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Saito S, Takahashi H, Yata Y, Takamizawa S, Hara S, Miyajima K, Iwatani K, Yasue K, Nishikawa H, Yamamoto T, Koide H, Sadakane I, Atsuta M, Mori K, Imai Y, Kayano S, Murakami M, Tashiro K, Tsuzuki S, Yamada H, Miki J, Urabe F, Kimura T, On Behalf Of Jikei-Scrum Collaborative Group. Associations between early changes in the neutrophil-to-lymphocyte ratio after radical nephroureterectomy and treatment outcomes. Jpn J Clin Oncol 2024:hyae081. [PMID: 38920339 DOI: 10.1093/jjco/hyae081] [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: 04/12/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVES This study explored the impacts of peri-operative changes in the neutrophil-to-lymphocyte ratio (NLR) on the survival rate after radical nephroureterectomy. METHODS This retrospective analysis included a multicentric cohort of patients diagnosed with upper tract urothelial carcinoma (UTUC) who had undergone radical nephroureterectomy from 2012 to 2021. We assessed the preoperative NLR, postoperative NLR, delta-NLR (difference between postoperative and preoperative NLRs), and NLR change (ratio of postoperative to preoperative NLR). Additionally, patients were categorized according to increases in their preoperative and/or postoperative NLRs. Associations of survival with peri-operative changes in the NLR were investigated using Cox multivariate regression models. RESULTS A total of 488 patients were included in the study, with a median age of 73 years. Among the patients, 105 (21.5%) exhibited elevated preoperative and postoperative NLRs, 88 (18.0%) exhibited elevated preoperative NLR only, 53 (10.9%) exhibited elevated postoperative NLR only, and 242 (49.6%) exhibited normal NLRs. Multivariate analysis indicated significant negative correlations between both preoperative and postoperative increased NLRs and oncological outcomes, including nonurothelial tract recurrence-free survival and cancer-specific survival (hazard ratio [HR]: 1.65, P = 0.017; HR: 2.12, P = 0.014, respectively). CONCLUSION This is the first study to evaluate the association between peri-operative changes in the NLR and the outcomes of patients with UTUC who underwent radical nephroureterectomy. Patients with elevated NLRs at both time points experienced considerably worse outcomes. Further research should explore whether increases in the NLR during long-term follow-up could indicate impending disease recurrence.
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Affiliation(s)
- Shun Saito
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Hidetsugu Takahashi
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuji Yata
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Shuhei Hara
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Keiichiro Miyajima
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kosuke Iwatani
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Keiji Yasue
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideomi Nishikawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Toshihiro Yamamoto
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Haruhisa Koide
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ibuki Sadakane
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Mahito Atsuta
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Keiichiro Mori
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yu Imai
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Sotaro Kayano
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Masaya Murakami
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kojiro Tashiro
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Urology, Jikei Katsushika Medical Center, Tokyo, Japan
| | - Shunsuke Tsuzuki
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroki Yamada
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Urology, Jikei Katsushika Medical Center, Tokyo, Japan
| | - Jun Miki
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Fumihiko Urabe
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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Keskin ET, Özdemir H, Uğur R, Savun M, Çolakoğlu Y, Şimşek A. Could Prognostic Nutritional Index be a new criteria for active surveillance of prostate cancer? Actas Urol Esp 2023; 47:573-580. [PMID: 37086847 DOI: 10.1016/j.acuroe.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 04/24/2023]
Abstract
OBJECTIVE To evaluate the importance of the Prognotic Nutritional Index(PNI) value for patient selection of active surveillance(AS) in prostate cancer. METHODS Between September 2020 and June 2022, the data of 125-patients who underwent Robot-Assisted-Laparoscopic-Prostatectomy(RALP) were retrospectively analyzed. All patients were suitable for AS preoperatively. Using the pathological results of RALP, patients have been divided two groups. Patients who met the criteria for AS were defined as the first group, others were defined second. Demographic datas, PNI values and hematological parameters of the groups were compared. RESULTS 38% (n:48) patients were found suitable for the group1, and 62%(n:77) were found suitable for the group 2. Upgrading and upstaging were found at 76 patients (61%) and 26(21%), respectively. There is no significant difference between groups on age, BMI, PSA, PSA-density, prostate volume, and PIRADS. PNI value was found higher at first group. The value of 49.45 was calculated by ROC analysis as the ideal PNI cut-off value for predicting upgrading and upstaging of prostate cancer (P < ,001). According to the both univariate and multivariate regression analysis, PNI was found a predictor for exclusion from AS (P < ,001). CONCLUSION Upgrading and upstaging are detected at a higher rate in patients with low PNI values. The use of PNI value in the selection of patients to AS will increase the success rate of ideal patient selection.
