1
|
Riedinger CJ, Sakach J, Maples JM, Fulton J, Chippior J, O'Donnell B, O'Malley DM, Chambers LM. Glucagon-like peptide-1 (GLP-1) receptor agonists for weight management: A review for the gynecologic oncologist. Gynecol Oncol 2024; 190:1-10. [PMID: 39116625 DOI: 10.1016/j.ygyno.2024.07.008] [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: 05/07/2024] [Revised: 07/04/2024] [Accepted: 07/15/2024] [Indexed: 08/10/2024]
Abstract
The use of glucagon-like peptide-1 receptor agonists (GLP-1RA) has experienced rapid growth amidst the obesity epidemic in the United States. While originally developed for glucose control in Type 2 Diabetes Mellitus, the scope of these agents now extends to encompass weight loss and cardiovascular risk reduction. GLP-1RAs have the potential to induce significant weight loss, in combination with lifestyle modifications, among adults who are overweight or obese. Furthermore, these agents demonstrate efficacy in ameliorating hyperglycemia, enhancing insulin sensitivity, regulating blood pressure, improving cardiometabolic parameters, mitigating kidney dysfunction, and potentially reducing the risk of several obesity-related cancers. Drug-related toxicity is primarily gastrointestinal and active management can prevent drug discontinuation. Obesity is associated both with an increased incidence of malignancy but also with decreased survival. More research is needed to evaluate the potential use of GLP-1RA to modify the endocrine function of adipocytes, regulate the chronic inflammatory state associated with obesity, and prospective applications in oncology. These agents can impact patients with gynecologic malignancies both through their direct mechanism of action as well as potential drug toxicity.
Collapse
Affiliation(s)
- Courtney J Riedinger
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The Ohio State University Comprehensive Cancer Center/James Cancer Hospital, Columbus, OH, USA
| | - Julia Sakach
- Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Jill M Maples
- Department of Obstetrics and Gynecology, The University of Tennessee Graduate School of Medicine, Knoxville, TN, USA
| | - Jessica Fulton
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The Ohio State University Comprehensive Cancer Center/James Cancer Hospital, Columbus, OH, USA
| | - Jessica Chippior
- Department of Internal Medicine, Division of Endocrinology Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Benjamin O'Donnell
- Department of Internal Medicine, Division of Endocrinology Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, OH, USA
| | - David M O'Malley
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The Ohio State University Comprehensive Cancer Center/James Cancer Hospital, Columbus, OH, USA
| | - Laura M Chambers
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The Ohio State University Comprehensive Cancer Center/James Cancer Hospital, Columbus, OH, USA.
| |
Collapse
|
2
|
Wang CC, Bharadwa S, Foley OW, Domenech I, Vega B, Towner M, Barber EL. Low serum creatinine levels are associated with major post-operative complications in patients undergoing surgery with gynecologic oncologists. Int J Gynecol Cancer 2024; 34:1060-1069. [PMID: 38627036 DOI: 10.1136/ijgc-2024-005308] [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] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVE Serum creatinine is a byproduct of muscle metabolism, and low creatinine is postulated to be associated with diminished muscle mass. This study examined the association between low pre-operative serum creatinine and post-operative outcomes. METHODS This retrospective cohort study utilized the 2014-2021 National Surgical Quality Improvement Program to identify patients undergoing surgery with gynecologic oncologists. Patients with missing pre-operative creatinine, end-stage renal disease, sepsis, septic shock, dialysis, or pregnancy were excluded. Pre-operative creatinine was categorized into markedly low (≤0.44 mg/dL), mildly low (0.45-0.64 mg/dL), normal (0.65-0.84 mg/dL), and four categories of elevated levels (0.85-1.04, 1.05-1.24, 1.25-1.44, and ≥1.45 mg/dL). Outcomes included major (≥Grade 3) 30-day complications, categorized into any complications, wound, cardiovascular and pulmonary, renal, infectious, and thromboembolic complications. Also examined were 30-day readmissions, reoperations, and mortality. Logistic regressions assessed the association between creatinine and complications, with stratification by albumin and sensitivity analysis with propensity score matching. RESULTS Among 84 786 patients, 0.8% had markedly low, 19.6% mildly low, and 50.2% normal creatinine; the remainder had elevated creatinine. As creatinine decreased, the risks of major complications increased in a dose-dependent manner on univariable and multivariable analyses. A total of 9.6% (n=63) markedly low patients experienced major complications, second to creatinine ≥1.45 mg/dL (9.9%, n=141). On multivariable models, both markedly and mildly low creatinine were associated with higher odds of major complications (OR 1.715, 95% CI 1.299 to 2.264 and OR 1.093, 95% CI 1.001 to 1.193) and infections (OR 1.575, 95% CI 1.118 to 2.218 and OR 1.165, 95% CI 1.048 to 1.296) versus normal. Markedly low creatinine had similar ORs to creatinine ≥1.45 mg/dL and was further associated with higher odds of cardiovascular and pulmonary complications (OR 2.301, 95% CI 1.300 to 4.071), readmissions (OR 1.403, 95% CI 1.045 to 1.884), and mortality (OR 2.718, 95% CI 1.050 to 7.031). After albumin stratification, associations persisted for markedly low creatinine. Propensity-weighted analyses demonstrated congruent findings. CONCLUSIONS Low creatinine levels are associated with major post-operative complications in gynecologic oncology in a dose-dependent manner. Low creatinine can offer useful information for pre-operative risk stratification, surgical counseling, and peri-operative management.
