMed, Web of Science, Cochrane Library, EMBASE, and MEDLINE was performed. The fields of "renal cell cancer," "upper tract urothelial cancer," and "controlling nutritional status" and other fields were used as search terms. STATA 16 software was used to carry out data merging and statistical analysis of binary variables, Q test and χ2 tests were used to verify the heterogeneity between the included works of studies. Subgroup analysis and sensitivity analysis were used to explain the sources of heterogeneity between studies. Begg's test was used to assess publication bias between studies. From the first 542 studies retrieved, through strict inclusion and exclusion criteria, 7 studies finally met the requirements and were included in the meta-analysis. Pooled results indicated that high CONUT indicates worse over survival (OS) [HR = 1.70, 95% CI (1.43-2.03), P = 0.02], cancer-specific survival (CSS) [HR = 1.84, 95% CI (1.52-2.23), P = 0.01], recurrence-free survival (RFS) [HR = 1.60, 95% CI (1.26-2.03), P = 0.116], and disease-free survival (DFS) [HR = 1.47, 95% CI (1.20-1.81), P = 0.03]. Based on cancer type, cutoff value, region, and sample size, a subgroup analysis was performed. The results showed that OS and CSS were not affected by the above factors, and the high CONUT score before surgery predicted worse OS and CSS. In conclusion, this meta-analysis revealed that the preoperative CONUT score is a potential independent predictor of the postoperative prognosis of RCC/UTUC patients. A high CONUT predicts worse OS/CSS/DFS and RFS in patients.
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16
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Wang K, Gu Y, Ni J, Zhang H, Xie J, Xu T, Geng J, Mao W, Peng B. Combination of Total Psoas Index and Albumin-Globulin Score for the Prognosis Prediction of Bladder Cancer Patients After Radical Cystectomy: A Population-Based Study. Front Oncol 2021; 11:724536. [PMID: 34616677 PMCID: PMC8488353 DOI: 10.3389/fonc.2021.724536] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 08/25/2021] [Indexed: 12/04/2022] Open
Abstract
Background Sarcopenia as the loss of skeletal muscle mass is related with poor postoperative survival. This work purposed to evaluate the prognostic prediction of the total psoas index (TPI), albumin–globulin score (AGS), and the combination of TPI and AGS (CTA) in bladder cancer (BCa) patients after radical cystectomy. Methods BCa patients that received radical cystectomy between 2012 and 2020 were retrieved from our medical center. The calculation of TPI was based on the plain computed tomography images. The predictive effects of TPI, AGS, and CTA grade on survival of BCa patients were analyzed and compared with the albumin–globulin ratio (AGR) through the receiver operating characteristic (ROC) curves. A nomogram was further established based on the Cox regression results from CTA grade and clinicopathological characteristics, which are verified by the decision curve analysis (DCA). Results A total of 112 eligible patients diagnosed as BCa were included in this study for retrospective analysis. The patients with lower TPI or higher AGS grade (1/2) contained poorer overall survival (OS) and disease-free survival (DFS). Divided by CTA grade, there were 35 (31.25%) patients in grade 1 associated with the best postoperative prognosis, which was accompanied with increased TPI and decreased AGS. The CTA grade could better predict postoperative outcomes compared with TPI, AGR, and AGS for the highest area under the curve (AUC; 0.674 of OS and 0.681 of DFS). The 3- and 5-year OS and DFS nomograms were conducted based on CTA grade and clinical variables, with a higher predictive performance than the TNM stage. Conclusion This study revealed that the novel index CTA functioned as an effective prognostic predictor for postoperative OS and DFS of BCa patients after radical cystectomy. Preoperative assessment of CTA would contribute to optimizing clinical therapies.
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Affiliation(s)
- Keyi Wang
- Department of Urology, Shanghai Shidong Hospital of Yangpu District, Shanghai, China.,Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yongzhe Gu
- Department of Neurology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jinliang Ni
- Department of Urology, Tenth People's Hospital, Anhui Medical University, Shanghai, China
| | - Houliang Zhang
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jinbo Xie
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Tianyuan Xu
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jiang Geng
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Weipu Mao
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Bo Peng
- Department of Urology, Shanghai Shidong Hospital of Yangpu District, Shanghai, China.,Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Department of Urology, Tenth People's Hospital, Anhui Medical University, Shanghai, China
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17
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Shimizu R, Honda M, Teraoka S, Yumioka T, Yamaguchi N, Kawamoto B, Iwamoto H, Morizane S, Hikita K, Takenaka A. Sarcopenia is associated with survival in patients with urothelial carcinoma treated with systemic chemotherapy. Int J Clin Oncol 2021; 27:175-183. [PMID: 34606022 DOI: 10.1007/s10147-021-02032-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/12/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sarcopenia impacts perioperative outcomes and prognosis in various carcinomas. We aimed to investigate whether sarcopenia at the time of chemotherapy induction in patients with urothelial carcinoma is associated with prognosis. METHODS We evaluated patients treated with chemotherapy for urothelial carcinoma between April 2013 and February 2018 at our institution and affiliated centers. Skeletal muscle mass (total psoas muscle, paraspinal muscle, and total skeletal muscle areas) were used to calculate the total psoas muscle index, paraspinal muscle index, and skeletal muscle index. All participants were grouped as per cutoff points set at the median value for each sex. Overall survival was evaluated using Cox regression analysis. RESULTS Of the 240 patients, 171 were men and 69 were women; mean age during chemotherapy was 71 years (range: 43-88); and 36, 56, and 148 patients were at stages II, III, and IV, respectively. Paraspinal muscle index was most associated with the prognosis; groups with lower paraspinal muscle index were defined as sarcopenic (men: ≤ 20.9 cm2/m2, women: ≤ 16.8 cm2/m2). The overall survival was significantly longer in the non-sarcopenia group including all stages (p = 0.001), and in stage III (p = 0.048) and IV (p = 0.005) patients. There was no significant difference among stage II patients (p = 0.648). After propensity score matching, survival was still significantly longer in the non-sarcopenia group (p = 0.004). CONCLUSIONS Paraspinal muscle index measurements obtained during chemotherapy induction for urothelial carcinoma were independent prognostic factors. The absence of sarcopenia may lead to long-term survival in patients undergoing chemotherapy for urothelial carcinoma.