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Affiliation(s)
- E T Keskin
- Servicio de Urología, Hospital Urbano de Basaksehir Cam y Sakura, Estambul, Turkey.
| | - H Özdemir
- Servicio de Urología, Hospital Urbano de Basaksehir Cam y Sakura, Estambul, Turkey
| | - R Uğur
- Servicio de Urología, Hospital Urbano de Basaksehir Cam y Sakura, Estambul, Turkey
| | - M Savun
- Servicio de Urología, Hospital Urbano de Basaksehir Cam y Sakura, Estambul, Turkey
| | - Y Çolakoğlu
- Servicio de Urología, Hospital Urbano de Basaksehir Cam y Sakura, Estambul, Turkey
| | - A Şimşek
- Servicio de Urología, Hospital Urbano de Basaksehir Cam y Sakura, Estambul, Turkey
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The Predictive Significance of Prognostic Nutritional Index and Serum Albumin/Globulin Ratio on the Overall Survival of Penile Cancer Patients Undergoing Penectomy. Curr Oncol 2022; 29:7569-7578. [PMID: 36290873 PMCID: PMC9599963 DOI: 10.3390/curroncol29100596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/25/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022] Open
Abstract
Objective: To assess the value of using the prognostic nutritional index (PNI) and serum albumin/globulin ratio (AGR) in predicting the overall survival (OS) of patients with penile cancer (PC) undergoing penectomy. Materials and methods: A retrospective analysis of 123 patients who were admitted to our hospital due to PC from April 2010 to September 2021 and who underwent penectomy were included in the study. The optimal cut-off value of the PNI and AGR was determined by receiver operating characteristic curve analysis. Kaplan-Meier analysis and the Cox proportional hazard model were used to evaluate the correlation between the PNI, AGR, and OS in patients with PC. Results: A total of 16 of the 123 patients died during the follow-up period, and the median follow-up time was 58.0 months. The best cut-off values of the PNI and AGR were set to 49.03 (95% confidence interval 0.705-0.888, Youden index = 0.517, sensitivity = 57.9%, specificity = 93.7%, p < 0.001) and 1.28 (95% confidence interval 0.610-0.860, Youden index = 0.404, sensitivity = 84.1%, specificity = 56.2%, p = 0.003). The Kaplan-Meier analysis showed that the OS of the patients in the high PNI group and the high AGR group was significantly higher than that of the patients in the low PNI group and the low AGR group (p < 0.001). The univariable analysis showed that the aCCI, the clinical N stage, the pathological stage, and the PNI, AGR, SII, and PLR are all predictors of OS in patients with PC (p < 0.05). The multivariable analysis showed that the PNI (risk rate [HR] = 0.091; 95% CI: 0.010-0.853; p = 0.036) and the AGR (risk rate [HR] = 0.171; 95% CI: 0.043-0.680; p = 0.012) are independent prognostic factors for predicting OS in patients with PC undergoing penectomy. Conclusions: Both the PNI score and the serum AGR are independent prognostic factors for predicting OS in patients with PC undergoing penectomy.
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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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Decreased Preoperative Serum AGR as a Diagnostic Marker of Poor Prognosis after Radical Surgery of Upper Urinary Tract and Bladder Cancers from a Pooled Analysis of 9,002 Patients. DISEASE MARKERS 2022; 2022:6575605. [PMID: 36105255 PMCID: PMC9467785 DOI: 10.1155/2022/6575605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/01/2022] [Indexed: 11/18/2022]
Abstract
A growing number of studies have regarded the preoperative serum albumin-to-globulin ratio (AGR) as a prognostic indicator of urothelial carcinoma (UC) following radical surgery. However, a pooled analysis of AGR's effect on UC prognosis was still insufficient. Up to January 2022, a systematic search was conducted using PubMed, Embase, Web of Science, and Cochrane Library. Stata SE software was applied in this study. The reviewers collected the hazard ratio (HR) with 95% confidence interval (CI) for overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), progression-free survival (PFS), and metastasis-free survival (MFS). A total of 9,002 patients from 12 retrospective studies were included in this analysis. The results showed that preoperative serum AGR was significantly associated with the OS (HR = 1.85, 95%CI = 1.43 to 2.39), CSS (HR = 2.38, 95%CI = 1.69 to 3.34), RFS (HR = 1.64, 95%CI = 1.29 to 2.08), PFS (HR = 2.16, 95%CI = 1.43 to 3.27), and MFS (HR = 3.00, 95%CI = 1.63 to 5.53) of patients with UC following radical surgery. Sensitivity analysis indicated the stability of the results. Subgroup analysis revealed that preoperative low AGR was seen as a risk factor for OS (HR = 1.90, 95%CI = 1.34 to 2.69), CSS (HR = 2.13, 95%CI = 1.40 to 3.26), and RFS (HR = 1.60, 95%CI = 1.24 to 2.07) in upper tract urothelial carcinoma (UTUC), but it was only a risk factor for CSS (HR = 2.95, 95%CI = 1.14 to 7.60) in bladder cancer (BC). Besides, preoperative AGR cut − value ≤ 1.4 could not be deemed as a stable prognostic indicator for RFS (HR = 2.07, 95%CI = 0.71 to 6.04) in UC. However, the predictive ability of AGR cut − value > 1.4 was stable. All in all, preoperative low AGR was considered as a risk factor for UC. AGR level can be regarded as a prognostic indicator for OS, CSS, and RFS in UTUC but only for CSS in BC. AGR greater than 1.4 can be a great cut-off value for predicting the prognosis of UC patients with radical operation.
