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1
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Sever N, Yıldırım S, Gurbuz AF, Karakaş Kılıç D, Zeynelgil E, Altintaş YE, Çimik BD, Ağyol Y, Güren AK, Erel P, Kocaaslan E, Paçacı B, Tunç MA, Çelebi A, Demircan NC, Işık S, Arıkan R, Araz M, Karakaya S, Sarı M, Köstek O, Bayoğlu İV. The Effect of Systemic Inflammation and Clinicopathologic Features on Survival in Malignant Pleural Mesothelioma: A Multicenter Analysis. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:144. [PMID: 39859125 PMCID: PMC11767005 DOI: 10.3390/medicina61010144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Revised: 12/29/2024] [Accepted: 01/08/2025] [Indexed: 01/27/2025]
Abstract
Background and Objectives: Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy with a poor prognosis. Identifying reliable prognostic factors is crucial for risk stratification and optimizing treatment strategies. This study aimed to evaluate the impact of clinicopathologic factors and systemic inflammatory markers on survival outcomes in patients with MPM. Materials and Methods: This retrospective, multicenter study included 217 patients diagnosed with MPM between January 2009 and March 2024. Data on age, gender, histology, disease stage, treatment modalities, and inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein/albumin ratio (CAR) were collected. Survival outcomes were analyzed using Kaplan-Meier methods, and prognostic factors were evaluated using Cox regression analysis. Results: CAR was identified as an independent prognostic factor for both overall survival (OS) and progression-free survival (PFS). Patients with CAR < 0.98 had significantly longer OS (87.0 months vs. 14.0 months, p < 0.001) and PFS (17.61 months vs. 8.96 months, p = 0.010). While NLR was significant in univariate analysis (OS: 25.0 months for NLR < 2.58 vs. 21.0 months for NLR ≥ 2.58, p = 0.040), it did not retain significance in the multivariate model (p = 0.180). Epithelioid histology and early-stage disease were strongly associated with improved survival outcomes (OS: 32.0 vs. 11.0 months for epithelioid vs. non-epithelioid histology, p < 0.001; 32.0 vs. 12.0 months for early-stage vs. metastatic disease, p < 0.001). Conclusions: CAR is a strong independent prognostic factor in MPM, reflecting systemic inflammation and nutritional status. Epithelioid histology and early-stage disease are associated with significantly longer survival, underscoring the critical role of early detection in improving patient outcomes.
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Affiliation(s)
- Nadiye Sever
- Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey; (Y.A.); (A.K.G.); (P.E.); (E.K.); (B.P.); (M.A.T.); (A.Ç.); (S.I.); (R.A.); (İ.V.B.)
| | - Sedat Yıldırım
- Medical Oncology, Department of Internal Medicine, Kartal Training and Research Hospital, İstanbul 34865, Turkey; (S.Y.); (Y.E.A.)
| | - Ali Fuat Gurbuz
- Medical Oncology, Department of Internal Medicine, Necmettin Erbakan University, Konya 42090, Turkey; (A.F.G.); (M.A.)
| | - Delyadil Karakaş Kılıç
- Medical Oncology, Department of Internal Medicine, Dicle University Faculty of Medicine, Diyarbakır 21280, Turkey;
| | - Esra Zeynelgil
- Medical Oncology, Department of Internal Medicine, Ankara Ataturk Senatorium Training and Research Hospital, Ankara 06290, Turkey; (E.Z.); (S.K.)
| | - Yunus Emre Altintaş
- Medical Oncology, Department of Internal Medicine, Kartal Training and Research Hospital, İstanbul 34865, Turkey; (S.Y.); (Y.E.A.)
| | - Berivan Deniz Çimik
- Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey;
| | - Yeşim Ağyol
- Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey; (Y.A.); (A.K.G.); (P.E.); (E.K.); (B.P.); (M.A.T.); (A.Ç.); (S.I.); (R.A.); (İ.V.B.)
| | - Ali Kaan Güren
- Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey; (Y.A.); (A.K.G.); (P.E.); (E.K.); (B.P.); (M.A.T.); (A.Ç.); (S.I.); (R.A.); (İ.V.B.)