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Affiliation(s)
- Ryutaro Shimizu
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8504, Japan.
| | - Masashi Honda
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8504, Japan
| | - Shogo Teraoka
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8504, Japan
| | - Tetsuya Yumioka
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8504, Japan
| | - Noriya Yamaguchi
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8504, Japan
| | - Bunya Kawamoto
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8504, Japan
| | - Hideto Iwamoto
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8504, Japan
| | - Shuichi Morizane
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8504, Japan
| | - Katsuya Hikita
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8504, Japan
| | - Atsushi Takenaka
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8504, Japan
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Hashimoto M, Fujita K, Nakayama T, Fujimoto S, Hamaguchi M, Nishimoto M, Kikuchi T, Adomi S, Banno E, De Velasco MA, Saito Y, Shimizu N, Mori Y, Minami T, Nozawa M, Nose K, Yoshimura K, Uemura H. Higher neutrophil-to-lymphocyte ratio after the first cycle of the first-line chemotherapy is associated with poor cancer specific survival of upper urinary tract carcinoma patients. Transl Androl Urol 2021; 10:2838-2847. [PMID: 34430386 PMCID: PMC8350230 DOI: 10.21037/tau-21-185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/19/2021] [Indexed: 01/29/2023] Open
Abstract
Background Inflammatory cytokines and immature myeloid derived suppressor cells (MDSCs), which increase during cancer progression, could lead to a neutrophil increase and lymphocyte reduction. Thus, the neutrophil-lymphocyte ratio (NLR) was used to predict survival of patients suffering from urological cancers including upper urinary tract carcinoma. We further determined whether the NLR during the first cycle of first-line chemotherapy could predict cancer specific survival. Methods We recruited patients with locally advanced or metastatic upper urinary tract urothelial carcinoma (UTUC) who received chemotherapy between January 2014 and July 2019. We investigated the impact of various clinical variables, including age, sex, performance status, and estimated creatinine clearance (CCr), and NLR before and after the first cycle of the first-line chemotherapy on prognosis. Results A total of 41 patients were included in our study. Cancer specific survival of the patients with lower NLR was significantly better than that of the patients with higher NLR measured after the first cycle of the first-line chemotherapy (log-rank test P=0.005, median 29.2 vs. 11.9 months, respectively). Cox proportional regression analysis showed that higher NLR after the first cycle of the first-line chemotherapy was a significant predictor of cancer specific survival. Conclusions The NLR after the first cycle of the first-line chemotherapy could be an indication for patients with locally advanced or metastatic UTUC to maintain their first-line chemotherapy treatment.
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Affiliation(s)
- Mamoru Hashimoto
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazutoshi Fujita
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Takahito Nakayama
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Saizo Fujimoto
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Mamoru Hamaguchi
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | | | - Takashi Kikuchi
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Shogo Adomi
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Eri Banno
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Marco A De Velasco
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yoshitaka Saito
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Nobutaka Shimizu
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yasunori Mori
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Takafumi Minami
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Masahiro Nozawa
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuhiro Nose
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuhiro Yoshimura
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hirotsugu Uemura
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
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19
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Wang B, Liu J, Zhong Z. Prediction of lymph node metastasis in oral tongue squamous cell carcinoma using the neutrophil-to-lymphocyte ratio and platelet-to-neutrophil ratio. J Clin Lab Anal 2021; 35:e23684. [PMID: 33942387 PMCID: PMC8183927 DOI: 10.1002/jcla.23684] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/17/2020] [Accepted: 12/02/2020] [Indexed: 12/12/2022] Open
Abstract
Background Lymph node metastasis in a variety of tumors is associated with systemic inflammatory markers. However, this association has not been reported in oral tongue squamous cell carcinoma (OTSCC). This study aimed to investigate how the preoperative neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐neutrophil ratio (PNR) in OTSCC patients correlated with the occurrence of OTSCC and lymph node metastasis. Methods The data of 73 patients with primary OTSCC who underwent surgical resection were retrospectively analyzed. Patients with other malignant tumors, patients who had received radiotherapy or chemotherapy before surgery, and patients with active inflammation were excluded. The enrolled patients were divided into groups N0 (no early‐stage lymph node metastasis) and N1 (early‐stage lymph node metastasis). Venous blood samples were collected before surgery and at the third week after surgery and subjected to complete blood counting in a blood analyzer. Eighty‐seven healthy people were included as a control group. In addition, the NLR and PNR in OTSCC patients were compared with those in the controls, and the postoperative NLR and PNR of group N0 were compared with those of group N1. Results The NLR was significantly higher in the OTSCC patients than the controls (p < 0.05). The area under the receiver operating characteristic curve was 0.595. Further comparison of the NLR and PLR between group N0 and group N1 showed that when NLR was ≤1.622, and the probability of early‐stage lymph node metastasis in OTSCC patients was 73.3%, and when PNR was >60.889, the probability was 86.7%. In re‐examination 3 weeks postoperatively, the NLR and PNR were not significantly different between groups. Conclusion The NLR has certain reference value for the diagnosis of OTSCC. The preoperative NLR and PNR can be used to predict early‐stage lymph node metastasis in patients with histopathologically confirmed OTSCC.