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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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Li S, Lu S, Liu X, Chen X. Association Between the Pretreatment Albumin-to-Alkaline Phosphatase Ratio and Clinical Outcomes in Patients With Bladder Cancer Treated With Radical Cystectomy: A Retrospective Cohort Study. Front Oncol 2021; 11:664392. [PMID: 33959511 PMCID: PMC8093628 DOI: 10.3389/fonc.2021.664392] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/30/2021] [Indexed: 12/14/2022] Open
Abstract
Objective Serum albumin-to-alkaline phosphatase ratio (AAPR) has been proven to be a prognostic indicator of many malignant tumors. However, whether it can predict the prognosis of bladder cancer (BC) patients who underwent radical cystectomy (RC) remains unclear. This study was designed to assess the relationship between AAPR and clinical outcomes in patients with BC treated with RC. Methods The clinicopathological data of 199 BC patients receiving RC in our institution from January 2012 to December 2017 were retrospectively collected and analyzed. They were divided into three groups based on the optimal cut-off values and the association between AAPR groups and their clinical outcomes were evaluated. Results The average age of the patients was (64.0 ± 8.7) years and 79.9% were male. Based on the cut-off values of AAPR, patients were divided into three groups: low-AAPR group (AAPR < 0.37, n = 35), medium-AAPR group (AAPR = 0.37-0.59, n = 61) and high-AAPR group (AAPR > 0.59, n = 103). The median overall survival (OS) of each AAPR group was 12.5, 24, and 29 months, respectively (P value <0.0001). After adjusting the Cox proportional hazards model, medium- and high- AAPR groups showed a reduced risk trend of death, with a risk ratio of 0.44 (95% CI = 0.21-0.91) and 0.25 (95% CI = 0.12-0.49), respectively (P for trend <0.001). No nonlinear relationship was identified by smooth fitting curve between AAPR and OS. By subgroup analysis, we observed that compared to the low-AAPR group, the trends of the HRs in the medium- and high-AAPR group were decreased across nearly all subgroups after stratification. Moreover, the AAPR-based nomograms for OS, CSS and RFS were also constructed. The C-index showed a good predictive accuracy (OS, C-index 0.728, 95% CI 0.663-0.793; CSS, C-index 0.792, 95% CI 0.748-0.838; RFS, C-index 0.784, 95% CI 0.739-0.829). Conclusion Pretreatment AAPR is significantly associated with the prognosis of BC patients receiving RC, which can be conducive to the clinical decision-making and risk stratification in those patients. The nomogram based on AAPR is a reliable model for predicting survival of BC patients after RC.
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Affiliation(s)
- Shijie Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shiyang Lu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xuefeng Liu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaonan Chen
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
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Shao Y, Li W, Wang D, Wu B. Prognostic value of preoperative lymphocyte-related systemic inflammatory biomarkers in upper tract urothelial carcinoma patients treated with radical nephroureterectomy: a systematic review and meta-analysis. World J Surg Oncol 2020; 18:273. [PMID: 33097052 PMCID: PMC7585317 DOI: 10.1186/s12957-020-02048-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/14/2020] [Indexed: 12/17/2022] Open
Abstract
Background Growing evidence shows that the preoperative lymphocyte-related systemic inflammatory biomarkers are associated with the prognosis of patients with upper tract urothelial carcinoma (UTUC). These markers include neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR). However, these findings are inconsistent, and the prognostic significance of these biomarkers is unclear. Moreover, the currently available prognostic indicators do not precisely predict the outcome of UTUC patients. This motivated us to investigate the prognostic values of NLR, PLR, and MLR in UTUC patients treated with radical nephroureterectomy (RNU). Methods We prospectively registered this in PROSPERO (CRD42020186531). We performed a comprehensive literature search of the PubMed, Web of Science, EMBASE, and Cochrane Library databases to identify the eligible studies evaluating the prognostic values of preoperative NLR, PLR, and MLR. Hazard ratios with 95% confidence intervals of overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), recurrence-free survival (RFS), metastasis-free survival (MFS), and progression-free survival (PFS) were extracted from the multivariate analyses and analyzed with fixed or random effects models when applicable. Heterogeneity among the studies was evaluated using Cochran’s Q test and I2 statistic. Sensitivity and subgroup analyses were conducted to explore the origin of heterogeneity. The Newcastle-Ottawa Scale (NOS) was applied to assess the quality of each enrolled study. Publication bias was determined using funnel plots together with Egger’s tests. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of the evidence. Results Overall, we included 10,339 UTUC patients from twenty-five retrospective studies. The results indicated that elevated preoperative NLR, PLR, and MLR were significantly associated with worse OS, CSS, DFS/RFS/MFS, and PFS in the UTUC patients undergoing RNU. Furthermore, the results of sensitivity and subgroup analyses demonstrated the rationality and reliability of the results. Conclusions The present meta-analysis demonstrated a significant association between elevated preoperative NLR, PLR, and MLR and poor prognosis in patients with surgically treated UTUC. Hence, lymphocyte-related systemic inflammatory biomarkers, in conjunction with clinicopathological factors, molecular markers, and other prognostic indicators, could be helpful to determine the primary treatment strategies and to design individualized follow-up plans for UTUC patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-020-02048-7.