| | - Pınar Erel
- Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey; (Y.A.); (A.K.G.); (P.E.); (E.K.); (B.P.); (M.A.T.); (A.Ç.); (S.I.); (R.A.); (İ.V.B.)
| | - Erkam Kocaaslan
- Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey; (Y.A.); (A.K.G.); (P.E.); (E.K.); (B.P.); (M.A.T.); (A.Ç.); (S.I.); (R.A.); (İ.V.B.)
| | - Burak Paçacı
- Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey; (Y.A.); (A.K.G.); (P.E.); (E.K.); (B.P.); (M.A.T.); (A.Ç.); (S.I.); (R.A.); (İ.V.B.)
| | - Mustafa Alperen Tunç
- Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey; (Y.A.); (A.K.G.); (P.E.); (E.K.); (B.P.); (M.A.T.); (A.Ç.); (S.I.); (R.A.); (İ.V.B.)
| | - Abdussamet Çelebi
- Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey; (Y.A.); (A.K.G.); (P.E.); (E.K.); (B.P.); (M.A.T.); (A.Ç.); (S.I.); (R.A.); (İ.V.B.)
| | - Nazım Can Demircan
- Medical Oncology, Department of Internal Medicine, Başakşehir Çam and Sakura City Hospital, İstanbul 34480, Turkey;
| | - Selver Işık
- Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey; (Y.A.); (A.K.G.); (P.E.); (E.K.); (B.P.); (M.A.T.); (A.Ç.); (S.I.); (R.A.); (İ.V.B.)
| | - Rukiye Arıkan
- Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey; (Y.A.); (A.K.G.); (P.E.); (E.K.); (B.P.); (M.A.T.); (A.Ç.); (S.I.); (R.A.); (İ.V.B.)
| | - Murat Araz
- Medical Oncology, Department of Internal Medicine, Necmettin Erbakan University, Konya 42090, Turkey; (A.F.G.); (M.A.)
| | - Serdar Karakaya
- Medical Oncology, Department of Internal Medicine, Ankara Ataturk Senatorium Training and Research Hospital, Ankara 06290, Turkey; (E.Z.); (S.K.)
| | - Murat Sarı
- Medical Oncology, Department of Internal Medicine, İstanbul Medipol University, İstanbul 34810, Turkey; (M.S.); (O.K.)
| | - Osman Köstek
- Medical Oncology, Department of Internal Medicine, İstanbul Medipol University, İstanbul 34810, Turkey; (M.S.); (O.K.)
| | - İbrahim Vedat Bayoğlu
- Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey; (Y.A.); (A.K.G.); (P.E.); (E.K.); (B.P.); (M.A.T.); (A.Ç.); (S.I.); (R.A.); (İ.V.B.)
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Solano S, Yang M, Tolomeo P, Kondo T, Shen L, Jhund PS, Anand IS, Desai AS, Lam CSP, Maggioni AP, Martinez FA, Rouleau JL, Vaduganathan M, van Veldhuisen DJ, Zannad F, Zile MR, Packer M, Solomon SD, McMurray JJV. Clinical Characteristics and Outcomes of Patients With Heart Failure With Preserved Ejection Fraction and With Reduced Ejection Fraction According to the Prognostic Nutritional Index: Findings From PARADIGM-HF and PARAGON-HF. J Am Heart Assoc 2025; 14:e037782. [PMID: 39719408 DOI: 10.1161/jaha.124.037782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 11/15/2024] [Indexed: 12/26/2024]
Abstract
BACKGROUND The importance of nutritional status is underappreciated in patients with heart failure (HF). This study aimed to describe the range of the prognostic nutrition index (PNI), and the clinical characteristics and outcomes according to PNI, in patients with HF with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). The primary outcome was the composite of HF hospitalization or cardiovascular death. METHODS AND RESULTS Individual patient data from the PARAGON-HF (Prospective Comparison of ARNI [Angiotensin Receptor-Neprilysin Inhibitor] with ARB [Angiotensin Receptor Blocker] Global Outcomes in HFpEF) and PARADIGM-HF (Prospective Comparison of ARNI With ACEI [Angiotensin-Converting Enzyme Inhibitor] to Determine Impact on Global Mortality and Morbidity in HF) trials were used to examine patient characteristics and outcomes according to quartiles of PNI. Cox regression was used to analyze clinical outcomes, and multivariable fractional polynomial interaction analysis to examine the effects of sacubitril-valsartan, according to PNI. Patients with lower PNI (poorer nutrition) were older, frailer, and had more comorbidities and worse HF status, with greater congestion. Patients with lower PNI had biomarker abnormalities indicating inflammation, bone marrow suppression, and increased collagen turnover, among other physiologic perturbations. Lower PNI was associated