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Affiliation(s)
- Bo Wang
- Department of Clinical Laboratory, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Junwen Liu
- Department of Clinical Laboratorial, The Children's Hospital of Fudan University, Shanghai, China
| | - Zhengrong Zhong
- Department of Clinical Laboratory, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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20
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Tsuzuki S, Kimura S, Fukuokaya W, Yanagisawa T, Hata K, Miki J, Kimura T, Abe H, Egawa S. Modified Glasgow prognostic score is a pre-surgical prognostic marker of disease mortality in upper urinary tract urothelial carcinoma. Jpn J Clin Oncol 2021; 51:138-144. [PMID: 32728722 DOI: 10.1093/jjco/hyaa133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/07/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To investigate the prognostic value of pre-surgical modified Glasgow prognostic score in upper urinary tract urothelial carcinoma patients treated with radical nephroureterectomy. METHODS We retrospectively reviewed the clinical records of 273 urinary tract urothelial carcinoma patients treated with radical nephroureterectomy. The modified Glasgow prognostic score was evaluated based on pre-surgical serum C-reactive protein and albumin. Association of modified Glasgow prognostic score with recurrence-free survival, cancer-specific survival and overall survival rates was estimated using Kaplan-Meier method and log-rank test was used to compare survival outcome. Cox regression analyses were performed for the assessment of the modified Glasgow prognostic score with recurrence-free survival, cancer-specific survival and overall survival. RESULTS Of total 273 patients, the modified Glasgow prognostic score 0, 1 and 2 were assigned in 216 (79%), 45 (17%) and 12 (4%), respectively. The recurrence-free survival, cancer-specific survival and overall survival of urinary tract urothelial carcinoma patients with modified Glasgow prognostic score 2 were significantly worse than those with modified Glasgow prognostic score 0. On univariate analysis, modified Glasgow prognostic score 2 was associated with worse recurrence-free survival, cancer-specific survival and overall survival (all P value <0.01). On multivariate analyses, modified Glasgow prognostic score 2 was independently associated with worse cancer-specific survival and overall survival (hazard ratio: 4.73, 95% confidence interval: 1.31-17.2 and hazard ratio: 3.66, 95% confidence interval: 1.08-12.4, respectively). In the subgroup analyses of advanced urinary tract urothelial carcinoma patients, modified Glasgow prognostic score 2 was independently associated with worse recurrence-free survival (hazard ratio 4.31, 95% confidence interval: 1.69-11.1). CONCLUSIONS Pre-surgical modified Glasgow prognostic score independently predicts cancer-specific survival and overall survival of urinary tract urothelial carcinoma patients. Assessment of pre-surgical modified Glasgow prognostic score status could help identifying the worse survivor of urinary tract urothelial carcinoma patients.
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Affiliation(s)
- Shunsuke Tsuzuki
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shoji Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Wataru Fukuokaya
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.,Department of Urology, Kameda Medical Center, Kamogawa City, Japan
| | - Takafumi Yanagisawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Hata
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Jun Miki
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hirokazu Abe
- Department of Urology, Kameda Medical Center, Kamogawa City, Japan
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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21
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Taguchi S, Nakagawa T, Uemura Y, Akamatsu N, Gonoi W, Naito A, Kawai T, Kume H, Fukuhara H. Comparison of major definitions of sarcopenia based on the skeletal muscle index in patients with urothelial carcinoma. Future Oncol 2020; 17:197-203. [PMID: 33305603 DOI: 10.2217/fon-2020-0570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
For the past decade, sarcopenia has been actively investigated in various cancers, including urothelial carcinoma (UC). Although skeletal muscle index (SMI) is the main parameter used to evaluate sarcopenia in oncology, the optimal definition of SMI-based sarcopenia is not entirely standardized. We recently highlighted the potential limitations of current definitions of SMI-based sarcopenia in another journal. In this study, we reviewed studies that assessed sarcopenia in UC patients. We then performed a comparative validation of three major SMI-based definitions of sarcopenia, including Prado's, the international and Martin's definitions in metastatic UC patients. We believe that the standardization of the sarcopenia definition is an urgent issue in oncology, and this paper discusses a possible new direction to address this issue.
