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Ou Y, Zheng Y, Wang D, Ren S, Liu Y. Analysis of preoperative nutrition, immunity and inflammation correlation index on the prognosis of upper tract urothelial carcinoma surgical patients: a retrospective single center study. BMC Surg 2024; 24:208. [PMID: 39010005 PMCID: PMC11251250 DOI: 10.1186/s12893-024-02496-y] [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: 02/21/2024] [Accepted: 07/01/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND SII, PNI, SIRI, AAPR, and LIPI are prognostic scores based on inflammation, nutrition, and immunity. The purpose of this study was to examine the prognostic value of the SII, PNI, SIRI, AAPR, and LIPI in patients with UTUC who underwent radical nephroureterectomy with bladder cuff excision. MATERIALS AND METHODS Data of UTUC patients in Sichuan Provincial People's Hospital from January 2017 to December 2021 were collected. The optimal critical values of SII, PNI, SIRI, and AAPR were determined by ROC curve, and LIPI was stratified according to the dNLR and LDH. The Kaplan-Meier method was used to draw the survival curve, and Cox proportional hazard model was used to analyze the factors affecting the prognosis of UTUC patients. RESULTS A total of 81 patients with UTUC were included in this study. The optimal truncation value of PNI, SII, SIRI and AAPR were determined to be 48.15, 596.4, 1.45 and 0.50, respectively. Univariate Cox proportional hazard regression showed that low PNI, high SII, high SIRI, low AAPR and poor LIPI group were effective predictors of postoperative prognosis of UTUC patients. Multivariate Cox proportional hazard regression showed that high SII was an independent risk factor for postoperative prognosis of UTUC patients. According to ROC curve, the prediction efficiency of fitting indexes of PNI, SII, SIRI, AAPR and LIPI is better than that of using them alone. CONCLUSIONS The SII, PNI, SIRI, AAPR, and LIPI was a potential prognostic predictor in UTUC patients who underwent radical nephroureterectomy with bladder cuff excision.
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Affiliation(s)
- Yong Ou
- Department of Urology, Xichang People's Hospital, Xichang, Sichuan, China
| | - Yang Zheng
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital and Affiliated Hospital of the University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Dong Wang
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital and Affiliated Hospital of the University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Shangqing Ren
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital and Affiliated Hospital of the University of Electronic Science and Technology of China, Chengdu, 610072, China.
| | - Yisha Liu
- Department of Pathology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
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Jin T, An J, Wu W, Zhou F. Development and Validation of a Machine Learning Model for Bone Metastasis in Prostate Cancer: Based on Inflammatory and Nutritional Indicators. Urology 2024:S0090-4295(24)00415-1. [PMID: 38825085 DOI: 10.1016/j.urology.2024.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/20/2024] [Accepted: 05/20/2024] [Indexed: 06/04/2024]
Abstract
OBJECTIVE To establish a predictive model for prostate cancer bone metastasis utilizing multiple machine learning algorithms. METHODS Retrospective analysis of the clinical data of prostate cancer initially diagnosed in the Department of Urology of Gansu Provincial People's Hospital from June 2017 to June 2022. Logistic regression (LR) and least absolute shrinkage and selection operator (LASSO) are used to jointly screen the model features. The filtered features are incorporated into algorithms including LR, random forest (RF), extreme gradient boosting (XGBoost), naive Bayes (NB), k-nearest neighbor (KNN), and decision tree (DT), to develop prostate cancer bone metastasis models. RESULTS A total of 404 patients were finally screened. Gleason score, T stage, N stage, PSA, and ALP were used as features for modeling. The average AUC of the 5-fold cross-validation for each machine learning model in the training set is as follows: LR (AUC=0.9054), RF (AUC=0.9032), NB (AUC=0.8961), KNN (AUC=0.8704), DT (AUC=0.8526), XGBoost (AUC=0.8066). The AUC of each machine learning model in the test set is KNN (AUC=0.9390, 95%CI: 0.8760-1), RF (AUC=0.9290, 95%CI: 0.8718-0.9861), NB (AUC=0.9268, 95%CI: 0.8615-0.9920), LR (AUC=0.9212, 95%CI: 0.8506-0.9917), XGBoost (AUC=0.8292, 95%CI: 0.7442-0.9141), DT (AUC=0.8057, 95%CI: 0.7100-0.9014). A comprehensive evaluation showed that LR performed well in interpretability and clinical applications. CONCLUSION A bone metastasis model of prostate cancer was established, and it was observed that indicators such as inflammation and nutrition had a weak correlation with bone metastasis.
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Affiliation(s)
- Tongtong Jin
- The First Clinical Medical College, Lanzhou University, Lanzhou; Department of Urology, Gansu Provincial People's Hospital, Lanzhou
| | - Jingjing An
- The First Clinical Medical College, Lanzhou University, Lanzhou
| | - Wangjian Wu
- The First Clinical Medical College, Lanzhou University, Lanzhou; Department of Urology, Gansu Provincial People's Hospital, Lanzhou
| | - Fenghai Zhou
- The First Clinical Medical College, Lanzhou University, Lanzhou; Department of Urology, Gansu Provincial People's Hospital, Lanzhou.
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Valter R, Paillaud E, Boudou-Rouquette P, Oubaya N, Arégui A, Lorisson E, Brain E, Rochette de Lempdes G, Histe A, Laurent M, Canouï-Poitrine F, Caillet P, Broussier A, Martinez-Tapia C. Comparison of the prognostic value of eight nutrition-related tools in older patients with cancer: A prospective study. J Nutr Health Aging 2024; 28:100188. [PMID: 38350302 DOI: 10.1016/j.jnha.2024.100188] [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: 10/17/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVES The primary objective of the present study was to evaluate and compare the ability of eight nutrition-related tools to predict 1-year mortality in older patients with cancer. DESIGN, SETTING AND PARTICIPANTS We studied older patients with cancer from the ELCAPA cohort and who had been referred for a geriatric assessment at one of 14 participating geriatric oncology clinics in the greater Paris area of France between 2007 and 2018. MEASUREMENTS The studied nutrition-related tools/markers were the body mass index (BMI), weight loss (WL) in the previous 6 months, the Mini Nutritional Assessment, the Geriatric Nutritional Risk Index (GNRI), the Prognostic Nutritional Index, the Glasgow Prognostic Score (GPS), the modified GPS, and the C-reactive protein/albumin ratio. RESULTS A total of 1361 patients (median age: 81; males: 51%; metastatic cancer: 49%) were included in the analysis. Most of the tools showed a progressively increase in the mortality risk as the nutrition-related risk category worsened (overall p-values <0.02 for all) after adjustment for age, outpatient status, functional status, severe comorbidities, cognition, mood, cancer treatment strategy, tumour site, and tumour metastasis. All the models were discriminant, with a C-index ranging from 0.748 (for the BMI) to 0.762 (for the GPS). The concordance probability estimate ranged from 0.764 (WL) to 0.773 (GNRI and GPS)). CONCLUSION After adjustment for relevant prognostic factors, all eight nutrition-related tools/markers were independently associated with 1-year mortality in older patients with cancer. Depending on the time or context of the GA, physicians do not always have the time or means to perform and assess all the tools/markers compared here. However, even when some information is missing, each nutritional tool/marker has prognostic value and can be used in the evaluation.