with worse outcomes; that is, the rate of the primary end point among patients in the first quartile was 11.31 (10.20-12.54) compared with 7.09 (6.17-8.14) per 100 person-years in the fourth quartile. These associations persisted after adjustment for other prognostic variables. PNI did not modify the effects of sacubitril-valsartan in HFrEF although sacubitril/valsartan seemed to have a greater benefit in patients with HFpEF with a higher PNI. CONCLUSIONS Nutritional status, assessed using PNI, is an independent predictor of poor outcomes in HF. Evaluation of nutritional status in clinical practice, the causes of undernutrition, and whether undernutrition should be a therapeutic target, are all worthy of further investigation in HF.
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Affiliation(s)
- Simone Solano
- BHF Cardiovascular Research Centre University of Glasgow United Kingdom
| | - Mingming Yang
- BHF Cardiovascular Research Centre University of Glasgow United Kingdom
- Department of Cardiology, Zhongda Hospital, School of Medicine Southeast University Nanjing China
| | - Paolo Tolomeo
- BHF Cardiovascular Research Centre University of Glasgow United Kingdom
| | - Toru Kondo
- BHF Cardiovascular Research Centre University of Glasgow United Kingdom
- Department of Cardiology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Li Shen
- BHF Cardiovascular Research Centre University of Glasgow United Kingdom
- School of Medicine Hangzhou Normal University Hangzhou China
| | - Pardeep S Jhund
- BHF Cardiovascular Research Centre University of Glasgow United Kingdom
| | - Inder S Anand
- Department of Cardiovascular Medicine University of Minnesota Minneapolis MN USA
| | - Akshay S Desai
- Cardiovascular Division Brigham and Women's Hospital, and Harvard Medical School Boston MA USA
| | - Carolyn S P Lam
- National Heart Centre Singapore & Duke-National University of Singapore Singapore
| | | | | | - Jean L Rouleau
- Institut de Cardiologie de Montréal Université de Montréal Montreal QC Canada
| | - Muthiah Vaduganathan
- Cardiovascular Division Brigham and Women's Hospital, and Harvard Medical School Boston MA USA
| | - Dirk J van Veldhuisen
- Department of Cardiology, Thorax Center University Medical Center Groningen The Netherlands
| | - Faiez Zannad
- Inserm CIC 1433 and Université de Lorraine Centre Hospitalier Régional Universitaire Nancy France
| | - Michael R Zile
- RHJ Department of Veterans Affairs Medical Center Medical University of South Carolina Charleston SC USA
| | - Milton Packer
- Baylor Heart and Vascular Institute Baylor University Medical Center Dallas TX USA
| | - Scott D Solomon
- Cardiovascular Division Brigham and Women's Hospital, and Harvard Medical School Boston MA USA
| | - John J V McMurray
- BHF Cardiovascular Research Centre University of Glasgow United Kingdom
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Hashino Y, Matushita T, Hatsuyama T, Wakamoto A, Goto K, Hoshi T, Iwayama K, Ohtaki K, Toda T, Sato H. Association of Nutritional Indices With Adverse Effects and Time-to-Treatment-Failure in Triple Therapy for Lung Cancer. In Vivo 2024; 38:864-872. [PMID: 38418111 PMCID: PMC10905434 DOI: 10.21873/invivo.13512] [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: 10/04/2023] [Revised: 11/13/2023] [Accepted: 11/23/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND/AIM Recent lung cancer treatments include an immune checkpoint inhibitor (ICI) pembrolizumab, platinum-based agents, plus an additional cytotoxic anticancer agent. Nutritional indices, such as the geriatric nutritional risk index (GNRI) and the prognostic nutritional index (PNI), are known to correlate with the prognosis of cancer chemotherapy. Several previous studies have investigated the relationship between PNI and treatment response in non-small cell lung cancer patients, reporting significantly increased OS and PFS in the high PNI group before treatment. However, the relationship between the three-drug combination and GNRI/PNI is unclear. The current study aimed to investigate the association of nutritional