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Affiliation(s)
- Satoru Taguchi
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.,Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tohru Nakagawa
- Department of Urology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Yukari Uemura
- Department of Data Science, Biostatistics Section, Center of Clinical Sciences, National Center for Global Health & Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan.,Biostatistics Division, Central Coordinating Unit, Clinical Research Support Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Nobuhiko Akamatsu
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Wataru Gonoi
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Akihiro Naito
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Taketo Kawai
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
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22
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Ye T, Yang X, Lv P, Liu H, Ye Z. Prognostic Value of Preoperative Hydronephrosis in Patients Undergoing Radical Nephroureterectomy for Upper Tract Urinary Carcinoma: A Systematic Review and Meta-Analysis. Front Oncol 2020; 10:600511. [PMID: 33425758 PMCID: PMC7793803 DOI: 10.3389/fonc.2020.600511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 10/27/2020] [Indexed: 01/11/2023] Open
Abstract
Background Several recent publications have evaluated the prognostic value of preoperative hydronephrosis (HN) in patients with upper tract urinary carcinoma (UTUC). The aim of this meta-analysis was to explore the pooled effect of preoperative HN on the prognosis of UTUC patients treated with radical nephroureterectomy (RNU) based on current evidence. Methods We performed a systematic search of Pubmed, Cochrane library, and Web of Science databases from inception to June 2020. The outcomes of interest included overall survival (OS), cancer-special survival (CSS), disease-free survival (DFS), and intravesical recurrence-free survival (IVRFS). Results Twenty-two studies with a total of 7,542 patients satisfied the eligibility criteria and were finally included in this meta-analysis. The percent of patients with preoperative HN varied in the eligible studies, ranging from 18 to 81%. The pooled results showed that preoperative HN was significantly associated with worse OS (P = 0.004), CSS (P < 0.001), and DFS (P = 0.005), but not IVRFS (P = 0.12). No obvious publication bias was detected by Begg’s test in all the analyses. Conclusions The results drawn in our meta-analysis suggest that the presence of preoperative HN is associated with worse prognosis in patients treated with RNU for UTUC. Therefore, closer surveillance and more aggressive therapy may be needed for UTUC patients present with preoperative HN. Well-designed prospective studies are necessary to substantiate the prognostic value of HN in UTUC.
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Affiliation(s)
- Tao Ye
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoqi Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peng Lv
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haoran Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhangqun Ye
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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23
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Hu Y, Cao Q, Wang H, Yang Y, Xiong Y, Li X, Zhou Q. Prognostic nutritional index predicts acute kidney injury and mortality of patients in the coronary care unit. Exp Ther Med 2020; 21:123. [PMID: 33335586 PMCID: PMC7739862 DOI: 10.3892/etm.2020.9555] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/29/2020] [Indexed: 02/07/2023] Open
Abstract
The current study aimed to investigate whether prognostic nutritional index (PNI) is an independent predictor of acute kidney injury (AKI) and mortality of patients in the coronary care unit (CCU). In the present two-stage observational study of patients in the CCU, 6,444 patients from the Medical Information Mart for Intensive Care (MIMIC) III database were first enrolled (test cohort), after which 412 patients from Zhongnan Hospital of Wuhan University were recruited in the validation cohort. AKI was defined based on the Kidney Disease Improving Global Outcomes AKI criteria. The primary endpoint was the incidence of AKI stratified by severity, while the second endpoint included in-hospital mortality and 2-year mortality. In the test cohort, 4,457 (69.2%) patients developed AKI during hospitalization. Following multivariable adjustment, the highest quartile of the PNI value was associated with a 1.8-fold increased risk of AKI compared with the lowest quartile. For the prediction of AKI, the area under the receiver operating characteristic curve outperformed the acute physiology score III score and clinical model in patients with or without preexisting chronic kidney disease, and this was further validated in the hospital cohort used in the present study. A total of 2,219 patients suffered mortality during the 2-year follow-up, and PNI was indicated to independently predict the risk of in-hospital mortality and 2-year mortality in the test cohort and in the validation cohort. Decision curve analysis indicated that the PNI values were clinically useful; Therefore, the current study demonstrated that the PNI value is an independent predictor of AKI and mortality in patients within the CCU.
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Affiliation(s)
- Yugang Hu
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, Hubei 430061, P.R. China
| | - Quan Cao
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, Hubei 430061, P.R. China
| | - Hao Wang
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, Hubei 430061, P.R. China
| | - Yuanting Yang
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, Hubei 430061, P.R. China
| | - Ye Xiong
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, Hubei 430061, P.R. China
| | - Xiaoning Li
- Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Qing Zhou
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, Hubei 430061, P.R. China
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24
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Li R, Sun Z, Song S, He X, Shi X, Li Z, Song J. NARFIB: A Novel Prognostic Score Based on the Neutrophil-to-Albumin Ratio and Fibrinogen Can Predict the Prognosis of Gastrointestinal Stromal Tumors. Cancer Manag Res 2020; 12:11183-11190. [PMID: 33177869 PMCID: PMC7650032 DOI: 10.2147/cmar.s281375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/08/2020] [Indexed: 12/16/2022] Open
Abstract
Objective The neutrophil-to-albumin ratio (NAR) and fibrinogen are significantly related to tumor progression. The present study evaluated the prognostic impact of the NAR plus fibrinogen concentration in gastrointestinal stromal tumor (GIST) cases. Methods The baseline characteristics, postoperative NAR, and fibrinogen concentrations were retrospectively analyzed for 229 Chinese patients who underwent radical gastrectomy for GIST. Receiver operating characteristic (ROC) curves were applied to estimate the optimal critical points for NAR and fibrinogen. Cox regression analysis was applied to determine significant prognostic variables. Results Multivariate analyses revealed that poor recurrence-free survival was associated with elevated values for fibrinogen (hazard ratio [HR]: 5.015, 95% confidence interval [CI]: 1.993-12.619, P=0.001) and NAR (HR: 4.669, 95% CI: 1.776-12.273, P = 0.002). Combining fibrinogen and the NAR into the NARFIB score provided an area under the ROC curve of 0.833, which was greater than the areas for NAR (0.708) or fibrinogen (0.778). When the NAR and fibrinogen were replaced by the NARFIB score in the multivariate analysis, the independent prognosticators were tumor site (HR: 2.927, 95% CI: 1.417-6.045, P=0.004), mitotic index (HR: 2.661, 95% CI: 1.110-6.380, P=0.028), and the NARFIB score (HR: 14.116, 95% CI: 3.243-61.443, P<0.001). The NARFIB score retained its prognostic significance in various subgroup analyses and was significantly related to gender, surgical approach, tumor size, mitosis, tumor site, risk classification, and recurrence. Conclusion These results suggest that the NARFIB score may help guide prognostication and risk stratification for GIST, which might benefit from targeted therapy.
