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Mao H, Yang F. Prognostic significance of albumin-to-globulin ratio in patients with renal cell carcinoma: a meta-analysis. Front Oncol 2023; 13:1210451. [PMID: 37538115 PMCID: PMC10394642 DOI: 10.3389/fonc.2023.1210451] [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: 04/22/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Background Whether the albumin-to-globulin ratio (AGR) predicts the prognosis of renal cell carcinoma (RCC) remains controversial. Herein, we performed a meta-analysis to critically evaluate the relationship between the AGR and RCC prognosis, as well as the association between the AGR and the clinicopathological characteristics of RCC. Methods The PubMed, Web of Science, Embase, and Cochrane Library databases were thoroughly and comprehensively searched from their inception until 24 June 2023. To determine the predictive significance of the AGR, hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated from the pooled data. The relationship between the AGR and the clinicopathological features of RCC was evaluated by estimating odds ratios (ORs) and 95% CIs in subgroup analyses. Results The meta-analysis included nine articles involving 5,671 RCC cases. A low AGR significantly correlated with worse overall survival (OS) (HR = 1.82, 95% CI = 1.37-2.41, p <0.001) and progression-free survival (PFS) (HR = 2.44, 95% CI = 1.61-3.70, p <0.001). Analysis of the pooled data also revealed significant associations between a low AGR and the following: female sex (OR = 1.48, 95% CI = 1.31-1.67, p <0.001), pT stage T3-T4 (OR = 4.12, 95% CI = 2.93-5.79, p <0.001), pN stage N1 (OR = 3.99, 95% CI = 2.40-6.64, p <0.001), tumor necrosis (OR = 3.83, 95% CI = 2.23-6.59, p <0.001), and Fuhrman grade 3-4 (OR = 1.82, 95% CI = 1.34-2.42, p <0.001). The AGR was not related to histology (OR = 0.83, 95% CI = 0.60-1.15, p = 0.267). Conclusion In patients with RCC, a low AGR strongly predicted poor OS and PFS and significantly correlated with clinicopathological features indicative of disease progression.
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Affiliation(s)
- Huaying Mao
- Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China
| | - Fan Yang
- Clinical Laboratory, Huzhou Maternity and Child Health Care Hospital, Huzhou, Zhejiang, China
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Sato MT, Ida A, Kanda Y, Takano K, Ohbayashi M, Kohyama N, Morita J, Fuji K, Sasaki H, Ogawa Y, Kogo M. Prognostic model for overall survival that includes the combination of platelet count and neutrophil-lymphocyte ratio within the first six weeks of sunitinib treatment for metastatic renal cell carcinoma. BMC Cancer 2022; 22:1214. [PMID: 36434552 PMCID: PMC9700994 DOI: 10.1186/s12885-022-10316-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 11/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The association between the combination of platelet count and neutrophil-lymphocyte ratio (COP-NLR) at the time of adverse events during sunitinib treatment and prognosis is unclear, and prognostic models combining the prognostic factors of sunitinib have not been well studied. Thus, we developed a prognostic model that includes the COP-NLR to predict the prognosis of patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib. METHODS We performed a retrospective cohort study of 102 patients treated with sunitinib for mRCC between 2008 and 2020 in three hospitals associated with Showa University, Japan. The primary outcome was overall survival (OS). The collected data included baseline patient characteristics, adverse events, laboratory values, and COP-NLR scores within the first 6 weeks of sunitinib treatment. Prognostic factors of OS were analyzed using the Cox proportional hazards model. The integer score was derived from the beta-coefficient (β) of these factors and was divided into three groups. The survival curves were visualized using the Kaplan-Meier method and estimated using a log-rank test. RESULTS The median OS was 32.3 months. Multivariable analysis showed that the number of metastatic sites, Memorial Sloan Kettering Cancer Center risk group, number of metastases, non-hypertension, modified Glasgow Prognostic Score, and 6-week COP-NLR were significantly associated with OS. A higher 6-week COP-NLR was significantly associated with a shorter OS (p < 0.001). The β values of the five factors for OS were scored (non-hypertension, mGPS, and 6-week COP-NLR = 1 point; number of metastatic sites = 2 points; MSKCC risk group = 3 points) and patients divided into three groups (≤ 1, 2-3, and ≥ 4). The low-risk (≤ 1) group had significantly longer OS than the high-risk (≥ 4) group (median OS: 99.0 vs. 6.2 months, p < 0.001). CONCLUSIONS This study showed that the COP-NLR within the first 6 weeks of sunitinib treatment had a greater impact on OS than the COP-NLR at the start of sunitinib treatment. The developed prognostic model for OS, including the 6-week COP-NLR, will be useful in decision-making to continue sunitinib in the early treatment stage of patients with mRCC.