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Affiliation(s)
- Yuan Shao
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Wenxia Li
- Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Dongwen Wang
- Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, People's Republic of China
| | - Bo Wu
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
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Bolat İ, Biteker M. Prognostic Nutritional Index Predicts Perioperative Adverse Events in Patients Undergoing Noncardiac Surgery. Indian J Surg 2020. [DOI: 10.1007/s12262-020-02112-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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10
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Levy A, Canes D. Perioperative complications and adverse sequelae of radical nephroureterectomy. Transl Androl Urol 2020; 9:1853-1859. [PMID: 32944549 PMCID: PMC7475668 DOI: 10.21037/tau.2019.12.25] [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] [Indexed: 11/06/2022] Open
Abstract
Radical nephroureterectomy (RNU) has long been considered the standard of care for treatment of upper tract urothelial carcinoma (UTUC). Despite providing oncologic control, RNU is associated with measurable morbidity and mortality. High quality data is lacking as a result of low disease incidence and very few randomized studies. In this article we will review preoperative nomograms that assist with patient counseling, summarize current knowledge about perioperative complications, and discuss adverse sequelae that may result after surgery.
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Affiliation(s)
- Alison Levy
- Department of Urology, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - David Canes
- Department of Urology, Lahey Hospital and Medical Center, Burlington, MA, USA
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11
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Omura S, Taguchi S, Miyagawa S, Matsumoto R, Samejima M, Ninomiya N, Masuda K, Nakamura Y, Yamaguchi T, Kinjo M, Tambo M, Okegawa T, Higashihara E, Fukuhara H. Prognostic significance of the albumin-to-globulin ratio for upper tract urothelial carcinoma. BMC Urol 2020; 20:133. [PMID: 32859201 PMCID: PMC7456038 DOI: 10.1186/s12894-020-00700-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 08/19/2020] [Indexed: 01/26/2023] Open
Abstract
Background Although the albumin-to-globulin ratio (AGR) is a promising biomarker for various malignancies, few studies have investigated its prognostic significance for upper tract urothelial carcinoma (UTUC). Methods This retrospective study conformed to the REporting recommendations for tumour MARKer prognostic studies (REMARK) guideline. We reviewed 179 patients with UTUC who underwent radical nephroureterectomy at our institution between 2008 and 2018. Associations of preoperative clinicopathological factors, including the AGR, with cancer-specific survival (CSS) and overall survival (OS) were assessed. The Cox proportional hazards model was used for univariate and multivariable analyses. AGR was dichotomized as < 1.25 and ≥ 1.25, according to the most discriminatory cutoff determined from the receiver operating characteristic curve analysis. Results During a median follow-up of 34 months after surgery, 37 patients died from UTUC and 13 died of other causes. The preoperative AGR significantly correlated with pathological T stage, pathological N stage, and adjuvant chemotherapy. Multivariate analyses demonstrated that a decreased (< 1.25) preoperative AGR was an independent poor prognostic factor for both CSS (hazard ratio [HR] = 2.81, P < 0.01) and OS (HR = 2.09, P < 0.05). Conclusions Preoperative AGR < 1.25 might serve as a useful prognostic marker for patients with UTUC undergoing radical nephroureterectomy.
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Affiliation(s)
- Shota Omura
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Satoru Taguchi
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Shogo Miyagawa
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Ryuki Matsumoto
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Mio Samejima
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Naoki Ninomiya
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Kazuki Masuda
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Yu Nakamura
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Tsuyoshi Yamaguchi
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Manami Kinjo
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Mitsuhiro Tambo
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Takatsugu Okegawa
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Eiji Higashihara
- Department of ADPKD Research, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
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12
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Zheng Y, Yu D, Yu Z, Zhao D, Chen Y, Chen W, Li Y, Lin B, Gao X. Association of preoperative systemic Immune-inflammation Index and Prognostic Nutritional Index with survival in patients with Upper Tract Urothelial Carcinoma. J Cancer 2020; 11:5665-5677. [PMID: 32913461 PMCID: PMC7477451 DOI: 10.7150/jca.44915] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 07/13/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Both systemic inflammation response and malnutrition are closely related to poor prognosis in patients with certain types of solid tumor. This study investigated the prognostic value of the preoperative combination of systemic immune-inflammation index and prognostic nutritional index (SII-PNI) in patients with upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU). Methods: The predictive ability of SII-PNI was developed and further validated in a cohort of 525 UTUC patients (253 in the training cohort and 272 in the validation cohort) who received RNU. Results: Survival analysis indicated that a SII ≥672.44 was significantly associated with worse overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) while a PNI ≥47.83 was associated with better survival outcomes (All P-values < 0.05). The combination of simultaneously SII ≥672.44 and PNI <47.83 was a powerful independent risk factor for OS, CSS, and RFS (P < 0.05). The SII-PNI had the largest area under the curve (AUC) compared to that for SII or PNI alone and other clinical factors, indicating its superior for predicting survival. In addition, the incorporation of the SII-PNI into established nomograms or current clinical parameters such as pathologic T stage and N stage, achieved higher c-indexes or larger AUC than without, indicating that adding SII-PNI helped predict prognosis. All results were found in the training cohort and confirmed in the validation cohort. Conclusions: SII-PNI was a strong independent predictor of UTUC patients after RNU.