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Affiliation(s)
- Rui Li
- Department of General Surgery, Beijing Hospital, Peking University Fifth School of Clinical Medicine, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, 100730, People's Republic of China
| | - Zhen Sun
- Department of General Surgery, Beijing Hospital, Peking University Fifth School of Clinical Medicine, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, 100730, People's Republic of China
| | - Shibo Song
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 300121, People's Republic of China
| | - Xiuwen He
- Department of General Surgery, Beijing Hospital, Peking University Fifth School of Clinical Medicine, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, 100730, People's Republic of China
| | - Xiaolei Shi
- Department of General Surgery, Beijing Hospital, Peking University Fifth School of Clinical Medicine, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, 100730, People's Republic of China
| | - Zhe Li
- Department of General Surgery, Beijing Hospital, Peking University Fifth School of Clinical Medicine, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, 100730, People's Republic of China
| | - Jinghai Song
- Department of General Surgery, Beijing Hospital, Peking University Fifth School of Clinical Medicine, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, 100730, People's Republic of China
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25
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Li R, Song S, He X, Shi X, Sun Z, Li Z, Song J. Relationship Between Fibrinogen to Albumin Ratio and Prognosis of Gastrointestinal Stromal Tumors: A Retrospective Cohort Study. Cancer Manag Res 2020; 12:8643-8651. [PMID: 32982455 PMCID: PMC7509338 DOI: 10.2147/cmar.s271171] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/26/2020] [Indexed: 12/26/2022] Open
Abstract
Objective The fibrinogen to albumin ratio (FAR) is an important parameter that reflects the coagulation state, systemic inflammation, and nutritional status of a patient and plays an essential role in tumor progression. Here, we evaluate the prognostic significance of FAR in gastrointestinal stromal tumor (GIST) patients that underwent radical surgery. Methods We retrospectively analyzed the data of 227 GIST patients that underwent radical surgery in Beijing Hospital from October 2004 to July 2018. We drew a curve of receiver operating characteristics to confirm the optimal critical values for hemoglobin (Hb), prognostic nutrition index (PNI), and FAR. Cox regression analysis and the Kaplan–Meier method were used to assess the prognostic factors. Results The FAR optimal critical value for postoperative recurrence-free survival (RFS) was 0.09. Many significant factors, including approach, the location and size of the tumor, mitotic index, risk classification, Hb levels, PNI, and recurrence, affect FAR. Multivariate analysis indicated that for patients with GISTs who underwent surgery, the tumor location (hazard ratio [HR]=3.393, 95% confidence interval [CI]: 1.539–7.479, P=0.002), mitotic index (HR=4.788, 95% CI: 1.836–12.486, P=0.001), tumor rupture (HR=10.954, 95% CI: 2.170–55.296, P=0.004), and FAR (HR=3.093, 95% CI: 1.303–7.339, P=0.010) were independent factors affecting RFS. Moreover, the FAR remained of prognostic significance for GIST stratified by subgroup analysis. Conclusion Preoperative FAR is a reliable marker for evaluating the prognosis of GIST, the prognostic ability of FAR is significantly better than Hb and PNI.
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Affiliation(s)
- Rui Li
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Peking University Fifth School of Clinical Medicine, Beijing 100730, People's Republic of China
| | - Shibo Song
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, 300121, People's Republic of China
| | - Xiuwen He
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Peking University Fifth School of Clinical Medicine, Beijing 100730, People's Republic of China
| | - Xiaolei Shi
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Peking University Fifth School of Clinical Medicine, Beijing 100730, People's Republic of China
| | - Zhen Sun
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Peking University Fifth School of Clinical Medicine, Beijing 100730, People's Republic of China
| | - Zhe Li
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Peking University Fifth School of Clinical Medicine, Beijing 100730, People's Republic of China
| | - Jinghai Song
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Peking University Fifth School of Clinical Medicine, Beijing 100730, People's Republic of China
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26
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Liu J, Wu P, Lai S, Song X, Fu C, Wang X, Liu S, Hou H, Liu M, Wang J. Preoperative Monocyte-to-lymphocyte Ratio Predicts for Intravesical Recurrence in Patients With Urothelial Carcinoma of the Upper Urinary Tract After Radical Nephroureterectomy Without a History of Bladder Cancer. Clin Genitourin Cancer 2020; 19:e156-e165. [PMID: 33121908 DOI: 10.1016/j.clgc.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/28/2020] [Accepted: 09/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study aimed to investigate the preoperative monocyte-to-lymphocyte ratio (MLR) as a biomarker for intravesical recurrence (IVR) in upper urinary tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) for the first time. PATIENTS AND METHODS This study involved the clinical data of 255 patients with UTUC without a history of bladder cancer who had undergone RNU from March 2004 to February 2019 at an academic institution. The associations between MLR and IVR were assessed with Kaplan-Meier method and Cox regression analysis. RESULTS The median follow-up was 43.93 months. Of the 255 patients, 37 developed IVR during the follow-up period. Kaplan-Meier analysis revealed that patients with high MLR (> 0.22) had poor IVR-free survival (P = .001); this prognostic value was in accordance with patients with high grade and more advanced stage UTUC. Cox regression preoperative models showed that ureteral tumor site (hazard ratio [HR], 2.784; P = .005), surgical approach (HR, 2.745; P = .008), and high MLR (HR, 4.085; P < .001) were an independent risk factor for IVR. These factors were used as a signature to establish a prognostic risk model, which revealed significant differences among the 3 subgroups of patients with low, intermediate, and high risk (P < .001). CONCLUSION Ureteral tumor site, surgical approach, and preoperative MLR are significant predictors for IVR in patients with UTUC after RNU. MLR may become a useful biomarker to predict IVR in patients with UTUC after RNU.