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Affiliation(s)
- Rémi Valter
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France
| | - Elena Paillaud
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France; AP-HP, Paris Cancer Institute CARPEM, hôpital Européen Georges Pompidou, département de gériatrie, F-75015 Paris, France
| | | | - Nadia Oubaya
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France; AP-HP, Hopital Henri-Mondor, Service de Santé Publique, F-94010 Creteil, France
| | - Amélie Arégui
- APHP, Hôpital St Louis, UCOG Paris Nord, F-75010 Paris, France
| | | | - Etienne Brain
- Institut Curie, 35 Rue Dailly, F-92210 Saint-Cloud, France
| | | | - Axelle Histe
- AP-HP, Hopital Henri-Mondor, Unité de Recherche Clinique, F-94010 Creteil, France
| | - Marie Laurent
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France; AP-HP, Hopital Henri-Mondor, Department of Internal Medicine and Geriatrics, F-94010 Creteil, France
| | - Florence Canouï-Poitrine
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France; AP-HP, Hopital Henri-Mondor, Service de Santé Publique, F-94010 Creteil, France
| | - Philippe Caillet
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France; AP-HP, Paris Cancer Institute CARPEM, hôpital Européen Georges Pompidou, département de gériatrie, F-75015 Paris, France
| | - Amaury Broussier
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France; AP-HP, Hopitaux Henri-Mondor/Emile Roux, Department of Geriatrics, F-94456 Limeil-Brevannes, France
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Niu Z, Yan B. Prognostic and clinicopathological effect of the prognostic nutritional index (PNI) in patients with cervical cancer: a meta-analysis. Ann Med 2023; 55:2288705. [PMID: 38039954 PMCID: PMC10836274 DOI: 10.1080/07853890.2023.2288705] [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: 09/11/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Numerous studies have explored whether the prognostic nutritional index (PNI) can predict the prognosis of cervical cancer (CC); however, their findings remain controversial. This meta-analysis focused on evaluating the relationship between the PNI and the prognosis of patients with CC. METHODS Relevant articles were collected from specific databases up to March 16, 2023. The relationship between the PNI and survival outcomes in patients with CC was estimated using combined hazard ratios (HRs) and associated 95% confidence intervals (CIs). The association of the PNI with clinicopathological features in patients with CC was assessed by combining odds ratios (ORs) and associated 95% CIs. RESULTS Nine articles with 2508 cases were included in the meta-analysis. According to our pooled findings, a decreased PNI showed a significant association with worse overall survival (OS) (HR = 2.98, 95% CI = 2.22-3.99, p < .001) as well as progression-free survival (PFS) (HR = 2.43, 95% CI = 1.92-3.07, p < .001) in patients with CC. The subgroup analysis indicated that the results were reliable. Moreover, the decreased PNI showed a significant association with the presence of lymph node metastasis (LN metastasis, OR = 1.53, 95% CI = 1.04-82.24, p = .030) and maximum tumor size >4 cm (OR = 1.73, 95% CI = 1.21-2.46, p = .002). However, the PNI was not significantly associated with histology, differentiation, or FIGO stage. CONCLUSION In this study, a low PNI predicted dismal OS and PFS in patients with CC, who also tend to suffer from LN metastasis and larger tumor size. PNI is a promising biomarker for predicting the prognosis of patients with CC in clinical practice.
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Affiliation(s)
- Zheng Niu
- Department of Gynecology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Bing Yan
- Department of Pharmacy, The First Affiliated Hospital of Huzhou University, Huzhou, Zhejiang, China
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Yamada Y, Sakamoto S, Sato K, Saito S, Kanesaka M, Rii J, Kurokawa K, Tachiwaki D, Fukui Y, Shibata H, Goto Y, Sazuka T, Imamura Y, Nakatsu H, Ichikawa T. Clinical utility of the prognostic nutritional index in patients with metastatic hormone-sensitive prostate cancer: A retrospective, multicenter, cohort study. Prostate 2023; 83:1610-1618. [PMID: 37690087 DOI: 10.1002/pros.24619] [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: 07/06/2023] [Revised: 08/05/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND The prognostic nutritional index (PNI) based on the serum albumin level and the lymphocyte count has been investigated as a prognostic factor in patients with malignant tumors. However, it has been poorly studied in prostate cancer (PCa), and little is known about its clinical utility. METHODS Clinical data of 353 patients with de novo, metastatic, hormone-sensitive PCa (mHSPC) who received androgen deprivation therapy (ADT) were obtained from multiple institutions between 2000 and 2019. The impacts of the pretreatment PNI level on treatment response and survival, together with clinical parameters, were examined. The Mann-Whitney U test, Cox proportional hazards models, and Kaplan-Meier methods were used to evaluate significance. RESULTS The median age and initial prostate-specific antigen level were 73 and 266.18 ng/mL, respectively. Patients with a low PNI had shorter progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) (p < 0.0001). On multivariate analysis, low PNI was an independent prognostic factor for OS (p = 0.0027, HR = 1.65), as well as advanced age (p = 0.049, HR = 1.38), the International Society of Urological Pathology (ISUP) grade group (GG) 5 (p = 0.0027, HR = 1.69), and elevated lactate dehydrogenase (LDH) (p < 0.0001, HR = 2.08). A propensity score-matching analysis showed that the PNI level remained a significant prognostic biomarker for PFS (p = 0.0263), CSS (p = 0.0006), and OS (p = 0.0015). Furthermore, a novel risk classification using PNI, LDH, and the ISUP GG was established to stratify patients' prognosis. An increase in the number of risk factors was significantly correlated with poor outcomes. CONCLUSIONS A low pretreatment PNI might be an effective biomarker of poor treatment response and survival in patients with mHSPC undergoing ADT.