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Affiliation(s)
- Miki Takenaka Sato
- grid.410714.70000 0000 8864 3422Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Ayuki Ida
- grid.410714.70000 0000 8864 3422Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Yuki Kanda
- grid.410714.70000 0000 8864 3422Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Kaori Takano
- grid.410714.70000 0000 8864 3422Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Masayuki Ohbayashi
- grid.410714.70000 0000 8864 3422Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Noriko Kohyama
- grid.410714.70000 0000 8864 3422Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Jun Morita
- grid.410714.70000 0000 8864 3422Department of Urology, Showa University School of Medicine, Tokyo, Japan
| | - Kohzo Fuji
- grid.482675.a0000 0004 1768 957XDepartment of Urology, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Haruaki Sasaki
- grid.412808.70000 0004 1764 9041Department of Urology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Yoshio Ogawa
- grid.410714.70000 0000 8864 3422Department of Urology, Showa University School of Medicine, Tokyo, Japan
| | - Mari Kogo
- grid.410714.70000 0000 8864 3422Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
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Shim SR, Kim SI, Kim SJ, Cho DS. Prognostic nutritional index as a prognostic factor for renal cell carcinoma: A systematic review and meta-analysis. PLoS One 2022; 17:e0271821. [PMID: 35930538 PMCID: PMC9355260 DOI: 10.1371/journal.pone.0271821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/07/2022] [Indexed: 11/29/2022] Open
Abstract
Background Prognostic nutritional index (PNI) is a simple parameter which reflects patient’s nutritional and inflammatory status and reported as a prognostic factor for renal cell carcinoma (RCC). Studies were included from database inception until February 2, 2022. The aim of this study is to evaluate prognostic value of PNI by meta-analysis of the diagnostic test accuracy in RCC. Methods and findings Studies were retrieved from PubMed, Cochrane, and EMBASE databases and assessed sensitivity, specificity, summary receiver operating characteristic curve (SROC) and area under curve (AUC). Totally, we identified 11 studies with a total of 7,296 patients were included to evaluate the prognostic value of PNI in RCC finally. They indicated a pooled sensitivity of 0.733 (95% CI, 0.651–0.802), specificity of 0.615 (95% CI, 0.528–0.695), diagnostic odds ratio (DOR) of 4.382 (95% CI, 3.148–6.101) and AUC of 0.72 (95% CI, 0.68–0.76). Heterogeneity was significant and univariate meta-regression revealed that metastasis and cut-off value of PNI might be the potential source of heterogeneity. Multivariate meta-regression analysis also demonstrated that metastasis might be the source of heterogeneity. Conclusions PNI demonstrated a good diagnostic accuracy as a prognostic factor for RCC and especially in case of metastatic RCC.
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Affiliation(s)
- Sung Ryul Shim
- Department of Health and Medical Informatics, Kyungnam University College of Health Sciences, Changwon, Republic of Korea
| | - Sun Il Kim
- Department of Urology, Ajou University School of Medicine, Suwon, Korea
| | - Se Joong Kim
- Department of Urology, Ajou University School of Medicine, Suwon, Korea
| | - Dae Sung Cho
- Department of Urology, Ajou University School of Medicine, Suwon, Korea
- * E-mail:
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Ni L, Huang J, Ding J, Kou J, Shao T, Li J, Gao L, Zheng W, Wu Z. Prognostic Nutritional Index Predicts Response and Prognosis in Cancer Patients Treated With Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis. Front Nutr 2022; 9:823087. [PMID: 35938131 PMCID: PMC9353139 DOI: 10.3389/fnut.2022.823087] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 06/14/2022] [Indexed: 12/12/2022] Open
Abstract
Objective To investigate the association between pretreatment prognostic nutritional index (PNI) and clinical survival outcomes for advanced-stage cancer patients treated with immune checkpoint inhibitors (ICIs). Methods We conducted a comprehensive literature search to identify eligible studies concerning the relationship between pretreatment PNI and survival outcomes in advanced cancer patients treated with ICIs. Published data were extracted and pooled odds ratio (pOR) for objective response rate (ORR), disease control rate (DCR), and pooled hazard ratio (pHR) for overall survival (OS), progressive-free survival (PFS), along with 95% confidence intervals (95% CIs) were calculated. Results Twelve studies with 1,359 participants were included in our study. A higher level of PNI indicated a greater ORR (pOR = 2.17, 95% CI = 1.52–3.10) and favorable DCR (pOR = 2.48, 95% CI = 1.87–3.29). Low PNI was associated with a shorter OS (pHR = 2.24, 95% CI = 1.57–3.20) and unfavorable PFS (pHR = 1.61, 95% CI = 1.37–1.88). Conclusion Low PNI might be an effective biomarker of poor tumor response and adverse prognosis of advanced cancer patients with ICIs. Further studies are needed to verify the prognostic value of PNI in clinical practice.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Zhen Wu
- Zhen Wu, , orcid.org/0000-0002-1140-273X
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Prognostic impact of prognostic nutritional index on renal cell carcinoma: A meta-analysis of 7,629 patients. PLoS One 2022; 17:e0265119. [PMID: 35312690 PMCID: PMC8936492 DOI: 10.1371/journal.pone.0265119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/23/2022] [Indexed: 12/03/2022] Open
Abstract
Background Prognostic nutritional index (PNI) is a parameter which reflects nutritional and inflammatory status. The prognostic value of PNI in renal cell carcinoma (RCC) remains in debate. The aim of this study is to evaluate the prognostic value and clinicopathological features of PNI in RCC. Methods A literature search was performed in the databases of PubMed, Embase, Web of Science, and Cochrane Library. Hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs) were extracted for meta-analysis. The association between PNI and overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), progression-free survival (PFS), recurrence-free survival (RFS), and clinicopathological factors were evaluated. Results Eleven studies involving 7,629 patients were included for meta-analysis. A decreased PNI was shown to be a significant predictor of worse OS (HR = 2.00, 95%CI = 1.64–2.42, p<0.001), CSS (HR = 2.54, 95%CI = 1.61–4.00, p<0.001), and DFS/PFS/RFS (HR = 2.12, 95%CI = 1.82–2.46, p<0.001) in RCC. Furthermore, a low PNI was correlated with Fuhrman grade III-IV (OR = 1.96, 95%CI = 1.27–3.02, p = 0.002), T stage T3-T4 (OR = 2.21, 95%CI = 1.27–3.87, p = 0.005), presence of sarcomatoid differentiation (OR = 5.00, 95%CI = 2.52–9.92, p<0.001), and presence of tumor necrosis (OR = 3.63, 95%CI = 2.54–5.19, p<0.001). Conclusion PNI is an independent prognostic indicator of survival and associated with Fuhrman grade, T stage, sarcomatoid differentiation, and tumor necrosis in patients with RCC.