indices with duration of treatment success and occurrence of side effects in triple therapy. PATIENTS AND METHODS Seventy-two patients with non-small cell lung cancer, treated with combination of carboplatin, pemetrexed, and pembrolizumab from November 2019 to September 30, 2022, were classified into two groups (High and Low) for GNRI and PNI, and a retrospective study was performed. RESULTS In terms of time-to-treatment-failure (TTF), univariate and multivariate Cox proportional hazards regression analysis showed the Low-PNI group to have significantly shorter TTF than the High-PNI group (p=0.006); multivariate analysis results also showed PNI as a factor affecting TTF (HR=2.791, 95%CI=1.362-5.721, p=0.005). On the other hand, GNRI was not shown to be a factor affecting TTF. CONCLUSION PNI at the start of treatment was an independent prognostic factor affecting treatment success time (TTF) in non-small cell lung cancer patients receiving triple therapy. However, PNI was not shown to be a prognostic predictor of irAE development.
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Affiliation(s)
- Yasuhisa Hashino
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Takumu Matushita
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Tae Hatsuyama
- Pharmaceutical Division, Sapporo Minami-Sanjo Hospital, Hokkaido, Japan
| | - Azusa Wakamoto
- Pharmaceutical Division, Sapporo Minami-Sanjo Hospital, Hokkaido, Japan
| | - Keisuke Goto
- Pharmaceutical Division, Sapporo Minami-Sanjo Hospital, Hokkaido, Japan
| | - Takanobu Hoshi
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Kuninori Iwayama
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Koichi Ohtaki
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Takaki Toda
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Hideki Sato
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan;
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Shimizu A, Fukasawa M, Mitani K, Goto K, Wakamoto A, Hatsuyama T, Hoshi T, Hasegawa I, Sato H. Association of Geriatric Nutritional Risk Index With Immune Checkpoint Inhibitor Treatment Duration and Adverse Events in Lung Cancer. In Vivo 2024; 38:418-424. [PMID: 38148096 PMCID: PMC10756459 DOI: 10.21873/invivo.13454] [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: 10/03/2023] [Revised: 10/27/2023] [Accepted: 11/09/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND/AIM Compared to conventional cytotoxic anticancer agent-based therapy, treatment with immune checkpoint inhibitors (ICI) significantly prolongs overall survival. The Geriatric Nutritional Risk Index (GNRI) has been used as a new prognostic indicator in cancer. As nutritional status is associated with prognosis and indicates treatment response, we investigated the effect of the pretreatment GNRI on the (1) occurrence of ICI-induced immune-related adverse events (ir-AE) and (2) association with time to treatment failure (TTF) in ICI monotherapy for lung cancer. PATIENTS AND METHODS In this study, 127 patients with lung cancer who were treated with ICI monotherapy were retrospectively enrolled. Based on a cutoff value of 92 for the GNRI, we investigated intergroup differences in the occurrence of adverse events and their association with TTF in the High-GNRI (≥92) and Low-GNRI (<92) groups. For intergroup comparisons, we used the Student's t-test, Welch's t-test, Fisher's direct probability test, and Mann-Whitney's U-test, and factors with p<0.05 in the intergroup comparison were extracted as explanatory variables. RESULTS Based on the pretreatment GNRI, the median TTF was 5.1 months (95%CI=2.4-7.9 months) in the High-GNRI group and 2.3 months (95%CI=1.6-3.1 months) in the Low-GNRI group, with the High-GNRI group having a significantly longer TTF (p<0.01). The incidence of skin rash (p=0.0129) and pruritus (p<0.01) was significantly higher in the High-GNRI group. CONCLUSION Pretreatment GNRI influences the continuation of ICI monotherapy. The High-GNRI group demonstrated a significantly higher frequency of skin lesions, which may have influenced the prolongation of TTF.