Collapse
Affiliation(s)
- Connor C Wang
- Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sonya Bharadwa
- Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Olivia W Foley
- Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Issac Domenech
- Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brenda Vega
- Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Mary Towner
- Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Emma L Barber
- Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
3
|
Asakitogum DA, Nutor JJ, Pozzar R, Hammer M, Alismail S, Kober KM, Miaskowski C. Multidimensional Model of Energy in Patients With Cancer. Semin Oncol Nurs 2024; 40:151644. [PMID: 38692969 DOI: 10.1016/j.soncn.2024.151644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES Evidence suggests that energy is a distinct symptom from fatigue in patients with cancer. The purpose of this paper is to present the Multidimensional Model of Energy in Patients with Cancer (MMEPC) that is based on emerging evidence and to make recommendations for clinical practice and future research. METHODS The literature was reviewed to determine various factors associated with variations in energy in patients with cancer. In addition, some of the emerging evidence in the model is supported by studies of energy in the general population and in patients with other chronic conditions. RESULTS Based on a review of the literature, specific concepts in the MMEPC include: person factors, clinical factors, cancer-related factors, biological factors, factors associated with energy balance, and co-occurring symptoms. The evidence to support the association between each of these factors and variations in energy levels in patients with cancer is described and synthesized. CONCLUSION This article provides emerging evidence on factors that influence variations in energy levels in patients with cancer. While the fundamental biobehavioral and biologic mechanisms that underlie variations in energy levels are not well understood, the model can be used to design pre-clinical and clinical studies of energy in patients with cancer. In addition, while emerging evidence supports the hypothesis that fatigue and energy are distinct symptoms, additional research on common and distinct risk factors and underlying mechanisms is warranted to be able to develop and test precision interventions for one or both symptoms. IMPLICATIONS FOR NURSING PRACTICE The risk factors (eg, being female, sleep quality) associated with variations in energy levels in patients with cancer identified in this paper have important clinical implications. Clinicians can use the identified risk factors to guide their assessments; identify high-risk patients with decrements in energy decrement; and develop targeted energy conservation interventions for the patients.
Collapse
Affiliation(s)
| | | | - Rachel Pozzar
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA
| | - Marilyn Hammer
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA
| | | | - Kord M Kober
- School of Nursing, University of California, San Francisco
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco; School of Medicine, University of California, San Francisco
| |
Collapse
|
4
|
Díaz Chavarro BC, Molina-Recio G, Assis Reveiz JK, Romero-Saldaña M. Factors Associated with Nutritional Risk Assessment in Critically Ill Patients Using the Malnutrition Universal Screening Tool (MUST). J Clin Med 2024; 13:1236. [PMID: 38592073 PMCID: PMC10931933 DOI: 10.3390/jcm13051236] [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: 12/13/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Malnutrition is an underdiagnosed condition that negatively affects the clinical outcomes of patients, being associated with an increased risk of adverse events, increased hospital stay, and higher mortality. Therefore, nutritional assessment is a required and necessary process in patient care. The objective of this study was to identify the factors associated with nutritional risk by applying the Malnutrition Universal Screening Tool (MUST) scale in a population of critically ill patients. Methods: This was an observational, analytical, and retrospective study. Sociodemographic, clinical, hematological, and biochemical variables and their relationship with nutritional risk and mortality were analyzed. Results: Of 630 patients, the leading cause of admission was pathologies of the circulatory and respiratory system (50%); 28.4% were at high nutritional risk; and mortality was 11.6% and associated with nutritional risk, hemoglobin, and plasma urea nitrogen. Conclusions: The presence of gastrointestinal symptoms and the type of nutritional support received during hospitalization could increase the likelihood of presenting a medium/high nutritional risk, while polycythemia reduced this probability. An associative model was found to determine nutritional risk with an adequate specificity and diagnostic validity index.