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Affiliation(s)
- Yasutaka Yamada
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kodai Sato
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinpei Saito
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Manato Kanesaka
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Junryo Rii
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Koichiro Kurokawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Daisuke Tachiwaki
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yudai Fukui
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiroki Shibata
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Goto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomokazu Sazuka
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Imamura
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
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Ellez HI, Keskinkilic M, Semiz HS, Arayici ME, Kısa E, Oztop I. The Prognostic Nutritional Index (PNI): A New Biomarker for Determining Prognosis in Metastatic Castration-Sensitive Prostate Carcinoma. J Clin Med 2023; 12:5434. [PMID: 37685501 PMCID: PMC10487438 DOI: 10.3390/jcm12175434] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/06/2023] [Accepted: 08/15/2023] [Indexed: 09/10/2023] Open
Abstract
Prognostic nutritional index (PNI), which is calculated using the albumin level reflecting nutritional status and lymphocyte count reflecting immune status, is useful in showing nutritional and immunological status related to survival and prognosis in many cancers. In this study, we aimed to evaluate the biomarker potential and effect of PNI in determining the prognosis of metastatic castration-sensitive prostate cancer (mCSPC). This retrospective observational study included the complete data of 108 patients with mCPSC who were treated for at least three months between 1 January 2010, and 1 June 2021. The relationships between cancer-specific survival (CSS), overall survival (OS), progression-free survival (PFS), and PNI were evaluated. The Kaplan-Meier method for OS, PFS, and CSS, as well as univariate and multivariate Cox regression models, were used for the statistical analyses. The median age of 108 patients included in the study was 68.54 (61.05-74.19) years. A value of 49.75 was determined to be the best cut-off point for the PNI. OS (months) was found to be significantly lower in patients with low PNI (median: 34.93, 95% CI: 21.52-48.34) than in patients with high PNI (median: 65.60, 95% CI: 39.36-91.83) (p = 0.016). Patients with high PNI (median: 48.20, 95% CI: 34.66-61.73) had significantly better CSS (months) than patients with low PNI (median: 27.86, 95% CI: 24.16-31.57) (p = 0.001). There was no statistically significant difference in PFS between patients with high PNI values (median: 24.60, 95% CI: 10.15-39.05) and patients with low PNI values (median: 20.03, 95% CI: 11.06-29.03) (p = 0.092). The PNI is a good predictor of OS and CSS in patients with mCSPC. The prediction of PFS, albeit showing a trend towards significance, was not statistically significant, probably due to the small number of cases.
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Affiliation(s)
- Halil Ibrahim Ellez
- Department of Internal Medicine, Division of Medical Oncology, Dokuz Eylül University, Izmir 35340, Türkiye;
| | - Merve Keskinkilic
- Department of Internal Medicine, Division of Medical Oncology, Dokuz Eylül University, Izmir 35340, Türkiye;
| | - Hüseyin Salih Semiz
- Institute of Oncology, Department of Medical Oncology, Dokuz Eylül University, Izmir 35340, Türkiye; (H.S.S.); (I.O.)
| | - Mehmet Emin Arayici
- Institute of Health Sciences, Department of Preventive Oncology, Dokuz Eylül University, Izmir 35340, Türkiye;
| | - Erdem Kısa
- Department of Urology, Tepecik Education and Research Hospital, Health Science University, Izmir 35180, Türkiye;
| | - Ilhan Oztop
- Institute of Oncology, Department of Medical Oncology, Dokuz Eylül University, Izmir 35340, Türkiye; (H.S.S.); (I.O.)
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Zheng Y, Wang K, Ou Y, Hu X, Wang Z, Wang D, Li X, Ren S. Prognostic value of a baseline prognostic nutritional index for patients with prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2023:10.1038/s41391-023-00689-9. [PMID: 37391595 DOI: 10.1038/s41391-023-00689-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/07/2023] [Accepted: 06/21/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND The prognostic nutritional index (PNI) integrates both nutritional and immune indicators and provides promising prognostic value for various malignancies. However, there is still no specific consensus relating to the precise relationship between the pretreatment PNI and the survival outcome of patients with prostate cancer (PCa). Here, we performed a meta-analysis to determine the prognostic significance of PNI for patients with PCa. METHODS We used the PubMed, EMBASE, Web of Science, Cochrane Library (CENTRAL), and CNKI databases to identify and retrieve eligible articles that were published in any language up to the 1st March 2023. Our analysis considered hazard ratios (HRs) and 95% confidence intervals (CIs) published in the included studies. Data synthesis and analysis were conducted using Stata 15.1 software. RESULTS A total of ten studies featuring 1631 cases were included in our quantitative analysis. Analysis showed that a low PNI at baseline was significantly associated with poor overall survival (OS) (HR: 2.16; 95% CI: 1.40-3.34; p = 0.01), progression-free survival (PFS) (HR: 2.17; 95% CI 1.63-2.89; p < 0.001). Owing to high levels of heterogeneity, we performed subgroup analysis based on disease staging, sample size, and cutoff value; we found that disease staging may have been the source of the heterogeneity. A low pretreatment PNI was associated with poor survival outcomes for both metastatic castration-resistant prostate cancer (mCRPC) patients and nonmetastatic castration-resistant prostate cancer (nmCRPC) patients. CONCLUSIONS A low pretreatment PNI was significantly correlated with a worse OS and PFS in patients with PCa. A low pretreatment PNI may act as a reliable and effective predictor for the prognosis of patients with PCa. Further well-designed studies should be performed to fully evaluate the prognostic performance of this novel indicator for PCa.
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Affiliation(s)
- Yang Zheng
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, China
- Robotic Minimally Invasive Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, Sichuan, China
| | - Kai Wang
- Department of Acute Care Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, Sichuan, China
| | - Yong Ou
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, China
- Robotic Minimally Invasive Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, Sichuan, China
| | - Xu Hu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ziyan Wang
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, China
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study and Department of Laboratory Medicine, Center for Medical Genetics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
- Laboratory of Ageing Research, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China
| | - Dong Wang
- Robotic Minimally Invasive Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, Sichuan, China.
| | - Xinglan Li
- Department of Pathology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, Sichuan, China.
| | - Shangqing Ren
- Robotic Minimally Invasive Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, Sichuan, China.
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Wu W, Zhang D, Jin T, Lu T, Zhou F. Progress in the study of biomarkers for early prediction of systemic inflammatory response syndrome after percutaneous nephrolithotomy. Front Immunol 2023; 14:1142346. [PMID: 37063849 PMCID: PMC10097887 DOI: 10.3389/fimmu.2023.1142346] [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: 01/12/2023] [Accepted: 03/22/2023] [Indexed: 04/01/2023] Open
Abstract
Urolithiasis is a common and frequent disease in urology. Percutaneous nephrolithotomy (PCNL) is preferred for the treatment of upper urinary tract stones and complicated renal stones >2 cm in diameter, but it has a higher rate of postoperative complications, especially infection, compared with other minimally invasive treatments for urinary stones. Complications associated with infection after percutaneous nephrolithotomy include transient fever, systemic inflammatory response syndrome (SIRS), and sepsis, which is considered one of the most common causes of perioperative death after percutaneous nephrolithotomy. In contrast, SIRS serves as a sentinel for sepsis, so early intervention of SIRS by biomarker identification can reduce the incidence of postoperative sepsis, which in turn reduces the length of stay and hospital costs for patients. In this paper, we summarize traditional inflammatory indicators, novel inflammatory indicators, composite inflammatory indicators and other biomarkers for early identification of systemic inflammatory response syndrome after percutaneous nephrolithotomy.