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Affiliation(s)
- Atsuya Shimizu
- Department of Pharmacy, JR Sapporo Hospital, Sapporo, Japan
| | - Miyu Fukasawa
- Pharmaceutical Division, Sapporo Minami-sanjo Hospital, Hokkaido, Japan
| | - Koharu Mitani
- Department of Pharmacy, JR Sapporo Hospital, Sapporo, Japan
| | - Keisuke Goto
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Azusa Wakamoto
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Tae Hatsuyama
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Takanobu Hoshi
- Pharmaceutical Division, Sapporo Minami-sanjo Hospital, Hokkaido, Japan
| | - Isao Hasegawa
- Department of Pharmacy, JR Sapporo Hospital, Sapporo, Japan
| | - Hideki Sato
- Pharmaceutical Division, Sapporo Minami-sanjo Hospital, Hokkaido, Japan;
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Furuno T, Sogawa R, Hashimoto T, Matsuo S, Shirahama W, Kamura T, Hosoya K, Senjyu Y, Yamashita Y, Inoue T, Yamauchi M, Katsuya H, Noguchi M, Sueoka-Aragane N, Shimanoe C. Association between the Prognostic Nutritional Index and the Occurrence of Immune-Related Adverse Events. Biol Pharm Bull 2024; 47:361-365. [PMID: 38311396 DOI: 10.1248/bpb.b23-00760] [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: 02/10/2024]
Abstract
Immune-related adverse events (irAEs) affect all organs and are associated with various symptoms. The identification of biomarkers that can predict irAEs may be particularly clinically useful. This study aimed to investigate whether the prognostic nutritional index (PNI) before the initiation of immune checkpoint inhibitor (ICI) treatment can predict the occurrence of irAEs. We conducted a survey of 111 patients with cancer who were receiving ICI fixed-dose monotherapy at Saga University Hospital from the time each ICI became available until January 2020. We compared the PNI between the patients with and without irAE expression, established a cutoff value for PNI associated with the development of irAEs, and investigated the incidence of irAEs and progression-free survival (PFS) in groups divided by the cutoff value. Patients with irAEs had significantly higher PNI than did those without, and there was a significant association between PNI and irAEs after adjusting for potential factors (odds ratio, 1.12; 95% confidence interval, 1.03-1.21). In addition, PNI ≥44.2 was associated with a significantly higher incidence of irAEs (75.0% vs. 35.2%, p = 0.0001) and significantly longer PFS than PNI <44.2 (p = 0.025). In conclusion, pretreatment PNI may be associated with the risk of developing irAEs in patients with advanced recurrent solid tumors. When the PNI is ≥44.2, patient management is important for avoiding serious AEs because while the treatment may be effective, the occurrence of irAEs is a concern.
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Affiliation(s)
| | | | | | | | | | | | | | - Yoko Senjyu
- Department of Pharmacy, Saga University Hospital
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Igarashi Y, Shirai Y, Tanji Y, Hamura R, Yanagaki M, Abe K, Onda S, Furukawa K, Matsumoto M, Tsunematsu M, Ikegami T. The Impact of Fibrinogen to Prognostic Nutritional Index Rate on Prognosis of Pancreatic Ductal Adenocarcinoma. Am Surg 2023; 89:4255-4261. [PMID: 37776159 DOI: 10.1177/00031348231204912] [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: 10/01/2023]
Abstract
INTRODUCTION The aim of the present study was to evaluate the prognostic value of the ratio of serum fibrinogen to prognostic nutritional index (PNI; Fbg/PNI) in patients undergoing resection for pancreatic ductal adenocarcinoma. METHODS A total of 140 patients who had undergone resection for pancreatic cancer were included. Patients were divided into two groups according to a Fbg/PNI ≥8.8 or <8.8. Survival data were analyzed using the log-rank test for univariate analysis and Cox proportional hazards for multivariate analysis. RESULTS Fbg/PNI was a significant prognostic indicator in univariate analysis for overall survival (OS) and disease-free survival (DFS). Fbg/PNI retained significance in multivariate analysis for OS (hazard ratio, 1.81; 95% confidence interval, 1.19-2.77; P < .01) in addition to tumor differentiation and nodal involvement. Fbg/PNI was a significant independent prognostic indicator of poor DFS on multivariate analysis (hazard ratio, 1.54; 95% confidence interval, 1.05-2.26; P = .03). CONCLUSION Preoperative Fbg/PNI is a novel significant independent prognostic indicator for OS and DFS following resection of pancreatic cancer with curative intent.