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Mao C, Xu W, Ma W, Wang C, Guo Z, Yan J. Prognostic Value of Pretreatment Prognostic Nutritional Index in Patients With Renal Cell Carcinoma: A Meta-Analysis. Front Oncol 2021; 11:719941. [PMID: 34676162 PMCID: PMC8523954 DOI: 10.3389/fonc.2021.719941] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/10/2021] [Indexed: 01/11/2023] Open
Abstract
Background The pretreatment prognostic nutritional index (PNI) is correlated with poor prognosis in several malignancies. However, the prognostic role of PNI in patients with renal cell carcinoma (RCC) remains unclear. Therefore, we performed a meta-analysis to investigate the prognostic significance of PNI in patients with RCC. Methods We searched the PubMed, Web of Science, Embase, Scopus, and Cochrane Library databases up to February 2021. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were used to estimate correlation between PNI and survival endpoints in RCC. Results Ten studies with 4,908 patients were included in the meta-analysis. The pooled results indicated that a low PNI associated with poor overall survival (HR = 2.10, 95% CI = 1.67–2.64, p<0.001), shorter progression-free survival, disease-free survival, recurrence-free survival (HR = 1.99, 95% CI = 1.67–2.36, p<0.001), and poor cancer-specific survival (HR = 2.95, 95% CI = 1.61–5.39, p<0.001). Additionally, the prognostic ability of PNI was not affected by subgroup analysis factors. Conclusion The meta-analysis indicated that low PNI associated with shorter survival outcomes in patients with RCC. Therefore, PNI could be used as an effective prognostic indicator in RCC.
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Affiliation(s)
- Changqing Mao
- Department of Nephrology, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Weixin Xu
- Department of Laboratory Medicine, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Weina Ma
- Department of Pharmacy, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Chun Wang
- Department of Oncology, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Zhaojiao Guo
- Department of Oncology, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Jun Yan
- Department of Oncology, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
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Arfsten H, Cho A, Prausmüller S, Spinka G, Novak J, Goliasch G, Bartko PE, Raderer M, Gisslinger H, Kornek G, Köstler W, Strunk G, Preusser M, Hengstenberg C, Hülsmann M, Pavo N. Inflammation-Based Scores as a Common Tool for Prognostic Assessment in Heart Failure or Cancer. Front Cardiovasc Med 2021; 8:725903. [PMID: 34746248 PMCID: PMC8569110 DOI: 10.3389/fcvm.2021.725903] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/08/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Inflammation-based scores are widely tested in cancer and have been evaluated in cardiovascular diseases including heart failure. Objectives: We investigated the impact of established inflammation-based scores on disease severity and survival in patients with stable heart failure with reduced ejection fraction (HFrEF) paralleling results to an intra-institutional cohort of treatment naïve cancer patients. Methods: HFrEF and cancer patients were prospectively enrolled. The neutrophil-to-lymphocyte-ratio (NLR), the monocyte-to-lymphocyte-ratio (MLR), the platelet-to-lymphocyte-ratio (PLR), and the prognostic nutritional index (PNI) at index day were calculated. Association of scores with disease severity and impact on overall survival was determined. Interaction analysis was performed for the different populations. Results: Between 2011 and 2017, a total of 818 patients (443 HFrEF and 375 cancer patients) were enrolled. In HFrEF, there was a strong association between all scores and disease severity reflected by NT-proBNP and NYHA class (p ≤ 0.001 for all). In oncologic patients, association with tumor stage was significant for the PNI only (p = 0.035). In both disease entities, all scores were associated with all-cause mortality (p ≤ 0.014 for all scores). Kaplan-Meier analysis confirmed the discriminatory power of all scores in the HFrEF and the oncologic study population, respectively (log-rank p ≤ 0.026 for all scores). A significant interaction with disease (HFrEF vs. cancer) was observed for PNI (p interaction = 0.013) or PLR (p interaction = 0.005), respectively, with higher increase in risk per inflammatory score increment for HFrEF. Conclusion: In crude models, the inflammatory scores NLR, MLR, PLR, and PNI are associated with severity of disease in HFrEF and with survival in HFrEF similarly to cancer patients. For PNI and PLR, the association with increase in risk per increment was even stronger in HFrEF than in malignant disease.