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Affiliation(s)
- Wangjian Wu
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Di Zhang
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
| | - Tongtong Jin
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Tianyi Lu
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
| | - Fenghai Zhou
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
- Department of Urology, Gansu Provincial Hospital, Lanzhou, China
- *Correspondence: Fenghai Zhou,
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The Neutrophil-to-Lymphocyte Ratio and Preoperative Pulmonary Function Test Results as Predictors of In-Hospital Postoperative Complications after Hip Fracture Surgery in Older Adults. J Clin Med 2022; 12:jcm12010108. [PMID: 36614909 PMCID: PMC9821284 DOI: 10.3390/jcm12010108] [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: 11/09/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose: This study retrospectively evaluated the usefulness of the neutrophil-to-lymphocyte ratio (NLR), prognostic nutritional index (PNI), and pulmonary function test (PFT) results as objective predictors of in-hospital postoperative complications after hip fracture surgery in older adults. Methods: The patients aged >65 years who underwent hip fracture surgery under general anaesthesia were enrolled. In-hospital postoperative complications with preoperative NLR, PNI and PFT results were evaluated. The NLR was calculated as the preoperative neutrophil count/lymphocyte count in peripheral blood. The PNI was calculated as the serum albumin (g/dL) × 10 + total lymphocyte count × 0.005 (/mm3). Results: One hundred ninety nine patients were analysed. The most common postoperative complications were respiratory complications. Compared with patients who did not have postoperative complications, patients with postoperative complications had a significantly higher NLR (8.01 ± 4.70 vs. 5.12 ± 4.34, p < 0.001), whereas they had a significantly lower PNI (38.33 ± 6.80 vs. 42.67 ± 6.47, p < 0.001), preoperative functional vital capacity (FVC; 2.04 ± 0.76 vs. 2.45 ± 0.71 L, p < 0.001), and forced expiratory volume at 1 s (FEV1; 1.43 ± 0.53 vs. 1.78 ± 0.58 L, p < 0.001). Multiple logistic regression analysis identified NLR (odds ratio [OR], 1.142; 95% confidence interval [CI], 1.060−1.230; p < 0.001) and FEV1 (OR, 0.340; 95% CI, 0.191−0.603; p < 0.001) as risk factors for postoperative complications after hip fracture surgery. Conclusion: Preoperative NLR and FEV1 are objective predictors of in-hospital postoperative complications after hip fracture surgery in older patients.
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Sun H, Chen L, Huang R, Pan H, Zuo Y, Zhao R, Xue Y, Song H. Prognostic nutritional index for predicting the clinical outcomes of patients with gastric cancer who received immune checkpoint inhibitors. Front Nutr 2022; 9:1038118. [PMID: 36438745 PMCID: PMC9686298 DOI: 10.3389/fnut.2022.1038118] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/19/2022] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE Although the application of immunotherapy in gastric cancer has achieved satisfactory clinical effects, many patients have no response. The aim of this retrospective study is to investigate the predictive ability of the prognostic nutrition index (PNI) to the prognosis of patients with gastric cancer who received immune checkpoint inhibitors (ICIs). MATERIALS AND METHODS Participants were 146 gastric cancer patients with ICIs (PD-1/PD-L1 inhibitors) or chemotherapy. All patients were divided into a low PNI group and a high PNI group based on the cut-off evaluated by the receiver operating characteristic (ROC) curve. We contrasted the difference in progression-free survival (PFS) and overall survival (OS) in two groups while calculating the prognosis factors for PFS and OS by univariate and multivariate analyses. Moreover, the nomogram based on the results of the multivariate analysis was constructed to estimate the 1- and 3-year survival probabilities. RESULTS There were 41 (28.1%) cases in the low PNI group and 105 (71.9%) cases in the high PNI group. The median survival time for PFS in the low PNI group and high PNI group was 12.30 months vs. 33.07 months, and 18.57 months vs. not reached in the two groups for OS. Patients in low PNI group were associated with shorter PFS and OS in all patients [Hazard ratio (HR) = 1.913, p = 0.013 and HR = 2.332, p = 0.001]. Additionally, in subgroup analysis, low PNI group cases also had poorer PFS and OS, especially in patients with ICIs. In addition, the multivariate analysis found that carbohydrate antigen 724 (CA724) and TNM stage were independent prognostic factors for PFS. At the same time, indirect bilirubin (IDBIL), CA724, PNI, and TNM stage were independent prognostic factors for OS. CONCLUSION Prognostic nutrition index was an accurate inflammatory and nutritional marker, which could predict the prognosis of patients with gastric cancer who received ICIs. PNI could be used as a biomarker for ICIs to identify patients with gastric cancer who might be sensitive to ICIs.
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Affiliation(s)
- Hao Sun
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Li Chen
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Rong Huang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Hongming Pan
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Yanjiao Zuo
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Ruihu Zhao
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Yingwei Xue
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Hongjiang Song
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
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Yang F, Pan M, Nie J, Xiao F, Zhang Y. Evaluation of the prognostic nutritional index for the prognosis of Chinese patients with high/extremely high-risk prostate cancer after radical prostatectomy. World J Clin Cases 2022; 10:8863-8871. [PMID: 36157668 PMCID: PMC9477051 DOI: 10.12998/wjcc.v10.i25.8863] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/22/2022] [Accepted: 07/29/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The incidence of prostate cancer (PCa) is on the rise in China. The risk level of patients with PCa is associated with disease-free survival rate at 10 years after radical prostatectomy. Predicting prognosis in advance according to the degree of risk can provide a reference for patients, especially treatment options and postoperative adjuvant treatment measures for high-risk/extremely high-risk patients.
AIM To explore the predictive value of the prognostic nutritional index (PNI) for biological recurrence in Chinese patients with high/extremely high-risk PCa after radical prostatectomy.
METHODS The biochemical test results and clinical data of 193 patients who underwent radical prostatectomy for the first time from January 2015 to December 2020 were retrospectively collected. The PNI value of peripheral blood within 1 wk before surgery was calculated, and during the follow-up period, prostate-specific antigen ≥ 0.2 ng/mL was considered to have biological recurrence. The receiver operating characteristic (ROC) curve was used to calculate the optimal critical value and area under the curve (AUC) of the patients. According to the critical value, the progression-free survival of the high PNI group and low PNI group was compared. The independent influencing factors of the patients' prognosis were obtained by the Cox proportional hazards regression model.
RESULTS The non-biological recurrence rates at 1, 3, and 5 years were 92.02%, 84.05%, and 74.85%, respectively. The optimal critical value for PNI to predict biological recurrence was 46.23, and the AUC was 0.789 (95% confidence interval: 0.651-0.860; P < 0.001). The sensitivity and specificity were 82.93% and 62.30%, respectively. In accordance with the optimal critical value of the ROC curve (46.23), 193 patients were further divided into a high PNI group (PNI ≤ 46.23, n = 108) and low PNI group (PNI > 46.23, n = 85). The incidence of postoperative complications in the high PNI group was lower than that in the low PNI group (21.18% vs 38.96%). Kaplan-Meier survival analysis showed that the overall survival rate at 5 years in the low PNI group was 87.96% (13/108), which was lower than that in the high PNI group (61.18%, 33/85; P < 0.05). Low PNI [hazard ratio (HR) = 1.74; P = 0.003] and positive incisal margin status (HR = 2.14; P = 0.001) were independent predictors of biological recurrence in patients with high/extremely high-risk PCa.