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Affiliation(s)
- Jianyong Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Pengjie Wu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Shicong Lai
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Xinda Song
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Chunlong Fu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Xuan Wang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Shengjie Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Huimin Hou
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Ming Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China.
| | - Jianye Wang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China.
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Shimizu T, Miyake M, Hori S, Ichikawa K, Omori C, Iemura Y, Owari T, Itami Y, Nakai Y, Anai S, Tomioka A, Tanaka N, Fujimoto K. Clinical Impact of Sarcopenia and Inflammatory/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with Pembrolizumab. Diagnostics (Basel) 2020; 10:diagnostics10050310. [PMID: 32429323 PMCID: PMC7277993 DOI: 10.3390/diagnostics10050310] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia is a muscle loss syndrome known as a risk factor of various carcinomas. The impact of sarcopenia and sarcopenia-related inflammatory/nutritional markers in metastatic urothelial carcinoma (mUC) treated with pembrolizumab was unknown, so this retrospective study of 27 patients was performed. Psoas muscle mass index (PMI) was calculated by bilateral psoas major muscle area at the L3 with computed tomography. The cut-off PMI value for sarcopenia was defined as ≤6.36 cm2/m2 for men and ≤3.92 cm2/m2 for women. Neutrophil-to-lymphocyte ratio (NLR) ≥ 4.0 and sarcopenia correlated with significantly shorter progression-free survival (PFS) (hazard ratio (HR) 3.81, p = 0.020; and HR 2.99, p = 0.027, respectively). Multivariate analyses identified NLR ≥ 4.0 and sarcopenia as independent predictors for PFS (HR 2.89, p = 0.025; and HR 2.79, p = 0.030, respectively). Prognostic nutrition index < 45, NLR ≥ 4.0 and sarcopenia were correlated with significantly worse for overall survival (OS) (HR 3.44, p = 0.046; HR 4.26, p = 0.024; and HR 3.92, p = 0.012, respectively). Multivariate analyses identified sarcopenia as an independent predictor for OS (HR 4.00, p = 0.026). Furthermore, a decrease in PMI ≥ 5% in a month was an independent predictor of PFS and OS (HR 12.8, p = 0.008; and HR 6.21, p = 0.036, respectively). Evaluation of sarcopenia and inflammatory/nutritional markers may help in the management of mUC with pembrolizumab.
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Affiliation(s)
- Takuto Shimizu
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
- Department of Urology, Saiseikai Chuwa Hospital, 323 Ooazaabe, Sakurai, Nara 633-0054, Japan
| | - Makito Miyake
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Shunta Hori
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Kazuki Ichikawa
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Chihiro Omori
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Yusuke Iemura
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
- Department of Urology, Saiseikai Chuwa Hospital, 323 Ooazaabe, Sakurai, Nara 633-0054, Japan
| | - Takuya Owari
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Yoshitaka Itami
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Satoshi Anai
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Atsushi Tomioka
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
- Department of Urology, Saiseikai Chuwa Hospital, 323 Ooazaabe, Sakurai, Nara 633-0054, Japan
| | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
- Correspondence: ; Tel.: +81-744-22-3051; Fax: +81-744-22-9282
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28
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Soria F, Giordano A, D'Andrea D, Moschini M, Rouprêt M, Margulis V, Karakiewicz PI, Briganti A, Bensalah K, Mathieu R, Chlosta P, Babjuk M, Glybochko PV, Enikeev DV, Remzi M, Gust K, Gontero P, Shariat SF. Prognostic value of the systemic inflammation modified Glasgow prognostic score in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy: Results from a large multicenter international collaboration. Urol Oncol 2020; 38:602.e11-602.e19. [PMID: 32037197 DOI: 10.1016/j.urolonc.2020.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/22/2019] [Accepted: 01/08/2020] [Indexed: 02/01/2023]
Abstract
INTRODUCTION AND OBJECTIVES To evaluate the prognostic role of modified Glasgow prognostic score (mGPS) for the prediction of oncological outcomes in a retrospective large multicenter cohort of upper tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy (RNU). MATERIALS AND METHODS We retrospectively analyzed a multicenter cohort of patients treated with RNU for clinically nonmetastatic UTUC. Multivariable logistic regression analyses were performed to evaluate the ability of mGPS to predict nonorgan confined (NOC) disease and lymph-node involvement (LNI) at RNU. Multivariable Cox-regression models were performed to evaluate the preoperative and postoperative prognostic effect of mGPS on survival outcomes. RESULTS Overall, 2,492 patients were included in the study. Of these, 1,929 (77%), 530 (21%), and 33 (1%) had a mGPS of 0, 1, and 2, respectively. mGPS was associated with characteristics of tumor aggressiveness and independently predicted LNI and NOC at RNU (both P < 0.05). On univariable and multivariable Cox-regression analyses, higher mGPS was independently associated with recurrence-free, cancer-specific, and overall survival, both in a preoperative and in a postoperative setting. The inclusion of mGPS significantly improved the discrimination of a preoperative model for the prediction of oncologic outcomes compared to standard prognosticators. CONCLUSIONS We found that mGPS is independently associated with clinicopathologic features and survival outcomes after RNU. Future studies should investigate the role of mGPS in a panel of preoperative markers for the prediction of NOC and LNI in UTUC patients, thus possibly improving the selection for perioperative systemic therapy.