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Affiliation(s)
- Henrike Arfsten
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Anna Cho
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Suriya Prausmüller
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Georg Spinka
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Johannes Novak
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Georg Goliasch
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Philipp E. Bartko
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Markus Raderer
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Heinz Gisslinger
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Gabriela Kornek
- Medical Direction, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Köstler
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | | | - Matthias Preusser
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Christian Hengstenberg
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Martin Hülsmann
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Noemi Pavo
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
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Prognostic nutritional index and prognosis in renal cell carcinoma: A systematic review and meta-analysis. Urol Oncol 2021; 39:623-630. [PMID: 34253447 DOI: 10.1016/j.urolonc.2021.05.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/11/2021] [Accepted: 05/21/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE To perform a systematic review and meta-analysis of the Prognostic Nutritional Index (PNI) as a prognostic factor for renal cell carcinoma (RCC). MATERIALS AND METHODS Eligible studies that evaluated the prognostic impact of pretreatment PNI in RCC patients were identified by comprehensive searching the electronic databases PubMed, Cochrane Central Search library, and EMBASE. The end points were overall/cancer-specific survival (OS/CSS) and recurrence-free/disease-free survival (RFS/DFS). Meta-analysis using random-effects models was performed to calculate hazard ratios (HRs) with 95 % confidence intervals (CIs). RESULTS In total, 9 retrospective, observational, case-control studies involving 5,976 patients were included for final analysis. Eight studies evaluated OS/CSS, and 5 evaluated RFS/DFS. Our results showed that lower PNI was significantly associated with unfavorable OS/CSS (HR = 1.68, 95% CI 1.44-1.96, P < 0.001, I2 = 9.2%, P = 0.359) and RFS/DFS (HR = 1.98, 95% CI 1.57-2.50, P < 0.001, I2 = 18.2%, P = 0.299) in patients with RCC. Subgroup and meta-regression analysis based on ethnicity, study sample size, presence of metastasis, PNI cut-off value, Newcastle-Ottawa quality assessment scale (NOS) score, and gender ratio all showed that lower PNI was associated with poorer OS/CSS and RFS/DFS. Funnel plots and Egger's tests indicated significant publication bias in OS/CSS (P = 0.001), but not in RFS/DFS (P = 0.757). CONCLUSION This meta-analysis indicated that lower PNI was a negative prognostic factor and associated with tumor progression and poorer survival of patients with RCC. Therefore, PNI could be a potential prognostic predictor of treatment outcomes for patients with RCC.
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Xiong SC, Hu X, Lia T, Wang YH, Li X. Prognostic Significance of Prognostic Nutritional Index in Patients with Renal Cell Carcinoma: A Meta-Analysis. Nutr Cancer 2021; 74:860-868. [PMID: 34060398 DOI: 10.1080/01635581.2021.1931702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The prognostic nutrition index (PNI), based on the serum lymphocyte counts and albumin levels, has been introduced as a prognostic factor in various cancer. In the present study, we explore the prognostic significance of PNI in patients with renal cell carcinoma (RCC). A literature search of all publications was conducted using the Cochrane library, PubMed and Embase databases from inception to April 2020. A total of 12 studies consisting of 7,391 patients were enrolled in the present study. We found that low pretreatment PNI is significantly correlated to poor survival, including overall survival (OS) (P < 0.001), cancer-specific survival (CSS) (P = 0.002), progression-free survival/recurrence-free survival/disease-free survival (PFS/RFS/DFS) (P < 0.001). The age (P < 0.001), clear cell histology (P = 0.044), T3-T4 (P = 0.049), and Fuhrman grade 3-4 (P = 0.024) were significantly differed in the low and high pretreatment PNI group. In summary, low pretreatment PNI was associated with adverse clinicopathological features in patients with RCC. Besides, low pretreatment PNI was also an unfavorable factor of OS, CSS, and PFS/RFS/DFS in RCC patients, which could serve as an unfavorable factor. More studies with large participants are required to verify our results.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1931702.