CONCLUSION The PNI has predictive value for the prognosis of patients with high/extremely high-risk PCa, and is an independent prognostic factor. Patients with low PNI value have a shorter time of non-biological recurrence after prostatectomy. It is expected that the combined prediction of other clinicopathological data will further improve the accuracy and guide postoperative adjuvant therapy to improve the quality of prognosis.
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Affiliation(s)
- Fan Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Min Pan
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Jin Nie
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Fan Xiao
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Yuan Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
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Prognostic Nutritional Index and Neutrophil/Lymphocyte Ratio Can Serve as Independent Predictors of the Prognosis of Hepatocellular Carcinoma Patients Receiving Targeted Therapy. JOURNAL OF ONCOLOGY 2022; 2022:1389049. [PMID: 35990994 PMCID: PMC9388296 DOI: 10.1155/2022/1389049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/13/2022] [Accepted: 07/01/2022] [Indexed: 12/17/2022]
Abstract
Objective The prognostic nutritional index (PNI) is an immunonutritional indicator, and the neutrophil/lymphocyte ratio (NLR) reflects the inflammatory status. This research intends to determine the implications of NLR and PNI in evaluating the outcome of hepatocellular carcinoma (HCC) patients undergoing targeted therapy (TT). Methods We retrospectively analyzed 83 patients' records with sorafenib treatment for advanced HCC in the Second Affiliated Hospital of Anhui Medical University. Patient records comprised general data and blood routines. The PNI and NLR values were calculated using the serum albumin levels (ALB), neutrophil (NEU) count, and lymphocyte (LY) count. The optimal thresholds of the PNI and NLR for predicting HCC patients' outcomes were calculated by X-tile. Patients were further assigned to low- and high-groups of PNI and NLR according to their thresholds. By using the Cox proportional hazards regression models, univariate and multivariate analyses were conducted to identify risk factors influencing the patient's prognosis. Results The participants were assigned to the corresponding low-PNI (≤42.9; n = 10) and high-PNI (>42.9; n = 73) groups, as well as low-NLR (≤2.4; n = 64) and high-NLR (>2.4; n = 19) groups based on the critical values of PNI (42.9) and NLR (2.4) obtained through the X-tile calculation. A higher overall survival (OS) rate was observed in the high-PNI group and low-NLR group, than in the low-PNI group and high-NLR group, respectively. The disease control rate showed no evident difference between the groups. The PNI and NLR were of high reliability in predicting the OS of patients. Cox multivariate analysis identified the independence of the PNI and NLR as prognostic factors for patients receiving TT for advanced HCC. Conclusions The pretreatment PNI and NLR levels have great prognostic implications for advanced HCC patients receiving TT. A higher PNI and a lower NLR suggest a higher postoperative survival rate.
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Tan X, Chen H. The Prognostic Value of Prognostic Nutritional Index in Patients with Ovarian Cancer: A Systematic Review and Meta-Analysis. Nutr Cancer 2022; 75:73-81. [PMID: 35900054 DOI: 10.1080/01635581.2022.2104879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Controversy still exists with regard to the prognostic value of prognostic nutritional index (PNI) in ovarian cancer. A systematic search based on the databases of Web of Science, Embase, PubMed, Chinese National Knowledge Infrastructure (CNKI) and WanFang Dataset were conducted up to March 22, 2022. We included both retrospective and prospective observational studies with comparison of prognosis of patients who were divided into two groups: low and high PNI group. The Newcastle-Ottawa Scale (NOS) was applied to evaluate the quality of enrolled studies. All analyses were performed using Stata software. The pooled results were reported as hazard ratios (HRs) with the 95% confidence intervals (95% CIs). Finally, 12 studies involving 3,190 patients were included. High PNI group had a significantly improved overall survival (OS, HR: 0.67, 95% CI: 0.53-0.84), progression-free survival (PFS, HR: 0.74, 95% CI: 0.63-0.87), and cancer-specific survival (CSS, HR: 0.43, 95% CI: 0.20-0.94) compared with the low PNI group. The sensitivity analysis and publication bias indicated our results were reliable. PNI could be applied as a promising index to predict prognosis in ovarian cancer. Our results need to be validated in future studies.
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Affiliation(s)
- Xi Tan
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Chengdu, Sichuan, PR China
| | - Hongqin Chen
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Chengdu, Sichuan, PR China
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14
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Gnagnarella P, Marvaso G, Jereczek-Fossa BA, de Cobelli O, Simoncini MC, Nevola Teixeira LF, Sabbatini A, Pravettoni G, Johansson H, Nezi L, Muto P, Borzillo V, Celentano E, Crispo A, Pinto M, Cavalcanti E, Gandini S. Life style and interaction with microbiota in prostate cancer patients undergoing radiotherapy: study protocol for a randomized controlled trial. BMC Cancer 2022; 22:794. [PMID: 35854230 PMCID: PMC9295396 DOI: 10.1186/s12885-022-09521-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/08/2022] [Indexed: 11/11/2022] Open
Abstract
Background Prostate cancer (PCa) is the second most common cancer in men worldwide. The standard non-surgical approach for localized PCa is radiotherapy (RT), but one of the limitations of high-dose RT is the potential increase in gastrointestinal and genitourinary toxicities. We present the protocol of the Microstyle study, a multicentre randomized two-arm crossover clinical trial. The primary outcome will be assessed at the end of 6-month intervention, by measuring the change in adherence to a healthy lifestyle score. The hypothesis is that modifying lifestyle we change microbiome and improve quality of life and decrease side effects of RT. Methods Study participants will be recruited among men undergoing RT in two Italian centers (Milan and Naples). We foresee to randomize 300 patients in two intervention arms: Intervention Group (IG) and Control Group (CG). Participants allocated to the IG will meet a dietitian and a physiotherapist before RT to receive personalized diet and exercise recommendations, according to their health status, to improve overall lifestyle and reduce side effects (bowel and/or urinary problems). Dietitian and physiotherapist will work together to set individualized goals to reduce or eliminate side effects and pain according to their health status. All participants (IG) will be given a pedometer device (steps counter) in order to monitor and to spur participants to increase physical activity and reduce sedentary behavior. Participants included in the CG will receive baseline general advice and materials available for patients undergoing RT. According to the cross-over design, the CG will cross to the intervention approach after 6-month, to actively enhance compliance towards suggested lifestyle recommendations for all patients. Discussion This trial is innovative in its design because we propose a lifestyle intervention during RT, that includes both dietary and physical activity counselling, as well as monitoring changes in microbiome and serum biomarkers. The promotion of healthy behaviour will be initiated before initiation of standard care, to achieve long lasting effects, controlling side effects, coping with feelings of anxiety and depression and improve efficacy of RT. Trial registration ClincalTrial.gov registration number: NCT05155618. Retrospectively registered on December 13, 2021. The first patient was enrolled on October 22, 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09521-4.