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Affiliation(s)
- Francesco Soria
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy; Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Andrea Giordano
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy
| | - David D'Andrea
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Marco Moschini
- Department of Urology, Medical University of Vienna, Vienna, Austria; Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Morgan Rouprêt
- Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | | | - Alberto Briganti
- Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Karim Bensalah
- Department of Urology, University of Rennes, Rennes, France
| | - Romain Mathieu
- Department of Urology, University of Rennes, Rennes, France
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University, Krakow, Poland
| | - Marek Babjuk
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr V Glybochko
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Dmitry V Enikeev
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Mesut Remzi
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Kilian Gust
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Paolo Gontero
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, Weill Cornell Medical College, New York, USA.
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29
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Bao Z, Li Y, Guan B, Xiong G, Zhang L, Tang Q, Wang T, Li X, Fang D, Zhou L. High Preoperative Controlling Nutritional Status Score Predicts a Poor Prognosis in Patients with Localized Upper Tract Urothelial Cancer: A Propensity Score Matching Study in a Large Chinese Center. Cancer Manag Res 2020; 12:323-335. [PMID: 32021446 PMCID: PMC6970241 DOI: 10.2147/cmar.s225711] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/28/2019] [Indexed: 12/17/2022] Open
Abstract
Purpose The aim of this study was to elucidate the prognostic value of the preoperative controlling nutritional status (CONUT) score, a new index based on the total lymphocyte count, serum albumin concentration and total cholesterol concentration, in patients with localized upper tract urothelial cancer (UTUC) after radical nephroureterectomy (RNU) using propensity score matching (PSM) analysis. Methods We retrospectively reviewed 908 consecutive patients with localized UTUC who underwent RNU between 1999 and 2015. Patients were divided into two groups according to the optimal cutoff value of the preoperative CONUT score. Relationships between the CONUT score with clinicopathological characteristics, overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) were analyzed before and after 1:1 PSM. Results A high preoperative CONUT score was significantly correlated with older age, low body mass index (BMI), poor American Statistical Association (ASA) score, advanced pathological T stage, and tumor squamous or glandular differentiation (all p<0.05). Kaplan-Meier curves showed poor OS, CSS, and DFS for patients with a high CONUT score before and after PSM (all p<0.001). Furthermore, multivariate analyses revealed that a high preoperative CONUT score was an independent risk factor for poor DFS (hazard ratio [HR] 1.418, 95% confidence interval [CI] 1.132–1.776, p=0.002) before PSM and an independent risk factor for poor DFS (HR 1.333, 95% CI 1.010–1.760, p=0.042) and OS (HR 1.459, 95% CI 1.010–2.107, p=0.044) after PSM. Conclusion A high preoperative CONUT score is an independent prognostic factor for poor outcomes in patients with localized UTUC after RNU.
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Affiliation(s)
- Zhengqing Bao
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Yifan Li
- Department of Urology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu 225000, People's Republic of China
| | - Bao Guan
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Gengyan Xiong
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Lei Zhang
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Qi Tang
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Tianyu Wang
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Dong Fang
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China.,Andrology Center, Peking University First Hospital, Beijing 100034, People's Republic of China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
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30
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Miyake M, Marugami N, Fujiwara Y, Komura K, Inamoto T, Azuma H, Matsumoto H, Matsuyama H, Fujimoto K. Down-Grading of Ipsilateral Hydronephrosis by Neoadjuvant Chemotherapy Correlates with Favorable Oncological Outcomes in Patients Undergoing Radical Nephroureterectomy for Ureteral Carcinoma. Diagnostics (Basel) 2019; 10:diagnostics10010010. [PMID: 31877969 PMCID: PMC7168216 DOI: 10.3390/diagnostics10010010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/13/2019] [Accepted: 12/19/2019] [Indexed: 01/18/2023] Open
Abstract
Few studies have analyzed the details of neoadjuvant chemotherapy (NAC)-induced changes in patients with upper tract urothelial carcinoma. This study aimed to describe the impact of down-grading ipsilateral hydronephrosis by NAC for ureteral carcinoma. An observational study was conducted in 32 patients with cT1-3N0M0 ureteral carcinoma treated with NAC and radical nephroureterectomy. Hydronephrosis was classified into five grades based on computed tomography findings. We focused on the differences between the baseline and post-NAC status of ipsilateral hydronephrosis, radiographic tumor response, and blood markers. Down-grading, no change, and up-grading was observed in 10 (31%), 21 (66%), and 1 (3%) patients, respectively. In univariate analysis, locally advanced disease (cT3), severe hydronephrosis (grade 3/4) at baseline, no change/up-grading of hydronephrosis after NAC, and pathological lymphovascular involvement were identified as potential prognostic factors of progression-free and cancer-specific survival after radical nephroureterectomy. Locally advanced disease (cT3) at baseline and no change/up-grading of hydronephrosis by NAC were independently associated with poor progression-free survival. Notably, none of the patients with NAC-induced down-grading of hydronephrosis died of ureteral carcinoma during the follow-up. We reported the prognostic impact of down-grading of ipsilateral hydronephrosis, which could serve as a useful aid or clinical marker for decision-making.