Collapse
Affiliation(s)
- Blanca Cecilia Díaz Chavarro
- Nursing Program, School of Health, Research Group Genetics, Physiology and Metabolism (GEFIME), Universidad Santiago de Cali, Santiago de Cali 760001, Colombia
- Doctoral Program in Biosciences and Agricultural and Food Sciences, University of Córdoba, 14014 Cordoba, Spain
| | - Guillermo Molina-Recio
- Nursing, Pharmacology and Physiotherapy Department, University of Cordoba, 14004 Cordoba, Spain
- Lifestyles, Innovation and Health (GA-16), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14014 Cordoba, Spain
| | - Jorge Karim Assis Reveiz
- Department of Research and Education, Clínica de Occidente SA, Santiago de Cali 760001, Colombia
| | - Manuel Romero-Saldaña
- Nursing, Pharmacology and Physiotherapy Department, University of Cordoba, 14004 Cordoba, Spain
- Lifestyles, Innovation and Health (GA-16), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14014 Cordoba, Spain
| |
Collapse
|
5
|
Nasser S, Bilir E, Derin X, Richter R, Grabowski JP, Ali P, Kulbe H, Chekerov R, Braicu E, Sehouli J. Pre-Operative Malnutrition in Patients with Ovarian Cancer: What Are the Clinical Implications? Results of a Prospective Study. Cancers (Basel) 2024; 16:622. [PMID: 38339372 PMCID: PMC10854561 DOI: 10.3390/cancers16030622] [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: 11/09/2023] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Malnutrition was associated with worse survival outcomes, impaired quality of life, and deteriorated performance status across various cancer types. We aimed to identify risk factors for malnutrition in patients with epithelial ovarian cancer (EOC) and impact on survival. METHODS In our prospective observational monocentric study, we included the patients with primary and recurrent EOC, tubal or peritoneal cancer conducted. We assessed serum laboratory parameters, body mass index, nutritional risk index, nutritional risk screening score (NRS-2002), and bio-electrical impedance analysis. RESULTS We recruited a total of 152 patients. Patients > 65 years-old, with ascites of >500 mL, or with platinum-resistant EOC showed statistically significant increased risk of malnutrition when evaluated using NRS-2002 (p-values= 0.014, 0.001, and 0.007, respectively). NRS-2002 < 3 was an independent predictive factor for complete tumor resectability (p = 0.009). The patients with NRS-2002 ≥ 3 had a median overall survival (OS) of seven months (95% CI = 0-24 months), as compared to the patients with NRS-2002 < 3, where median OS was forty-six months (p = 0.001). A phase angle (PhAα) ≤ 4.5 was the strongest predictor of OS. CONCLUSIONS In our study, we found malnutrition to be an independent predictor of incomplete cytoreduction and independent prognostic factor for poor OS. Preoperative nutritional assessment is an effective tool in the identification of high-risk EOC groups characterized by poor clinical outcome.
Collapse
Affiliation(s)
- Sara Nasser
- Department of Gynecology with Center for Oncological Surgery, Charite Comprehensive Cancer Center, 13353 Berlin, Germany (E.B.)
| | - Esra Bilir
- Department of Global Health, Koç University Graduate School of Health Sciences, İstanbul 34450, Turkey;
| | - Xezal Derin
- Department of Gynecology with Center for Oncological Surgery, Charite Comprehensive Cancer Center, 13353 Berlin, Germany (E.B.)
| | - Rolf Richter
- Department of Gynecology with Center for Oncological Surgery, Charite Comprehensive Cancer Center, 13353 Berlin, Germany (E.B.)
| | - Jacek P. Grabowski
- Department of Gynecology with Center for Oncological Surgery, Charite Comprehensive Cancer Center, 13353 Berlin, Germany (E.B.)
| | - Paulina Ali
- Department of Gynecology with Center for Oncological Surgery, Charite Comprehensive Cancer Center, 13353 Berlin, Germany (E.B.)
| | - Hagen Kulbe
- Department of Gynecology with Center for Oncological Surgery, Charite Comprehensive Cancer Center, 13353 Berlin, Germany (E.B.)
| | - Radoslav Chekerov
- Department of Gynecology with Center for Oncological Surgery, Charite Comprehensive Cancer Center, 13353 Berlin, Germany (E.B.)
| | - Elena Braicu
- Department of Gynecology with Center for Oncological Surgery, Charite Comprehensive Cancer Center, 13353 Berlin, Germany (E.B.)