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Affiliation(s)
- Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology IRCSS, Milan, Italy.
| | - Giulia Marvaso
- Department of Radiation Oncology, European Institute of Oncology IRCSS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Department of Radiation Oncology, European Institute of Oncology IRCSS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Ottavio de Cobelli
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.,Division of Urology, European Institute of Oncology IRCSS, Milan, Italy
| | | | | | - Annarita Sabbatini
- Dietetic and Clinical Nutrition Unit, European Institute of Oncology IRCSS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Sciences, European Institute of Oncology IRCSS, Milan, Italy
| | - Harriet Johansson
- Division of Cancer Prevention and Genetics, European Institute of Oncology IRCSS, Milan, Italy
| | - Luigi Nezi
- Department of Experimental Oncology, European Institute of Oncology IRCSS, Milan, Italy
| | - Paolo Muto
- Department of Radiation Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Valentina Borzillo
- Department of Radiation Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Monica Pinto
- Rehabilitation Medicine Unit, Strategic Health Services Department, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Ernesta Cavalcanti
- Laboratory Medicine Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology IRCSS, Milan, Italy
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15
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Küçükarda A, Gökyer A, Gökmen I, Özcan E, Hacıoğlu MB, Erdoğan B, Uzunoğlu S, Çiçin I. Prognostic nutritional index is an independent prognostic factor for treatment response, survival and drug choice in metastatic castration-resistant prostate cancer treated with abiraterone acetate or enzalutamide. Actas Urol Esp 2022; 46:301-309. [PMID: 35256324 DOI: 10.1016/j.acuroe.2021.12.005] [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: 02/17/2021] [Revised: 04/06/2021] [Accepted: 04/18/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE We designed this study to identify the prognostic value of baseline prognostic nutritional index (PNI) in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate or enzalutamide. METHODS 101 mCRPC patients were included. PNI was calculated using formula 10 x serum albumin value (gr/dL) + 0.005 × total lymphocyte count (per mm3). ROC analysis was used for determining prognostic PNI value. RESULTS The statistically significant cut-off value for PNI was 46.62. Initial PSA response and PSA kinetics (early PSA response and 30 %-50%-90% PSA response at any time) were much better in PNI > 46.62 group than the PNI ≤ 46.62 group (p < 0.01). In multivariate analysis, baseline PNI level >46.62 was an independent predictor of PSA-PFS (HR: 0.42, p < 0.01), radiologic PFS (HR: 0.53, p < 0.01), and OS (HR: 0.42, p < 0.01). In the PNI ≤ 46.62 group, median OS was 7.4 months (95% CI: 4.1-10.7) for the abiraterone acetate subgroup vs. 17.6 months (95% CI: 10.1-25.1) for enzalutamide subgroups (p < 0.01). CONCLUSION PNI is a useful, independent prognostic marker for mCRPC patients treated with either abiraterone acetate or enzalutamide. Using pre-treatment PNI may help clinicians in the prediction of survival and decision making based on abiraterone acetate or enzalutamide.
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Affiliation(s)
- A Küçükarda
- Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey.
| | - A Gökyer
- Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey
| | - I Gökmen
- Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey
| | - E Özcan
- Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey
| | - M B Hacıoğlu
- Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey
| | - B Erdoğan
- Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey
| | - S Uzunoğlu
- Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey
| | - I Çiçin
- Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey
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16
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Preoperative nutritional evaluation of prostate cancer patients undergoing laparoscopic radical prostatectomy. PLoS One 2022; 17:e0262630. [PMID: 35108317 PMCID: PMC8809613 DOI: 10.1371/journal.pone.0262630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 12/31/2021] [Indexed: 12/29/2022] Open
Abstract
Background and objective Prostate cancer (PCa) is one of the most common malignant tumors in men. Geriatric Nutritional Risk Index (GNRI) is an objective index for evaluating nutritional status of elderly people over 65 years old. The aim of the current study was to explore the correlation and predictive value between GNRI and postoperative recovery and complications in PCa patients undergoing laparoscopic radical prostatectomy (LRP). Methods Taking 98 as the GNRI boundary value, 96 PCa patients (aged≥65 y) undergoing LRP in the Department of Urology, Affiliated Hospital of North Sichuan Medical College from January 2018 to December 2020 were grouped into malnutrition group (MNg, 34 patients, 35.4%) and normal nutrition group (NNg, 62 patients, 64.6%). Basic information, laboratory examination indexes, operation conditions, postoperative complications and postoperative recovery indexes of patients were recorded and retrospectively analyzed. Clavien-Dindo Classification System (CDCS) was used to assess postoperative complications. T-test was used to analyze differences between the two groups. ROC curve was generated to determine the predictive value of GNRI for postoperative complications. Results Percentage of complications was significantly higher in MNg group compared with that in NNg group (P < 0.01). The average grade based on CDCS was significantly lower in NNg group compared with that in MNg group (P < 0.01). Body weight, Body Mass Index (BMI), preoperative hemoglobin value (HGB), serum albumin (ALB) values of MNg and NNg were significantly positively correlated with GNRI (P<0.01). Incidence and severity of postoperative complications of MNg patients were significantly higher compared with those of NNg patients (P<0.05). Average hospitalization cost of MNg patients was higher in MNg patients compared with that of NNg patients (P<0.05). Duration of post-anesthesia care unit (PACU), duration of antibiotic use and duration of indwelling drainage tube were longer in MNg patients compared with those in NNg patients (P<0.05). Furthermore, volume of indwelling drainage tube was higher in MNg patients compared with that in NNg patients (P<0.05). Conclusion GNRI is an effective and reliable tool for evaluation of preoperative nutritional status of prostate cancer patients. The findings showed that GNRI is correlated with postoperative recovery and complications, and is an effective predictive marker.