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Affiliation(s)
- Makito Miyake
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan;
- Correspondence: ; Tel.: +81-744-22-3051 (ext. 2338); Fax: +81-744-22-9282
| | - Nagaaki Marugami
- Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan;
| | - Yuya Fujiwara
- Department of Urology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (Y.F.); (K.K.); (T.I.); (H.A.)
| | - Kazumasa Komura
- Department of Urology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (Y.F.); (K.K.); (T.I.); (H.A.)
| | - Teruo Inamoto
- Department of Urology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (Y.F.); (K.K.); (T.I.); (H.A.)
| | - Haruhito Azuma
- Department of Urology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (Y.F.); (K.K.); (T.I.); (H.A.)
| | - Hiroaki Matsumoto
- Department of Urology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube 755-8505, Japan; (H.M.); (H.M.)
| | - Hideyasu Matsuyama
- Department of Urology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube 755-8505, Japan; (H.M.); (H.M.)
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan;
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31
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Bao Y, Wang Y, Li X, Pan M, Zhang H, Cheng Z, Wang X. Prognostic significance of platelet-to-lymphocyte ratio in urothelial carcinoma patients: a meta-analysis. Cancer Cell Int 2019; 19:315. [PMID: 31798344 PMCID: PMC6882352 DOI: 10.1186/s12935-019-1032-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/12/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The prognostic value of pre-treatment platelet-to-lymphocyte ratio (PLR) in patients with urothelial carcinoma (UC) remains controversial. Therefore, this meta-analysis aimed to identify the prognostic impact of PLR on UC. METHODS The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to summarize the correlations between PLR and overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), and cancer-specific survival (CSS). Odds ratios (ORs) with 95% CIs were used to measure the association between PLR and tumor clinicopathological factors. RESULTS The meta-analysis included 15 studies published from 2015 to 2019 with a total of 5354 patients. Overall, a high PLR was correlated to poorer PFS (HR = 1.81, 95% CI 1.28-2.56, p = 0.001) and DFS (HR = 1.09, 95% CI 1.31-2.16, p < 0.001) but not poor OS (HR = 1.23, 95% CI 0.95-1.59, p = 0.124) or CSS (HR = 1.000, 95% CI 0.998-1.002, p = 0.919) in UC. In addition, an elevated PLR was correlated with patient age > 65 years (OR = 1.72, 95% CI 1.25-2.38, p = 0.001) and hypertension (OR = 1.48, 95% CI 1.01-2.18, p = 0.046). However, no significant association was observed between PLR and sex (OR = 0.79, 95% CI 0.56-1.14, p = 0.206) or diabetes (OR = 1.29, 95% CI 0.77-2.15, p = 0.333). CONCLUSIONS Our results demonstrated a significant correlation between elevated PLR and poor prognosis in UC. The prognostic role of PLR may help guide the management and prognostication of UC patients.
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Affiliation(s)
- Yuhai Bao
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Yin Wang
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Xiaodong Li
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Mingjun Pan
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Hongze Zhang
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Zegen Cheng
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Xueyi Wang
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
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32
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Hori S, Ichikawa K, Morizawa Y, Gotoh D, Itami Y, Nakai Y, Miyake M, Yoneda T, Tanaka N, Yoshida K, Fujimoto K. Clinical Significance of Postoperative Nutritional Status as a Prognostic Factor in Kidney Transplant Recipients. Transplant Proc 2019; 51:1763-1772. [PMID: 31255359 DOI: 10.1016/j.transproceed.2019.04.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 04/05/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite advancements in the management of kidney transplantation (KT), kidney transplant recipients (KTRs) have a higher risk of mortality than the age-matched general population. Improvement of long-term graft and patient survival is a significant issue. Therefore we investigated the effects of postoperative nutritional status on graft and patient survival and explored the predictive factors involved in nutritional status. METHODS Our retrospective study included 118 KTRs who underwent KT at our hospital. Clinical and laboratory data were obtained from medical charts. The prognostic nutritional index (PNI) was used to assess nutritional status. Changes in nutritional status after KT were monitored and the effect of nutritional status on graft and patient survival was investigated. The variables involved in nutritional status were also explored. RESULTS The KTRs in this cohort comprised 66 men and 52 women with a median age of 47 years at KT. There were 16, 32, and 22 cases of cadaveric, preemptive, and ABO-incompatible KTs, respectively. Postoperative PNI gradually improved and was stable from 6 months after KT. Although graft survival was regulated by ABO-compatibility, independent predictors for patient survival were history of dialysis, PNI, and serum-corrected calcium levels. Preemptive KT and inflammatory status contributed to PNI. CONCLUSIONS Nutritional status of KTRs improved over time after KT and could contribute to patient survival. Optimal nutritional educational programs and interventions can lead to better outcomes in KTRs. Further studies are needed to validate our results and develop appropriate nutritional educational programs, interventions, and exercise programs.
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Affiliation(s)
- Shunta Hori
- Department of Urology, Nara Medical University, Nara, Japan
| | | | | | - Daisuke Gotoh
- Department of Urology, Nara Medical University, Nara, Japan
| | | | - Yasushi Nakai
- Department of Urology, Nara Medical University, Nara, Japan
| | - Makito Miyake
- Department of Urology, Nara Medical University, Nara, Japan
| | - Tatsuo Yoneda
- Department of Urology, Nara Medical University, Nara, Japan
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Hu X, Dou WC, Shao YX, Liu JB, Xiong SC, Yang WX, Li X. The prognostic value of sarcopenia in patients with surgically treated urothelial carcinoma: A systematic review and meta-analysis. Eur J Surg Oncol 2019; 45:747-754. [DOI: 10.1016/j.ejso.2019.03.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 12/25/2022] Open
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