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Affiliation(s)
- San-Chao Xiong
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xu Hu
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Thongher Lia
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yao-Hui Wang
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xiang Li
- Department of Urology, West China Hospital, West China Medical School, Sichuan University, Chengdu, People's Republic of China
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Tang Y, Liang J, Liu Z, Zhang R, Zou Z, Wu K, Lu Y, Wei X. Clinical significance of prognostic nutritional index in renal cell carcinomas. Medicine (Baltimore) 2021; 100:e25127. [PMID: 33725913 PMCID: PMC7969234 DOI: 10.1097/md.0000000000025127] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 02/15/2021] [Indexed: 02/05/2023] Open
Abstract
Prognostic nutritional index (PNI) could reflect the nutrition and inflammation status in cancer patients. This study aims to identify the prognostic significance of PNI in patients with renal cell carcinoma (RCC).A total of 694 RCC patients from our institution were included in this study. The prognostic correlation between PNI and overall survival (OS) and recurrence-free survival (RFS) was analyzed respectively using Kaplan-Meier method and univariate and multivariate Cox model. Studies about the association between pretreatment or preoperative PNI and prognosis of RCC were systemically reviewed and a meta-analysis method was performed to further evaluate the pooled prognostic value of PNI in RCC.267 (38.47%) RCC patients had low PNI according to the cut off value (49.08). Low PNI was associated with poor OS (P < .001) and RFS (P < .001), respectively. In the multivariate Cox analysis, PNI was identified to be an independent prognostic factor for OS (hazard ratio [HR] = 2.13, 95%CI: 1.25-3.62, P = .005). Compared to other nutritional indexes, this risk correlation of PNI is better than that of geriatric nutritional risk index (GNRI; HR = 1.19; P = .531), while is no better than that of neutrophil-lymphocyte ratio (NLR; 1/HR = 2.56; P < .001) and platelet-lymphocyte ratio (PLR; 1/HR = 2.85; P < .001) respectively. Meanwhile, additional 4785 patients from 6 studies were included into pooled analysis. For RCC patients who underwent surgery, low preoperative PNI was significantly associated with worse OS (pooled HR = 1.57, 95%CI: 1.37-1.80, P < .001) and worse RFS (pooled HR = 1.69, 95%CI: 1.45-1.96, P < .001). Furthermore, low PNI (<41-51) was also significantly associated with poor OS (HR = 1.78, 95%CI: 1.26-2.53 P < .05) and poor RFS (HR = 2.03, 95%CI: 1.40-2.95, P < .05) in advanced cases treated with targeted therapies.The present evidences show that PNI is an independent prognostic factor in RCC. Low PNI is significant associated with poor prognosis of RCC patients.
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Affiliation(s)
- Yongquan Tang
- Department of Pediatric Surgery
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan
| | - Jiayu Liang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan
| | - Zhihong Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan
| | - Ruochen Zhang
- Department of Urology, Fujian Province Hospital, NO.134 East Street, Fuzhou, Fujian
| | - Zijun Zou
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kan Wu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan
| | - Yiping Lu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan
| | - Xin Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan
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Liu J, Li S, Zhang S, Yang C, Zhang L, Zhang B, Cheng Y, Wang C. Pretreatment prognostic nutritional index is a prognostic marker for extensive-stage small cell lung cancer patients treated with anlotinib. J Thorac Dis 2020; 12:5765-5773. [PMID: 33209408 PMCID: PMC7656377 DOI: 10.21037/jtd-20-755] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Anlotinib is a multi-targeted tyrosine kinase inhibitor that inhibits tumor angiogenesis which has shown activity in several malignancies and approved for the treatment of small cell lung cancer (SCLC) in China. However, there are no markers can predict the clinical outcomes of anlotinib. We aimed to evaluate the efficacy of anlotinib in extensive stage SCLC (ES-SCLC) patients who failed at least two regimens treatment and to explore potential factors related to its survival benefit. Methods Patients with ES-SCLC treated with anlotinib monotherapy were screened between March 2017 and May 2019, prognostic nutritional index (PNI) before treatment were collected. Progression free survival (PFS) and overall survival (OS) were calculated and compared using the Kaplan–Meier method and the log-rank test. The prognostic values of each variable were evaluated with univariate and multivariate Cox proportional hazard regression (PHR) analyses. Results A total of 41 patients with ES-SCLC were received anlotinib treatment, the median age was 57 (range, 33–76). Median OS was significantly longer in the PNI high arm compared with the low arm [8.4 months (95% CI, 5.1–9.6 months) vs. 4.7 months (95% CI, 2.1–6.3 months); hazard ratio (HR) 0.42 (95% CI, 0.21–0.85); P=0.01]. The median PFS of two arms were 4.1 months (95% CI, 2.1–8.2 months) and 2.6 months (95% CI, 0.7–3.9 months), respectively (HR =0.53, 95% CI, 0.27–1.02, P=0.05). Multivariate analysis confirmed that PNI (P<0.01) and LDH (P<0.01) were significant independent biomarkers for OS. Conclusions The present study demonstrated that pretreatment PNI can be used as a novel and convenient biomarker to predict the prognosis in ES-SCLC patients treated with anlotinib.