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Charite Comprehensive Cancer Center, 13353 Berlin, Germany (E.B.)
| |
Collapse
|
6
|
Martínez-Herrera BE, Muñoz-García MG, José-Ochoa LL, Quiroga-Morales LA, Cervántes-González LM, Mireles-Ramírez MA, Delgadillo-Cristerna R, Nuño-Guzmán CM, Leal-Cortés CA, Portilla-de-Buen E, Hernández BT, Gómez-Sánchez E, Velázquez-Flores MC, Salazar-Páramo M, Ochoa-Plascencia MR, Sat-Muñoz D, Balderas-Peña LMA. Role of Incretins in Muscle Functionality, Metabolism, and Body Composition in Breast Cancer: A Metabolic Approach to Understanding This Pathology. Biomedicines 2024; 12:280. [PMID: 38397883 PMCID: PMC10886934 DOI: 10.3390/biomedicines12020280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024] Open
Abstract
A poorly studied issue in women with breast cancer is the role of incretins (GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1)) in the quantity and quality of muscle mass in lean and obese individuals. The current report aims to analyze the patterns of association and the role of incretin in muscle functionality and body composition in women with cancer compared with healthy women (mammography BI-RADS I or II) to elucidate whether GIP and GLP-1 can be used to estimate the risk, in conjunction with overweight or obesity, for breast cancer. We designed a case-control study in women with a breast cancer diagnosis confirmed by biopsy in different clinical stages (CS; n = 87) and healthy women with a mastography BI-RADS I or II within the last year (n = 69). The women were grouped according to body mass index (BMI): lean (<25 kg/m2BS), overweight (≥25-<30 kg/m2BS), and obese (≥30 kg/m2BS). We found that GLP-1 and GIP levels over 18 pg/mL were associated with a risk of breast cancer (GIP OR = 36.5 and GLP-1 OR = 4.16, for the entire sample), particularly in obese women (GIP OR = 8.8 and GLP-1 OR = 6.5), and coincidentally with low muscle quality indexes, showed an association between obesity, cancer, incretin defects, and loss of muscle functionality.
Collapse
Affiliation(s)
- Brenda-Eugenia Martínez-Herrera
- Departamento de Nutrición y Dietética, Hospital General de Zona #1, Instituto Mexicano del Seguro Social, OOAD Aguascalientes, Boulevard José María Chavez #1202, Fracc, Lindavista, Aguascalientes 20270, Mexico
| | - Michelle-Guadalupe Muñoz-García
- Carrera de Médico Cirujano y Partero, Coordinación de Servicio Social, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Guadalajara 44340, Mexico
- Becaria de la Dirección General de Calidad y Educación en Salud, Secretaría de Salud Mexico, Comisión Interinstitucional de Formación de Recursos Humanos en Salud, Programa Nacional de Servicio Social en Investigación 2021, Demarcación Territorial Miguel Hidalgo, Ciudad de Mexico 11410, Mexico
| | - Laura-Liliana José-Ochoa
- Carrera de Médico Cirujano y Partero, Coordinación de Servicio Social, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Guadalajara 44340, Mexico
| | - Luis-Aarón Quiroga-Morales
- Unidad Académica de Ciencias de la Salud, Clínica de Rehabilitación y Alto Rendimiento ESPORTIVA, Universidad Autónoma de Guadalajara, Zapopan 45129, Mexico
| | - Luz-María Cervántes-González
- Carrera de Médico Cirujano y Partero, Coordinación de Servicio Social, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Guadalajara 44340, Mexico
- Becaria de la Dirección General de Calidad y Educación en Salud, Secretaría de Salud Mexico, Comisión Interinstitucional de Formación de Recursos Humanos en Salud, Programa Nacional de Servicio Social en Investigación 2021, Demarcación Territorial Miguel Hidalgo, Ciudad de Mexico 11410, Mexico
| | - Mario-Alberto Mireles-Ramírez
- División de Investigación en Salud, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, 1000 Belisario Domínguez, Guadalajara 44340, Mexico
| | - Raúl Delgadillo-Cristerna
- Unidad Médica de Alta Especialidad (UMAE), Departamento Clínico de Radiologia e Imágen, Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), 1000 Belisario Domínguez, Guadalajara 44340, Mexico
| | - Carlos-M Nuño-Guzmán
- Unidad Médica de Alta Especialidad (UMAE), Departamento Clínico de Cirugía General, División de Cirugía, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, 1000 Belisario Domínguez, Guadalajara 44340, Mexico