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Affiliation(s)
- Yangqin Zheng
- Department of Hematology, The Third Clinical Institute Affiliated to Wenzhou Medical University, People's Hospital of Wenzhou, Wenzhou, Zhejiang province, 325006, P.R. China
| | - Dongdong Yu
- Department of Andrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang province, 325006, P.R. China
| | - Zhixian Yu
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang province,325006, P.R. China
| | - Dewei Zhao
- Department of Urology, Wenzhou Central Hospital, Wenzhou, Zhejiang province, 325200, P.R. China
| | - Yuming Chen
- Department of Urology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu province, 225001, P.R. China
| | - Wu Chen
- Department of Urology, The Third Clinical Institute Affiliated to Wenzhou Medical University, People's Hospital of Wenzhou, Wenzhou, Zhejiang province, 325006, P.R. China
| | - Yeping Li
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang province,325006, P.R. China
| | - Binwei Lin
- Department of Urology, Rui'an People's Hospital, The Third Affiliated Hospital of the Wenzhou Medical University, Wenzhou, Zhejiang province, 325200, P.R. China
| | - Xiaomin Gao
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, P.R. China
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Brighi N, Farolfi A, Conteduca V, Gurioli G, Gargiulo S, Gallà V, Schepisi G, Lolli C, Casadei C, De Giorgi U. The Interplay between Inflammation, Anti-Angiogenic Agents, and Immune Checkpoint Inhibitors: Perspectives for Renal Cell Cancer Treatment. Cancers (Basel) 2019; 11:E1935. [PMID: 31817109 PMCID: PMC6966461 DOI: 10.3390/cancers11121935] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/30/2019] [Accepted: 12/01/2019] [Indexed: 12/12/2022] Open
Abstract
Treatment options for metastatic renal cell carcinoma (RCC) have been expanding in the last years, from the consolidation of several anti-angiogenic agents to the approval of immune checkpoint inhibitors (ICIs). The rationale for the use of immunomodulating agents derived from the observation that RCC usually shows a diffuse immune-cell infiltrate. ICIs target Cytotoxic T Lymphocytes Antigen 4 (CTLA-4), programmed death 1 (PD-1), or its ligand (PD-L1), showing promising therapeutic efficacy in RCC. PD-L1 expression is associated with poor prognosis; however, its predictive role remains debated. In fact, ICIs may be a valid option even for PD-L1 negative patients. The establishment of valid predictors of treatment response to available therapeutic options is advocated to identify those patients who could benefit from these agents. Both local and systemic inflammation contribute to tumorigenesis and development of cancer. The interplay of tumor-immune status and of cancer-related systemic inflammation is pivotal for ICI-treatment outcome, but there is an unmet need for a more precise characterization. To date, little is known on the role of inflammation markers on PD-1 blockade in RCC. In this paper, we review the current knowledge on the interplay between inflammation markers, PD-1 axis, and anti-angiogenic agents in RCC, focusing on biological rationale, implications for treatment, and possible future perspectives.
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Affiliation(s)
- Nicole Brighi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (N.B.); (V.C.); (G.S.); (C.L.); (C.C.); (U.D.G.)
| | - Alberto Farolfi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (N.B.); (V.C.); (G.S.); (C.L.); (C.C.); (U.D.G.)
| | - Vincenza Conteduca
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (N.B.); (V.C.); (G.S.); (C.L.); (C.C.); (U.D.G.)
| | - Giorgia Gurioli
- Bioscience Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (G.G.); (S.G.)
| | - Stefania Gargiulo
- Bioscience Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (G.G.); (S.G.)
| | - Valentina Gallà
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy;
| | - Giuseppe Schepisi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (N.B.); (V.C.); (G.S.); (C.L.); (C.C.); (U.D.G.)
| | - Cristian Lolli
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (N.B.); (V.C.); (G.S.); (C.L.); (C.C.); (U.D.G.)
| | - Chiara Casadei
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (N.B.); (V.C.); (G.S.); (C.L.); (C.C.); (U.D.G.)
| | - Ugo De Giorgi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (N.B.); (V.C.); (G.S.); (C.L.); (C.C.); (U.D.G.)
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Chatterjee S. Commentary: "It's tough to make predictions, especially about the future"-Use of the Prognostic Nutritional Index for cardiac surgery outcomes. J Thorac Cardiovasc Surg 2019; 160:156-157. [PMID: 31606167 DOI: 10.1016/j.jtcvs.2019.08.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 08/14/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Subhasis Chatterjee
- Michael E. DeBakey Department of Surgery, Divisions of General and Cardiothoracic Surgery, Baylor College Medicine, Houston, Tex; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Tex.