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Affiliation(s)
- Jingjing Liu
- Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Lung Cancer Center, Tianjin, China
| | - Shuang Li
- Department of Thoracic Oncology, Jilin Provincial Cancer Hospital, Changchun, China
| | - Shuang Zhang
- Department of Thoracic Oncology, Jilin Provincial Cancer Hospital, Changchun, China
| | - Changliang Yang
- Department of Thoracic Oncology, Jilin Provincial Cancer Hospital, Changchun, China
| | - Liang Zhang
- Department of Thoracic Oncology, Jilin Provincial Cancer Hospital, Changchun, China
| | - Bin Zhang
- Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Lung Cancer Center, Tianjin, China
| | - Ying Cheng
- Department of Thoracic Oncology, Jilin Provincial Cancer Hospital, Changchun, China
| | - Changli Wang
- Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Lung Cancer Center, Tianjin, China
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Yang Y, Ji N, Cai C, Wang J, Lei Z, Teng Q, Wu Z, Cui Q, Pan Y, Chen Z. Modulating the function of ABCB1: in vitro and in vivo characterization of sitravatinib, a tyrosine kinase inhibitor. Cancer Commun (Lond) 2020; 40:285-300. [PMID: 32525624 PMCID: PMC7365458 DOI: 10.1002/cac2.12040] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/26/2020] [Accepted: 05/14/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Overexpression of ATP-binding cassette (ABC) transporter is a major contributor to multidrug resistance (MDR), in which cancer cells acquire resistance to a wide spectrum of chemotherapeutic drugs. In this work, we evaluated the sensitizing effect of sitravatinib, a broad-spectrum tyrosine kinase inhibitor (TKI), on ATP-binding cassette subfamily B member 1 (ABCB1)- and ATP-binding cassette subfamily C member 10 (ABCC10)-mediated MDR. METHODS MTT assay was conducted to examine cytotoxicity and evaluate the sensitizing effect of sitravatinib at non-toxic concentrations. Tritium-labeled paclitaxel transportation, Western blotting, immunofluorescence analysis, and ATPase assay were carried out to elucidate the mechanism of sitravatinib-induced chemosensitization. The in vitro findings were translated into preclinical evaluation with the establishment of xenograft models. RESULTS Sitravatinib considerably reversed MDR mediated by ABCB1 and partially antagonized ABCC10-mediated MDR. Our in silico docking simulation analysis indicated that sitravatinib strongly and stably bound to the transmembrane domain of ABCB1 human-mouse chimeric model. Furthermore, sitravatinib inhibited hydrolysis of ATP and synchronously decreased the efflux function of ABCB1. Thus, sitravatinib could considerably enhance the intracellular concentration of anticancer drugs. Interestingly, no significant alterations of both expression level and localization of ABCB1 were observed. More importantly, sitravatinib could remarkably restore the antitumor activity of vincristine in ABCB1-mediated xenograft model without observable toxic effect. CONCLUSIONS The findings in this study suggest that the combination of sitrvatinib and substrate antineoplastic drugs of ABCB1 could attenuate the MDR mediated by the overexpression of ABCB1.
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Affiliation(s)
- Yuqi Yang
- Department of Pharmaceutical SciencesCollege of Pharmacy and Health SciencesSt. John's UniversityQueensNew York11439USA
| | - Ning Ji
- Department of Pharmaceutical SciencesCollege of Pharmacy and Health SciencesSt. John's UniversityQueensNew York11439USA
- State Key Laboratory of Experimental HematologyChinese Academy of Medical Science and Peking Union Medical CollegeInstitute of Hematology and Blood Diseases HospitalTianjin300020P. R. China
| | - Chao‐Yun Cai
- Department of Pharmaceutical SciencesCollege of Pharmacy and Health SciencesSt. John's UniversityQueensNew York11439USA
| | - Jing‐Quan Wang
- Department of Pharmaceutical SciencesCollege of Pharmacy and Health SciencesSt. John's UniversityQueensNew York11439USA
| | - Zi‐Ning Lei
- Department of Pharmaceutical SciencesCollege of Pharmacy and Health SciencesSt. John's UniversityQueensNew York11439USA
| | - Qiu‐Xu Teng
- Department of Pharmaceutical SciencesCollege of Pharmacy and Health SciencesSt. John's UniversityQueensNew York11439USA
| | - Zhuo‐Xun Wu
- Department of Pharmaceutical SciencesCollege of Pharmacy and Health SciencesSt. John's UniversityQueensNew York11439USA
| | - Qingbin Cui
- Department of Pharmaceutical SciencesCollege of Pharmacy and Health SciencesSt. John's UniversityQueensNew York11439USA
- School of Public HealthGuangzhou Medical UniversityGuangzhouGuangdong511436P. R. China
| | - Yihang Pan
- Tomas Lindahl Nobel Laureate Laboratorythe Seventh Affiliated Hospital of Sun Yat‐sen UniversityShenzhenGuangdong518107P. R. China
| | - Zhe‐Sheng Chen
- Department of Pharmaceutical SciencesCollege of Pharmacy and Health SciencesSt. John's UniversityQueensNew York11439USA
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Prognostic value of preoperative prognostic nutritional index in patients with renal cell carcinoma after nephrectomy. Clin Chim Acta 2020; 509:210-216. [PMID: 32562664 DOI: 10.1016/j.cca.2020.06.025] [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] [Received: 04/22/2020] [Revised: 06/06/2020] [Accepted: 06/12/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The present study was performed to explore the prognostic value of prognostic nutritional index (PNI) in renal cell carcinoma (RCC) patients following nephrectomy. METHODS A total of 660 patients were included. PNI was calculated based on the following formula: serum albumin level (g/L) + 0.005 × total lymphocyte count (per mm3). Kaplan-Meier survival curve and the log-rank test were conducted. Univariate analysis and multivariate Cox regression analysis were performed to explore the prognostic factors. RESULTS The patients in low PNI group were more likely to be older (P < 0.001), have a larger tumor (P < 0.001), higher pathological T stage (P < 0.001), positive lymph node (P = 0.038), distant metastasis (P = 0.005), higher tumor grade (P < 0.001) and tumor necrosis (P < 0.001). Multivariable analysis revealed low preoperative PNI was an independent predictor of overall survival (OS) (P = 0.034) and progression-free survival (PFS) (P = 0.004) for all patients. Besides, low preoperative PNI was also significantly associated with poor OS (P = 0.008), cancer-specific survival (CSS) (P = 0.032) and PFS (P = 0.003) for non-metastatic RCC patients. CONCLUSION The patients with lower preoperative PNI were associated with adverse factors. Furthermore, the low preoperative PNI was also associated with inferior oncological outcomes in RCC patients who underwent nephrectomy.