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17
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Hirahara N, Matsubara T, Kaji S, Uchida Y, Hyakudomi R, Yamamoto T, Takai K, Sasaki Y, Kawakami K, Tajima Y. Influence of nutrition on stage-stratified survival in gastric cancer patients with postoperative complications. Oncotarget 2022; 13:183-197. [PMID: 35079325 PMCID: PMC8782615 DOI: 10.18632/oncotarget.28179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/06/2022] [Indexed: 11/25/2022] Open
Abstract
Background: We assessed the relationship between preoperative prognostic nutritional index (PNI) and short- and long-term outcomes among gastric cancer patients because the clinical significance of PNI in these patients remains controversial. Materials and Methods: We retrospectively reviewed the medical records of 434 consecutive patients who underwent curative laparoscopic gastrectomy for gastric cancer. Results: Patients with postoperative complications had a significantly poorer overall survival (OS) than those without. On multivariate analyses, postoperative complications were independently associated with PNI value and operative procedure type. In the low PNI group (n = 118), those with postoperative complications experienced significantly poorer OS than those without complications. Among the low PNI group with pTNM stage I and II disease, those with postoperative complications experienced significantly worse OS than those without complications. However, among the high PNI group and patients with stage II and III disease in the low PNI group, OS was similar with respect to postoperative complications. Conclusions: The present study confirmed that long-term prognosis was unaffected by postoperative complications in well-nourished gastric cancer patients. In addition, preoperative nutritional status and postoperative complications, may be crucial in determining the prognosis of gastric cancer, especially in early-stage cancer.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Shunsuke Kaji
- Department of Surgery, Matsue Red Cross Hospital, Shimane, Matsue, Horomachi, Japan
| | - Yuki Uchida
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Kiyoe Takai
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Yohei Sasaki
- Department of Surgery, Masuda Red Cross Hospital, Shimane, Masuda, Otoyoshi-cho, Japan
| | - Koki Kawakami
- Department of Surgery, Matsue Red Cross Hospital, Shimane, Matsue, Horomachi, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
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Rajwa P, Huebner NA, Hostermann DI, Grossmann NC, Schuettfort VM, Korn S, Quhal F, König F, Mostafaei H, Laukhtina E, Mori K, Motlagh RS, Yanagisawa T, Aydh A, Bryniarski P, Pradere B, Paradysz A, Baltzer PA, Grubmüller B, Shariat SF. Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy. J Pers Med 2021; 11:jpm11111231. [PMID: 34834583 PMCID: PMC8625876 DOI: 10.3390/jpm11111231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/13/2021] [Accepted: 11/16/2021] [Indexed: 02/02/2023] Open
Abstract
The aim of this study was to assess the predictive value of pre-biopsy blood-based markers in patients undergoing a fusion biopsy for suspicious prostate magnetic resonance imaging (MRI). We identified 365 consecutive patients who underwent MRI-targeted and systematic prostate biopsy for an MRI scored Prostate Imaging–Reporting and Data System Version (PI-RADS) ≥ 3. We evaluated the neutrophil/lymphocyte ratio (NLR), derived neutrophil/lymphocyte ratio (dNLR), platelet/lymphocyte ratio (PLR), systemic immune inflammation index (SII), lymphocyte/monocyte ratio (LMR,) de Ritis ratio, modified Glasgow Prognostic Score (mGPS), and prognostic nutrition index (PNI). Uni- and multivariable logistic models were used to analyze the association of the biomarkers with biopsy findings. The clinical benefits of biomarkers implemented in clinical decision-making were assessed using decision curve analysis (DCA). In total, 69% and 58% of patients were diagnosed with any prostate cancer and Gleason Grade (GG) ≥ 2, respectively. On multivariable analysis, only high dNLR (odds ratio (OR) 2.61, 95% confidence interval (CI) 1.23–5.56, p = 0.02) and low PNI (OR 0.48, 95% CI 0.26–0.88, p = 0.02) remained independent predictors for GG ≥ 2. The logistic regression models with biomarkers reached AUCs of 0.824–0.849 for GG ≥ 2. The addition of dNLR and PNI did not enhance the net benefit of a standard clinical model. Finally, we created the nomogram that may help guide biopsy avoidance in patients with suspicious MRI. In patients with PI-RADS ≥ 3 lesions undergoing MRI-targeted and systematic biopsy, a high dNLR and low PNI were associated with unfavorable biopsy outcomes. Pre-biopsy blood-based biomarkers did not, however, significantly improve the discriminatory power and failed to add a clinical benefit beyond standard clinical factors.
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Affiliation(s)
- Pawel Rajwa
- Department of Urology, Medical University of Silesia, 41-800 Zabrze, Poland; (P.B.); (A.P.)
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Correspondence: ; Tel./Fax: +48-32-37-04-405
| | - Nicolai A. Huebner
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Working Group for Diagnostic Imaging in Urology (ABDU), Austrian Association of Urology (ÖGU), 1090 Vienna, Austria
| | - Dadjar I. Hostermann
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
| | - Nico C. Grossmann
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Department of Urology, Luzerner Kantonsspital, 6000 Lucerne, Switzerland
- Department of Urology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Victor M. Schuettfort
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Department of Urology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Stephan Korn
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
| | - Fahad Quhal
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Department of Urology, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Frederik König
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Department of Urology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Hadi Mostafaei
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz 51666-15731, Iran
| | - Ekaterina Laukhtina
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Institute for Urology and Reproductive Health, Sechenov University, 19435 Moscow, Russia
| | - Keiichiro Mori
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Department of Urology, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Reza Sari Motlagh
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran 19857-17443, Iran
| | - Takafumi Yanagisawa
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Department of Urology, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Abdulmajeed Aydh
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Department of Urology, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Piotr Bryniarski
- Department of Urology, Medical University of Silesia, 41-800 Zabrze, Poland; (P.B.); (A.P.)
| | - Benjamin Pradere
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
| | - Andrzej Paradysz
- Department of Urology, Medical University of Silesia, 41-800 Zabrze, Poland; (P.B.); (A.P.)
| | - Pascal A. Baltzer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria;
| | - Bernhard Grubmüller
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
| | - Shahrokh F. Shariat
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
- Institute for Urology and Reproductive Health, Sechenov University, 19435 Moscow, Russia
- Karl Landsteiner Institute of Urology and Andrology, 1010 Vienna, Austria
- Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Urology, Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic
- Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan
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Küçükarda A, Gökyer A, Gökmen İ, Özcan E, Hacıoğlu M, Erdoğan B, Uzunoğlu S, Çiçin İ. El índice nutricional pronóstico como factor pronóstico independiente para la respuesta al tratamiento, la supervivencia y la elección del fármaco en el cáncer de próstata metastásico resistente a la castración tratado con acetato de abiraterona o enzalutamida. Actas Urol Esp 2021. [DOI: 10.1016/j.acuro.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Xu YS, Liu G, Zhao C, Lu SL, Long CY, Zhong HG, Chen Y, Huang LX, Liang Z. Prognostic Value of Combined Preoperative Carcinoembryonic Antigen and Prognostic Nutritional Index in Patients With Stage II-III Colon Cancer. Front Surg 2021; 8:667154. [PMID: 34355011 PMCID: PMC8329091 DOI: 10.3389/fsurg.2021.667154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/25/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Tumor status can affect patient prognosis. Prognostic nutritional index (PNI), as a nutritional indicator, is closely related to the prognosis of cancer. However, few studies have examined the combined prognostic value of CEA and PNI in patients. This study investigated the relationship between CEA/PNI and prognosis of colon cancer patients. Methods: A total of 513 patients with stage II–III colon cancer who underwent curative resection at two medical centers from 2009 to 2019 were included. Clinicopathological factors were assessed and overall survival (OS) was assessed in a cohort of 413 patients. Multivariate analysis was used to identify independent prognostic variables to construct histograms predicting 1-year and 3-year OS. Data from 100 independent patients in the validation group was used to validate the prognostic model. Results: The median OS time was 33.6 months, and mortality was observed in 54 patients. Multivariate analysis revealed that preoperative CEA/PNI, lymph node metastasis, peripheral nerve invasion, operation mode, and postoperative chemotherapy were independent factors for prognosis evaluation and thus were utilized to develop the nomogram. The C-index was 0.788 in the learning set and 0.836 in the validation set. The calibration curves reached favorable consensus among the 1-, 3-year OS prediction and actual observation. Conclusion: The combined use of CEA and PNI is an independent prognostic factor and thus can serve as a basis for a model to predict the prognosis of patients with stage II–III colon cancer.