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15
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Trujillo EB, Dixon SW, Claghorn K, Levin RM, Mills JB, Spees CK. Closing the Gap in Nutrition Care at Outpatient Cancer Centers: Ongoing Initiatives of the Oncology Nutrition Dietetic Practice Group. J Acad Nutr Diet 2019; 118:749-760. [PMID: 29576094 DOI: 10.1016/j.jand.2018.02.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Indexed: 12/16/2022]
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16
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Xue W, Tan P, Xu H, Yang L, Wei Q. Impact of the preoperative prognostic nutritional index on survival outcomes in upper tract urothelial carcinomas. Cancer Med 2019; 8:2971-2978. [PMID: 31070304 PMCID: PMC6558464 DOI: 10.1002/cam4.2161] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 03/28/2019] [Indexed: 02/05/2023] Open
Abstract
PURPOSES To investigate the value of prognostic nutritional index (PNI) in patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU). PATIENTS AND METHODS A total of 717 patients were included in our study from 2003 to 2016. PNI was calculated as 10 × serum albumin level (g/dL) + 0.005 × total lymphocyte count (per mm3 ). Kaplan-Meier analysis and Cox regression models were adapted to analyze the value of PNI on survival outcomes. RESULTS The cutoff value of PNI was set as 46.91 and 298 patients (47.6%) had PNI <46.91. The median follow-up was 50 months. The results suggested that low PNI was significantly associated with worse pathologic features (all P < 0.001). Multivariable Cox regression analysis revealed that PNI < 46.91 was an independent predictor of poor overall survival (Hazard ratios [HR] = 1.777, 95% CI = 1.383-2.284, P < 0.001), cancer-specific survival (HR = 1.850, 95% CI = 1.399-2.445, P < 0.001), and recurrence-free survival (HR = 1.554, 95% CI = 1.229-1.964, P < 0.001). CONCLUSIONS Low preoperative PNI was associated with worse survival outcomes in patients with UTUC. PNI could be an easily assessed blood-based biomarker to predict the prognosis in patients with UTUC treated with RNU.
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Affiliation(s)
- Wenbin Xue
- Department of Urology & Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Tan
- Department of Urology & Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Hang Xu
- Department of Urology & Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Lu Yang
- Department of Urology & Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology & Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
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17
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Kushiyama S, Sakurai K, Kubo N, Tamamori Y, Nishii T, Tachimori A, Inoue T, Maeda K. The Preoperative Geriatric Nutritional Risk Index Predicts Postoperative Complications in Elderly Patients with Gastric Cancer Undergoing Gastrectomy. In Vivo 2019; 32:1667-1672. [PMID: 30348732 DOI: 10.21873/invivo.11430] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND/AIM The relationship between the preoperative Geriatric Nutritional Risk Index (GNRI) and morbidity of patients with gastric cancer (GC) undergoing gastrectomy has not yet been reported. Our study aimed to investigate whether preoperative GNRI is associated with short-term outcomes in elderly patients with GC. PATIENTS AND METHODS This study enrolled 348 elderly patients with GC who were more than 75 years old and underwent curative gastrectomy for GC at our Institution between January 2006 and December 2015. GNRI was invoked to stratify patients as high (GNRI≥92; n=190) or low (GNRI<92; n=158) GNRI nutritional status. The clinicopathologic features and short-term outcomes were compared. RESULTS In multivariate analysis, low GNRI emerged as an independent predictor of postoperative complications (Clavien Dindo classification grade II≤). Low GNRI demonstrated significantly more frequent extra-surgical complications than high GNRI. Significantly more patients with low GNRI suffered from postoperative pneumoniae than patients with high GNRI (p=0.013). On the other hand, the incidence of surgical field complications such as leakage, pancreatic fistula and intraabdominal abscess did not differ significantly between the groups. CONCLUSION GNRI is useful in predicting postoperative complications of elderly patients with GC undergoing gastrectomy. Preoperative GNRI has merit as a gauge of postoperative complications in the extra-surgical field, especially pneumonia. There was no relationship between preoperative GNRI and surgical field complications in this setting.