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Prognostic Significance of Preoperative Prognostic Nutritional Index in Patients Undergoing Nephrectomy for Nonmetastatic Renal Cell Carcinoma. Am J Clin Oncol 2020; 43:388-392. [DOI: 10.1097/coc.0000000000000680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Yasar HA, Bir Yucel K, Arslan C, Ucar G, Karakaya S, Bilgin B, Taban H, Kucukarda A, Erturk I, Hızal M, Yıldız B, Yıldırım N, Demirci U, Sendur MA, Utkan G, Kılıckap S, Cicin I, Karadurmus N, Ürün Y. The relationship between prognostic nutritional index and treatment response in patients with metastatic renal cell cancer. J Oncol Pharm Pract 2019; 26:1110-1116. [DOI: 10.1177/1078155219883004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Introduction and aim To investigate the effect of the prognostic nutritional index on treatment response and survival in patients with metastatic renal cell cancer. Methods We retrospectively analyzed the treatment modalities; the demographic, clinical and pathological features of 396 patients with RCC and prognostic nutritional index. Based on the median value, patients were grouped as having low and high prognostic nutritional index values. Kaplan-Meier method was used for survival analysis, and Cox-regression analysis was used for multivariate analysis. Results The median overall survival was 39 months (95% CI 26.1–51.8), 28 months (95% CI 17.9–38) and 7 months (95% CI 4.7–9.2) in patients with favorable, intermediate and poor International Metastatic Renal Cell Carcinoma Database Consortium risk group, respectively. The difference between the groups was statistically significant (p < 0001). Overall survival was 11 months (95% CI 7.5–14.5) in the low-prognostic nutritional index (prognostic nutritional index ≤38.5) group, and 41 months (95% CI 30.5–51.4) in the high prognostic nutritional index (prognostic nutritional index >38.5) group (p < 0.001). In Cox regression analysis, Eastern Cooperative Oncology Group performance score (HR: 2.5), time to systemic treatment (HR: 1.7) and prognostic nutritional index (HR: 1.8) were associated with overall survival. Conclusion In patients with renal cell cancer, prognostic nutritional index is closely related to survival and has prognostic significance.
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Affiliation(s)
- Hatime Arzu Yasar
- Faculty of Medicine, Medical Oncology Department, Ankara University Ankara, Turkey
- Cancer Research Institute, Ankara University, Ankara, Turkey
| | - Kadriye Bir Yucel
- Faculty of Medicine, Internal Medicine Department, Ankara University, Ankara, Turkey
| | - Cagatay Arslan
- Faculty of Medicine, Department of Internal Medicine and Medical Oncology, Bahcesehir University, Istanbul, Turkey
| | - Gokhan Ucar
- Ankara Numune Education and Research Hospital, Medical Oncology Department, University of Health Sciences, Ankara, Turkey
| | - Serdar Karakaya
- Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Medical Oncology Department, University of Health Sciences, Ankara, Turkey
| | - Burak Bilgin
- Faculty of Medicine, Medical Oncology Department, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Hakan Taban
- Faculty of Medicine, Medical Oncology Department, Hacettepe University, Ankara, Turkey
| | - Ahmet Kucukarda
- Faculty of Medicine, Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Ismail Erturk
- Gülhane Education and Research Hospital, Medical Oncology Department, University of Health Sciences, Ankara, Turkey
| | - Mutlu Hızal
- Faculty of Medicine, Medical Oncology Department, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Birol Yıldız
- Gülhane Education and Research Hospital, Medical Oncology Department, University of Health Sciences, Ankara, Turkey
| | - Nuriye Yıldırım
- Faculty of Medicine, Medical Oncology Department, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Umut Demirci
- Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Medical Oncology Department, University of Health Sciences, Ankara, Turkey
| | - Mehmet Ali Sendur
- Faculty of Medicine, Medical Oncology Department, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Gungor Utkan
- Faculty of Medicine, Medical Oncology Department, Ankara University Ankara, Turkey
- Cancer Research Institute, Ankara University, Ankara, Turkey
| | - Saadettin Kılıckap
- Faculty of Medicine, Medical Oncology Department, Hacettepe University, Ankara, Turkey
| | - Irfan Cicin
- Faculty of Medicine, Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Nuri Karadurmus
- Gülhane Education and Research Hospital, Medical Oncology Department, University of Health Sciences, Ankara, Turkey
| | - Yüksel Ürün
- Faculty of Medicine, Medical Oncology Department, Ankara University Ankara, Turkey
- Cancer Research Institute, Ankara University, Ankara, Turkey
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Qi F, Zhou X, Wang Y, Wang Y, Wang Y, Zhang Q, Cong R, Yang J, Song N. Pre-treatment prognostic nutritional index may serve as a potential biomarker in urinary cancers: a systematic review and meta-analysis. Cancer Cell Int 2018; 18:207. [PMID: 30564063 PMCID: PMC6296044 DOI: 10.1186/s12935-018-0708-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 12/11/2018] [Indexed: 12/17/2022] Open
Abstract