- Servicio de Cirugía General, OPD Hospital Civil de Guadalajara "Fray Antonio Alcalde", 278 Hospital, Guadalajara 44280, Mexico
- División de Disciplinas Clínicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), 950 Sierra Mojada, Building N, 1st Level, Guadalajara 44340, Mexico
| | - Caridad-Aurea Leal-Cortés
- División de Investigación Quirúrgica, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Órgano de Operación Administrativa Desconcentrada, Guadalajara 44340, Mexico
| | - Eliseo Portilla-de-Buen
- División de Investigación Quirúrgica, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Órgano de Operación Administrativa Desconcentrada, Guadalajara 44340, Mexico
| | - Benjamín Trujillo Hernández
- Posgrado en Ciencias Médicas, Universidad de Colima, Av. Universidad No. 333, Las Víboras, Colima 28040, Mexico
| | - Eduardo Gómez-Sánchez
- División de Disciplinas Clínicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), 950 Sierra Mojada, Building N, 1st Level, Guadalajara 44340, Mexico
- Cuerpo Académico UDG CA-874 "Ciencias Morfológicas en el Diagnóstico y Tratamiento de la Enfermedad", 950 Sierra Mojada, Gate 7, Building C, 1st Level, Guadalajara 44340, Mexico
| | - Martha-Cecilia Velázquez-Flores
- Departamento de Morfología, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), 950 Sierra Mojada, Gate 7, Building C, 1st Level, Guadalajara 44340, Mexico
- Unidad Médica de Alta Especialidad (UMAE), Departamento Clínico de Anestesiología, División de Cirugía, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, 1000 Belisario Domínguez, Guadalajara 44340, Mexico
| | - Mario Salazar-Páramo
- Academia de Inmunología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), 950 Sierra Mojada, Gate 7, Building O, 1st Level, Guadalajara 44340, Mexico
| | - Miguel-Ricardo Ochoa-Plascencia
- División de Disciplinas Clínicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), 950 Sierra Mojada, Building N, 1st Level, Guadalajara 44340, Mexico
- OPD Hospital General de Zapopan, Calle Ramón Corona 500, Colonia Centro, Zapopan 45100, Mexico
| | - Daniel Sat-Muñoz
- Cuerpo Académico UDG CA-874 "Ciencias Morfológicas en el Diagnóstico y Tratamiento de la Enfermedad", 950 Sierra Mojada, Gate 7, Building C, 1st Level, Guadalajara 44340, Mexico
- Departamento de Morfología, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), 950 Sierra Mojada, Gate 7, Building C, 1st Level, Guadalajara 44340, Mexico
- Comité de Cabeza y Cuello, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, 1000 Belisario Domínguez, Guadalajara 44340, Mexico
- Unidad Médica de Alta Especialidad (UMAE), Departamento Clínico de Oncología Quirúrgica, División de Oncología Hematología, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, 1000 Belisario Domínguez, Guadalajara 44340, Mexico
| | - Luz-Ma-Adriana Balderas-Peña
- Cuerpo Académico UDG CA-874 "Ciencias Morfológicas en el Diagnóstico y Tratamiento de la Enfermedad", 950 Sierra Mojada, Gate 7, Building C, 1st Level, Guadalajara 44340, Mexico
- Departamento de Morfología, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), 950 Sierra Mojada, Gate 7, Building C, 1st Level, Guadalajara 44340, Mexico
- Unidad de Investigación Biomédica 02 (UIBM 02), Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), 1000 Belisario Domínguez, Guadalajara 44340, Mexico
| |
Collapse
|
7
|
Deng C, Zhang S, Ling J, Chen Z, Feng Y, Xie Y, Liu X, Hu C, Hou T. Prognostic value of the fibrinogen albumin ratio index (FARI) in nasopharyngeal carcinoma patients undergoing radiotherapy. Sci Rep 2023; 13:20630. [PMID: 37996660 PMCID: PMC10667530 DOI: 10.1038/s41598-023-48029-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/21/2023] [Indexed: 11/25/2023] Open
Abstract