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Affiliation(s)
- Syuhei Kushiyama
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Katsunobu Sakurai
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Naoshi Kubo
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Yutaka Tamamori
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Takafumi Nishii
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Akiko Tachimori
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Toru Inoue
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Kiyoshi Maeda
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
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18
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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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Xu H, Tan P, Jin X, Ai J, Lin T, Lei H, Yang L, Wei Q. Validation of the preoperative controlling nutritional status score as an independent predictor in a large Chinese cohort of patients with upper tract urothelial carcinoma. Cancer Med 2018; 7:6112-6123. [PMID: 30485712 PMCID: PMC6308095 DOI: 10.1002/cam4.1902] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/30/2018] [Accepted: 11/10/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pretreatment controlling nutritional status (CONUT) score is a novel index which was used to predict outcomes in cancer patients. We aim to explore the prognostic significance of CONUT score in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). PATIENTS AND METHODS A total of 662 UTUC patients between 2004 and 2016 were retrospectively analyzed. Patients were categorized into three groups based on CONUT score (Normal: 0-1; Light: 2-4; Moderate/severe: 5-12). Associations of CONUT score with oncological outcomes were analyzed using Logistic and Cox regression analysis. Harrell concordance index was used to assess the predictive accuracy of the multivariate models. Subgroup analyses were conducted according to tumor grade and stage. RESULTS The median follow-up duration was 41 months. Multivariate Logistic analysis showed that high CONUT score was independently associated with high-grade disease, high pT stage, lymphovascular invasion, sessile carcinoma, variant histology, and positive surgical margins (each P < 0.05). Multivariate analysis demonstrated that CONUT score 5-12 was an independent factor for worse cancer-specific survival (CSS, hazard ratio [HR]:2.39, 95% confidence interval [CI] 1.55-3.68, P < 0.0001), disease recurrence-free-survival (RFS, HR: 1.80, 95% CI 1.24-2.60, P = 0.002), and overall survival (OS, HR: 2.26, 95% CI 1.53-3.34, P < 0.0001). The estimated c-index of the multivariate models for CSS, RFS, and OS increased from 0.755, 0.715 and 0.745 to 0.772, 0.723, and 0.756 when CONUT score supplemented. Subgroup analyses showed that especially in patients with high-grade carcinoma and advanced stage (≥pT3), higher CONUT score predicts decreased CSS, RFS, and OS (all P < 0.05). CONCLUSION Preoperative CONUT score is a negative independent prognostic indicator for both pathologic and survival outcomes in UTUC, especially in those with high-grade carcinoma and advanced stage. Adding this parameter into our clinical prediction model is appropriate so as to improve its predictive accuracy.
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Affiliation(s)
- Hang Xu
- Department of Urology, Institute of UrologyWest China Hospital, Sichuan UniversityChengduChina
| | - Ping Tan
- Department of Urology, Institute of UrologyWest China Hospital, Sichuan UniversityChengduChina
| | - Xi Jin
- Department of Urology, Institute of UrologyWest China Hospital, Sichuan UniversityChengduChina
| | - Jianzhong Ai
- Department of Urology, Institute of UrologyWest China Hospital, Sichuan UniversityChengduChina
| | - Tianhai Lin
- Department of Urology, Institute of UrologyWest China Hospital, Sichuan UniversityChengduChina
| | - Haoran Lei
- Department of Urology, Institute of UrologyWest China Hospital, Sichuan UniversityChengduChina
| | - Lu Yang
- Department of Urology, Institute of UrologyWest China Hospital, Sichuan UniversityChengduChina
| | - Qiang Wei
- Department of Urology, Institute of UrologyWest China Hospital, Sichuan UniversityChengduChina
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Hersh EH, Sarkiss CA, Ladner TR, Lee N, Kothari P, Lakomkin N, Caridi JM. Perioperative Risk Factors for Thirty-Day Morbidity and Mortality in the Resection of Extradural Thoracic Spine Tumors. World Neurosurg 2018; 120:e950-e956. [DOI: 10.1016/j.wneu.2018.08.195] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 10/28/2022]
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Abstract
Preoperative prognostic nutritional index (PNI) has been proven to be associated with clinical outcomes in patients with malignancies. However, data regarding the role of PNI in human glioblastomas (GBMs) is lacking. We, therefore, aimed to investigate the association between PNI and clinical parameters and survival in GBM patients.This retrospective analysis included 300 GBM patients who were surgically treated at our institute from 2008 to 2017. PNI was calculated as albumin (g/L) + 5×total lymphocyte count (10/L). SPSS 22.0, GraphPad Prism 5, and X tile were the primary tools used for data analysis, figuring drawing, and calculating optimal cutoffs, respectively.Mean albumin value, lymphocyte count, and PNI were 42.13 ± 4.43 g/L, 1.73 ± 0.71 × 10/L, and 50.80 ± 6.01, respectively. PNI was increased in patients aged ≤60 years and in men. Moreover, PNI ≥44 was associated with improved overall survival in younger patients and women. PNI was not associated with isocitric dehydrogenase (IDH)-1 mutations or predicted survival in GBM patients without such mutations. Univariate analysis showed that a high preoperative Karnofsky performance score, gross total resection, completed chemoradiotherapy, IDH-1 mutations, and higher PNI levels were associated with favorable outcomes. Multivariate analysis showed that only completed chemoradiotherapy and IDH-1 mutations were independent prognostic factors.Our results indicated that PNI is associated with age and sex in GBM patients but fails to provide independent prognostic values.