Background To investigate the potential prognostic role of pre-treatment prognostic nutritional index (PNI) in urinary cancers. Methods Relevant articles were searched comprehensively from PubMed, Embase and Web of Science, up to November 2018. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted to evaluate their associations. Result A total of 12 related articles including 6561 patients were ultimately enrolled. Our results indicated that a relatively lower level of pre-treatment PNI was associated with decreased OS, CSS/DSS and DFS/RFS/PFS (pooled HR = 1.68, 95% CI 1.45–1.95; pooled HR = 1.57, 95% CI 1.33–1.86; pooled HR = 1.75, 95% CI 1.53–1.99, respectively). Subsequent stratified analysis by cancer type for OS showed that PNI could also be a predictor no matter in renal cell cancer (RCC) or bladder cancer (BC) (pooled HR = 1.65, 95% CI 1.37–1.97 and pooled HR = 1.67, 95% CI 1.20–2.33). Similar results could be found in DFS/RFS/PFS (RCC: HR = 1.81, 95% CI 1.54–2.13 and BC: HR = 1.68, 95% CI 1.32–2.12) and in CSS/DSS (RCC: HR = 1.50, 95% CI 1.23–1.82 and upper tract urothelial carcinoma: HR = 1.61, 95% CI 1.13–2.28). As for the treatment subgroup, a relatively lower level of PNI could also be a positive predictor for OS (surgery: HR = 1.64, 95% CI 1.40–1.93; target therapy: HR = 1.88, 95% CI 1.34–2.63) and DFS/RFS/PFS (surgery: HR = 1.69, 95% CI 1.47–1.95; target therapy: HR = 2.14, 95% CI 1.50–3.05). Conclusion The outcomes of us shed light on that elevated pre-treatment PNI was positively associated with OS, CSS/DSS and DFS/RFS/PFS, indicating that it could be an independent prognostic factor in urinary cancers.
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Affiliation(s)
- Feng Qi
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210009 China
| | - Xiang Zhou
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210009 China
| | - Yi Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210009 China
| | - Yamin Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210009 China
| | - Yichun Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210009 China
| | - Qijie Zhang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210009 China
| | - Rong Cong
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210009 China
| | - Jie Yang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210009 China
| | - Ninghong Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210009 China
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Tang Y, Liu Z, Liang J, Zhang R, Wu K, Zou Z, Zhou C, Zhang F, Lu Y. Early post-operative serum albumin level predicts survival after curative nephrectomy for kidney cancer: a retrospective study. BMC Urol 2018; 18:111. [PMID: 30522461 PMCID: PMC6282248 DOI: 10.1186/s12894-018-0427-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 11/28/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Previous studies have shown that albumin-related systemic inflammation is associated with the long-term prognosis of cancer, but the clinical significance of an early (≤ 7 days) post-operative serum albumin level has not been well-documented as a prognostic factor in patients with renal cell cancer. METHODS We retrospectively included patients hospitalized for kidney cancer from January 2009 to May 2014. First, the receiver operating characteristic analysis was used to define the best cut-off of an early post-operative serum albumin level in determining the prognosis, from which survival analysis was performed. RESULTS A total of 329 patients were included. The median duration of follow-up was 54.8 months. Patients with an early post-operative serum albumin level < 32 g/L had a significantly shorter median recurrence-free survival (RFS; 49.1 versus 56.5 months, P = 0.001) and median overall survival (OS; 52.2 versus 57.0 months, P = 0.049) than patients with an early post-operative serum albumin level ≥ 32 g/L. After adjusting for age, BMI, tumor stage, post-operative hemoglobin concentration, and pre-operative albumin, globulin, and hemoglobin levels, multivariate Cox regression showed that an early post-operative serum albumin level < 32 g/L was an independent prognostic factor associated with a decreased RFS (HR = 3.60; 95% CI,1.05-12.42 [months], P = 0.042) and decreased OS (HR = 9.95; 95% CI, 1.81-54.80 [months], P = 0.008). CONCLUSION An early post-operative serum albumin level < 32 g/L is an independent prognostic factor leading to an unfavorable RFS and OS. Prospective trials and further studies involving additional patients are warranted.
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Affiliation(s)
- Yongquan Tang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, No. 37 of Guoxue Xiang, Chengdu, 610041 China
| | - Zhihong Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiayu Liang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Ruochen Zhang
- Department of Urology, Fujian Provincial Hospital, Fuzhou, China
| | - Kan Wu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Zijun Zou
- Department of Urology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chuan Zhou
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Fuxun Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yiping Lu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
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