There is mounting evidence that malnutrition and systemic inflammation status are involved in the prognosis of various cancers. In this study, we aimed to evaluate the prognostic value of the pretreatment fibrinogen-albumin ratio index (FARI) in nasopharyngeal carcinoma (NPC) patients receiving definite radiotherapy. NPC patients who received definite radiotherapy between January 2013 and December 2019 were included. A receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value. The clinicopathological characteristics of the patients were compared via the Chi-square test. Survival curves were analyzed by the Kaplan‒Meier method. The prognostic factors were evaluated by univariate and multivariate analyses via Cox hazards regression analysis. A total of 225 patients were enrolled, and the median follow-up time was 48.5 months. High FARI was correlated with worse ECOG score (p = 0.003), higher EBV-DNA titer (p = 0.047), and more advanced clinical stage (p < 0.001). In the multivariable analysis, FARI independently predicted OS (HR 2.399, 95% CI 1.294-4.450, P < 0.001), PFS (HR 2.085, 95% CI 1.200-3.625, P = 0.009), and DMFS (HR 2.527, 95% CI 1.288-4.958, P < 0.001). The current findings suggest that a high pretreatment FARI is an independent predictor of OS, PFS and DMFS in NPC patients undergoing definite radiotherapy.
Collapse
Affiliation(s)
- Chao Deng
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People's Republic of China
| | - Sujuan Zhang
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People's Republic of China
| | - Jie Ling
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People's Republic of China
| | - Zui Chen
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People's Republic of China
| | - Yuhua Feng
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People's Republic of China
| | - Yangchun Xie
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People's Republic of China
| | - Xianling Liu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People's Republic of China
| | - Chunhong Hu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People's Republic of China
| | - Tao Hou
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People's Republic of China.
| |
Collapse
|
8
|
Yu Q, Tian M, Pi G, Jia Y, Jin X. Geriatric nutritional risk index as a predictor of prognosis in hematologic malignancies: a systematic review and meta-analysis. Front Nutr 2023; 10:1274592. [PMID: 37941772 PMCID: PMC10627839 DOI: 10.3389/fnut.2023.1274592] [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: 08/08/2023] [Accepted: 09/29/2023] [Indexed: 11/10/2023] Open
Abstract
Objective Recent studies have reported inconsistent results regarding the association between geriatric nutritional risk index (GNRI) and clinical outcomes in patients with hematologic malignancies (HMs). We performed a meta-analysis to evaluate the effect of low GNRI on the overall survival (OS) and progression-free survival (PFS) in patients with HMs. Research Methods and Procedures We conducted the research via PubMed, Embase, and Cochrane Library databases to identify trials. Exploring the association between GNRI and prognosis in patients with HMs. A meta-analysis of OS and PFS was performed. Quality In Prognostic Studies instrument and Newcastle-Ottawa quality assessment Scale were used to assess the quality of included trials. Results Fourteen studies enrolling 3,524 patients with HMs were included. Low GNRI was associated with shorter OS (Hazard ratio (HR) = 1.77; 95% CI = 1.44-2.18, p < 0.01) and PFS (HR = 1.63; 95% CI = 1.17-2.27, p < 0.01) in patients with HMs. In the subgroup analysis, GNRI was not significantly associated with prognosis in Chinese patients with HMs (OS, HR =1.33; 95% CI = 0.89-1.98, p = 0.16; PFS, HR = 1.70; 95% CI = 0.72-4.01, p = 0.23). For the subgroup with a GNRI cutoff value less than 98, there was no significant difference in PFS (HR = 1.34; 95% CI = 0.98-1.83, p = 0.06). Conclusion Low GNRI negatively impacted on the prognosis in patients with HMs. Prospective studies to identify the best cut-off value for GNRI are required.
Collapse
Affiliation(s)
- Qiong Yu
- Department of Digestive Medicine, Wuhan Sixth Hospital and Affiliated Hospital of Jianghan University, Wuhan, China
| | - Mengxing Tian
- Department of Clinical Nutrition, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guoliang Pi
- Department of Thoracic Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yegui Jia
- Department of Digestive Medicine, Wuhan Sixth Hospital and Affiliated Hospital of Jianghan University, Wuhan, China
| | - Xin Jin
- Department of Clinical Nutrition, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|