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Affiliation(s)
- Yosuke Igarashi
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Japan
| | - Yoshihiro Shirai
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Japan
| | - Yoshiaki Tanji
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Japan
| | - Ryoga Hamura
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Japan
| | - Mitsuru Yanagaki
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Japan
| | - Kyohei Abe
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Japan
| | - Shinji Onda
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Japan
| | - Kenei Furukawa
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Japan
| | - Michinori Matsumoto
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Japan
| | - Masashi Tsunematsu
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Japan
| | - Toru Ikegami
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Japan
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Gradel KO. Interpretations of the Role of Plasma Albumin in Prognostic Indices: A Literature Review. J Clin Med 2023; 12:6132. [PMID: 37834777 PMCID: PMC10573484 DOI: 10.3390/jcm12196132] [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: 07/07/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
This review assesses how publications interpret factors that influence the serum or plasma albumin (PA) level in prognostic indices, focusing on inflammation and nutrition. On PubMed, a search for "albumin AND prognosis" yielded 23,919 results. From these records, prognostic indices were retrieved, and their names were used as search strings on PubMed. Indices found in 10 or more original research articles were included. The same search strings, restricted to "Review" or "Systematic review", retrieved yielded on the indices. The data comprised the 10 latest original research articles and up to 10 of the latest reviews. Thirty indices had 294 original research articles (6 covering two indices) and 131 reviews, most of which were from recent years. A total of 106 articles related the PA level to inflammation, and 136 related the PA level to nutrition. For the reviews, the equivalent numbers were 54 and 65. In conclusion, more publications mention the PA level as a marker of nutrition rather than inflammation. This is in contrast to several general reviews on albumin and nutritional guidelines, which state that the PA level is a marker of inflammation but not nutrition. Hypoalbuminemia should prompt clinicians to focus on the inflammatory aspects in their patients.
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Affiliation(s)
- Kim Oren Gradel
- Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense, Denmark; ; Tel.: +45-21-15-80-85
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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Gao J, Zhang C, Wei Z, Ye X. Immunotherapy for early-stage non-small cell lung cancer: A system review. J Cancer Res Ther 2023; 19:849-865. [PMID: 37675709 DOI: 10.4103/jcrt.jcrt_723_23] [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: 09/08/2023]
Abstract
With the addition of immunotherapy, lung cancer, one of the most common cancers with high mortality rates, has broadened the treatment landscape. Immune checkpoint inhibitors have demonstrated significant efficacy in the treatment of non-small cell lung cancer (NSCLC) and are now used as the first-line therapy for metastatic disease, consolidation therapy after radiotherapy for unresectable locally advanced disease, and adjuvant therapy after surgical resection and chemotherapy for resectable disease. The use of adjuvant and neoadjuvant immunotherapy in patients with early-stage NSCLC, however, is still debatable. We will address several aspects, namely the initial efficacy of monotherapy, the efficacy of combination chemotherapy, immunotherapy-related biomarkers, adverse effects, ongoing randomized controlled trials, and current issues and future directions for immunotherapy in early-stage NSCLC will be discussed here.