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Affiliation(s)
| | - Kun Yao
- Department of Pathology, Sanbo Brain Hospital, Capital Medical University, China
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Ohno Y. Role of systemic inflammatory response markers in urological malignancy. Int J Urol 2018; 26:31-47. [PMID: 30253448 DOI: 10.1111/iju.13801] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/20/2018] [Indexed: 12/14/2022]
Abstract
The systemic inflammatory response is associated with survival in patients with a variety of cancers. This inflammatory response is measured in the peripheral blood, and can be monitored using two categories of indices: concentration of specific serum proteins (albumin, C-reactive protein) and differential blood cell count (neutrophils, lymphocytes and platelets). Furthermore, combinations of these indices, such as the Glasgow Prognostic Score, which consists of the serum C-reactive protein and albumin level; the neutrophil-to-lymphocyte ratio; the platelet-to-lymphocyte ratio; and the prognostic nutritional index, which is based on peripheral blood lymphocyte count and serum albumin level, have also been evaluated and compared in cancer research. To date, there are hundreds of studies that have shown the prognostic value of systemic inflammatory response markers in patients with urological cancer. Most studies have evaluated the prognostic and predictive role of the pretreatment value of the markers, although some have focused on the role of the post-treatment value at specific points during the clinical course. The advantages of systemic inflammatory response markers are that they are easily measurable and inexpensive in the clinical setting. However, it is important to consider how clinicians use these markers in clinical practice. The present review provides a concise overview regarding systemic inflammatory markers in urological cancers, specifically C-reactive protein, Glasgow Prognostic Score/modified Glasgow Prognostic Score, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and prognostic nutritional index.
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Affiliation(s)
- Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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23
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Otsuka M, Kamasako T, Uemura T, Takeshita N, Shinozaki T, Kobayashi M, Komaru A, Fukasawa S. Prognostic role of the preoperative serum albumin : globulin ratio after radical nephroureterectomy for upper tract urothelial carcinoma. Int J Urol 2018; 25:871-878. [DOI: 10.1111/iju.13767] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/28/2018] [Indexed: 01/22/2023]
Affiliation(s)
- Masafumi Otsuka
- Prostate Center and Division of Urology; Chiba Cancer Center; Chiba Japan
| | - Tomohiko Kamasako
- Prostate Center and Division of Urology; Chiba Cancer Center; Chiba Japan
| | - Toshihiro Uemura
- Prostate Center and Division of Urology; Chiba Cancer Center; Chiba Japan
| | | | - Tetsuo Shinozaki
- Prostate Center and Division of Urology; Chiba Cancer Center; Chiba Japan
| | - Masayuki Kobayashi
- Prostate Center and Division of Urology; Chiba Cancer Center; Chiba Japan
| | - Atsushi Komaru
- Prostate Center and Division of Urology; Chiba Cancer Center; Chiba Japan
| | - Satoshi Fukasawa
- Prostate Center and Division of Urology; Chiba Cancer Center; Chiba Japan
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24
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Wang PF, Meng Z, Song HW, Yao K, Duan ZJ, Li SW, Yan CX. Higher Plasma Fibrinogen Levels are Associated with Malignant Phenotype and Worse Survival in Patients with Glioblastomas. J Cancer 2018; 9:2024-2029. [PMID: 29896287 PMCID: PMC5995933 DOI: 10.7150/jca.24714] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/05/2018] [Indexed: 12/17/2022] Open
Abstract
Preoperative plasma fibrinogen levels were associated with poor clinical outcomes in malignancies. There were few data about the prognostic value of plasma fibrinogen in glioblastomas (GBMs). The objective of our study was to investigate the association between fibrinogen and patients' clinicopathological factors and overall survival (OS). From 2008 to 2016, 315 patients with GBMs who had a surgical treatment at our institute, were retrospectively involved in this study. IDH (isocitrate dehydrogenase) mutations and ATRX (alpha thalassemia/mental retardation syndrome X-linked) loss were detected with IHC (Immunohistochemistry). The preoperative plasma fibrinogen levels ranged from 1.00 to 5.22 g/L, with a mean of were 2.57 g/L. There were increased levels of plasma fibrinogen in patients aged ≥ 65 years, secondary GBMs, IDH mutation (p = 0.033) and ATRX loss (p = 0.040). Moreover, the plasma fibrinogen level was the highest in the subtype of IDH-1R132H wildtype - ATRX expression, which showed a shorter OS compared to the group of IDH-1R132H mut and IDH-1R132H wildtype - ATRX loss (p = 0.001, log-rank test). ROC curves for fibrinogen and IDH-1R132H wildtype - ATRX expression was also plotted, and indicated a potential diagnostic value of fibrinogen in molecular pathology. Univariate analysis found that younger age, higher KPS (Karnofsky Performance Score), gross total resection, complete chemoradiotherapy, IDH-1R132H mutations and lower levels of fibrinogen were associated with favorable outcomes. Multivariate analysis proved that chemoradiotherapy, IDH-1R132H and fibrinogen were independent prognostic factors. In conclusion, plasma fibrinogen could predict clinical outcome and molecular subtype in GBMs.
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Affiliation(s)
- Peng-Fei Wang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, China
| | - Zhe Meng
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, China
| | - Hong-Wang Song
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, China
| | - Kun Yao
- Department of Pathology, Sanbo Brain Hospital, Capital Medical University, China
| | - Ze-Jun Duan
- Department of Pathology, Sanbo Brain Hospital, Capital Medical University, China
| | - Shou-Wei Li
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, China
| | - Chang-Xiang Yan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, China
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25
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Is neutrophil-to-lymphocytes ratio a clinical relevant preoperative biomarker in upper tract urothelial carcinoma? A meta-analysis of 4385 patients. World J Urol 2018; 36:1019-1029. [DOI: 10.1007/s00345-018-2235-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 02/12/2018] [Indexed: 12/12/2022] Open
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