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Affiliation(s)
- Jingyi Gao
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong; Department of Oncology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong Province, China
| | - Chao Zhang
- Department of Oncology, Affiliated Qujing Hospital of Kunming Medical University, QuJing, Yunnan Province, China
| | - Zhigang Wei
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong Province, China
| | - Xin Ye
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong Province, China
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Lee DS, Kim CW, Kim HY, Ku YM, Won YD, Lee SL, Sun DS. Association between Posttreatment Serum Platelet-to-Lymphocyte Ratio and Distant Metastases in Patients with Hepatocellular Carcinoma Receiving Curative Radiation Therapy. Cancers (Basel) 2023; 15:cancers15071978. [PMID: 37046639 PMCID: PMC10092989 DOI: 10.3390/cancers15071978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/07/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Background: We sought to investigate whether serum immune and inflammatory parameters can help to predict distant metastasis (DM) in patients with unresectable hepatocellular carcinoma (HCC) undergoing curative radiation therapy (RT). Methods: A total of 76 RT courses were analyzed. The following variables were included in the analysis: systemic inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), absolute lymphocyte count, lymphocyte-to-monocyte ratio, albumin, albumin-to-alkaline phosphatase ratio, RT-related parameters, and levels of total protein, hemoglobin, α-fetoprotein, and PIVKA-II. Distant control (DC) and overall survival (OS) rates were calculated and compared. Results: The mean age was 61.4 years, and most patients were men (n = 62, 81.6%). The median RT fraction number and fractional doses were 12 (range, 4–30) and 5 (range, 2–12) Gy, respectively. With a median follow-up of 12 (range, 3.1–56.7) months, the 1-year DC and OS rates were 64.4% and 55.2%, respectively. The development of DM significantly deteriorated OS (p = 0.013). In the multivariate analysis, significant independent prognostic indicators for DC and OS rates were the highest posttreatment PLR (≤235.7 vs. >235.7, p = 0.006) and the lowest posttreatment PNI (≤25.4 vs. >25.4, p < 0.001), respectively. Conclusions: Posttreatment serum PLR might be helpfully used as a predictive biomarker of DM in unresectable HCC patients undergoing RT. Future research is necessary to confirm our findings.
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Affiliation(s)
- Dong Soo Lee
- Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Correspondence:
| | - Chang Wook Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (C.W.K.); (H.Y.K.)
| | - Hee Yeon Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (C.W.K.); (H.Y.K.)
| | - Young-Mi Ku
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (Y.-M.K.); (Y.D.W.); (S.-L.L.)
| | - Yoo Dong Won
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (Y.-M.K.); (Y.D.W.); (S.-L.L.)
| | - Su-Lim Lee
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (Y.-M.K.); (Y.D.W.); (S.-L.L.)
| | - Der Sheng Sun
- Division of Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
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Dai M, Wu W. Prognostic role of C-reactive protein to albumin ratio in cancer patients treated with immune checkpoint inhibitors: a meta-analysis. Front Oncol 2023; 13:1148786. [PMID: 37213304 PMCID: PMC10196627 DOI: 10.3389/fonc.2023.1148786] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/18/2023] [Indexed: 05/23/2023] Open
Abstract
Background There are numerous articles investigating whether C-reactive protein to albumin ratio (CAR) is significant for predicting prognosis of cancer cases receiving immune checkpoint inhibitors (ICIs), whereas the results were inconsistent. We thus retrieved the literature and conducted the present meta-analysis for clarifying relation of CAR with survival outcomes among ICI-treated cancer patients. Methods Through search against the Web of Science, PubMed, Cochrane Library, and Embase databases was carried out. The search was updated on 11 December 2022. This work later determined the combined hazard ratios (HRs) together with 95% confidence intervals (CIs) for estimating CAR for its prognostic efficiency for overall survival (OS) and progression-free survival (PFS) in cancer patients receiving ICIs. Results A total of 11 studies consisting of 1,321 cases were enrolled into the present meta-analysis. As revealed by combined data, the increased CAR level markedly predicted dismal OS (HR = 2.79, 95% CI = 1.66-4.67, p < 0.001) together with shortened PFS (HR = 1.95, 95% CI = 1.25-3.03, p = 0.003) among carcinoma cases using ICIs. The prognostic effect of CAR was not influenced by clinical stage or study center. Our result reliability was suggested by sensitivity analysis and publication bias test. Conclusions High CAR expression showed marked relation to worse survival outcomes among ICI-treated cancer cases. CAR is easily available and cost effective, which can be the potential biomarker for selecting cancer cases benefiting from ICIs.
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