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Affiliation(s)
- Yan-Song Xu
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Gang Liu
- Department of Gastrointestinal and Anorectal Surgery, Nanning First People's Hospital, Nanning, China
| | - Chang Zhao
- Department of Colorectal Surgery, The Eighth Hospital of Wuhan, Wuhan, China
| | - Shao-Long Lu
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Chen-Yan Long
- Second Department of General Surgery, Zhuzhou Central Hospital, Zhuzhou, China
| | - Hua-Ge Zhong
- Guangxi Clinical Research Center for Colorectal Cancer, Nanning, China
| | - Yi Chen
- Guangxi Clinical Research Center for Colorectal Cancer, Nanning, China
| | - Ling-Xu Huang
- Guangxi Clinical Research Center for Colorectal Cancer, Nanning, China
| | - Zheng Liang
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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21
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Al‐Ezzi EM, Alqaisi HA, Iafolla MAJ, Wang L, Sridhar SS, Sacher AG, Fallah‐Rad N, Jiang DM, Watson GA, Catton CN, Warde PR, Hamilton RJ, Fleshner NE, Zlotta AR, Hansen AR. Clinicopathologic factors that influence prognosis and survival outcomes in men with metastatic castration-resistant prostate cancer treated with Radium-223. Cancer Med 2021; 10:5775-5782. [PMID: 34254464 PMCID: PMC8419779 DOI: 10.1002/cam4.4125] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 12/17/2022] Open
Abstract
Background In men with metastatic castration‐resistant prostate cancer (mCRPC) with primarily bone metastases, radium‐223 (223Ra) improves overall survival (OS). However, the selection of 223Ra is not guided by specific validated clinicopathologic factors, and thus outcomes are heterogeneous. Patients and methods This retrospective survival analysis was performed in men with mCRPC treated with 223Ra at our cancer center. Demographics and disease characteristics were collected. OS was calculated using the Kaplan–Meier method (log‐rank). The potential prognostic factors were determined using both univariable (UVA) and multivariable analysis (MVA) (Cox‐regression) methods. Results In total, 150 patients with a median age of 74 years (52–93) received 223Ra between May 2015 and July 2018, and 58% had 6–20 bone metastases. Ninety‐four (63%) patients received >4 223Ra doses, and 56 (37%) received ≤4. The following pre‐treatment factors were analyzed (median [range]): eastern cooperative oncology group performance status (ECOG PS), (1 [0–3]); Albumin (ALB), (39 g/L [24–47]); alkaline phosphatase (ALP), (110 U/L [35–1633]); and prostate‐specific antigen (PSA), (49 µg/L [0.83–7238]). The median OS for all patients was 14.5 months (95% CI: 11.2–18). These factors were associated with poor survival outcomes in UVA and MVA: ALB <35 g/L, ALP >150 U/L, ECOG PS 2–3, and PSA >80 µg/L. By assigning one point for each of these factors, a prognostic model was developed, wherein three distinct risk groups were identified: good, 0–1 (n = 103); intermediate, 2 (n = 30); and poor risk, 3–4 points (n = 17). The median OS was 19.4, 10.0, and 3.1 months, respectively (p < 0.001). Conclusions Pre‐treatment ALB, ALP, ECOG, and PSA, were significantly correlated with OS and could guide treatment selection for men with mCRPC by identifying those who are most or least likely to benefit from 223Ra. Validation in an independent dataset is required prior to widespread clinical utilization.
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Affiliation(s)
- Esmail M. Al‐Ezzi
- Division of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoONCanada
| | - Husam A. Alqaisi
- Division of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoONCanada
| | - Marco A. J. Iafolla
- Division of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoONCanada
| | - Lisa Wang
- Department of BiostatisticsPrincess Margaret Cancer CentreTorontoONCanada
| | - Srikala S. Sridhar
- Division of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoONCanada
| | - Adrian G. Sacher
- Division of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoONCanada
| | - Nazanin Fallah‐Rad
- Division of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoONCanada
| | - Di M. Jiang
- Division of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoONCanada
| | - Geoffrey A. Watson
- Division of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoONCanada
| | - Charles N. Catton
- Department of Radiation OncologyPrincess Margaret Cancer CentreTorontoONCanada
| | - Padraig R. Warde
- Department of Radiation OncologyPrincess Margaret Cancer CentreTorontoONCanada
| | - Rob J. Hamilton
- Division of Urologic OncologyPrincess Margaret Cancer CentreTorontoONCanada
| | - Neil E. Fleshner
- Division of Urologic OncologyPrincess Margaret Cancer CentreTorontoONCanada
| | | | - Aaron R. Hansen
- Division of Medical Oncology and HematologyPrincess Margaret Cancer CentreTorontoONCanada
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Prognostic Nutritional Index Predicts Toxicity in Head and Neck Cancer Patients Treated with Definitive Radiotherapy in Association with Chemotherapy. Nutrients 2021; 13:nu13041277. [PMID: 33924581 PMCID: PMC8070136 DOI: 10.3390/nu13041277] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 02/07/2023] Open
Abstract
Background: The Prognostic Nutritional Index (PNI) is a parameter of nutritional and inflammation status related to toxicity in cancer treatment. Since data for head and neck cancer are scanty, this study aims to investigate the association between PNI and acute and late toxicity for this malignancy. Methods: A retrospective cohort of 179 head and neck cancer patients treated with definitive radiotherapy with induction/concurrent chemotherapy was followed-up (median follow-up: 38 months) for toxicity and vital status between 2010 and 2017. PNI was calculated according to Onodera formula and low/high PNI levels were defined according to median value. Odds ratio (OR) for acute toxicity were calculated through logistic regression model; hazard ratios (HR) for late toxicity and survival were calculated through the Cox proportional hazards model. Results: median PNI was 50.0 (interquartile range: 45.5–53.5). Low PNI was associated with higher risk of weight loss > 10% during treatment (OR = 4.84, 95% CI: 1.73–13.53 for PNI < 50 versus PNI ≥ 50), which was in turn significantly associated with worse overall survival, and higher risk of late mucositis (HR = 1.84; 95% CI:1.09–3.12). PNI predicts acute weight loss >10% and late mucositis. Conclusions: PNI could help clinicians to identify patients undergoing radiotherapy who are at high risk of acute and late toxicity.
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Wang B, Jiang XW, Tian DL, Zhou N, Geng W. Combination of Haemoglobin and Prognostic Nutritional Index Predicts the Prognosis of Postoperative Radiotherapy for Esophageal Squamous Cell Carcinoma. Cancer Manag Res 2020; 12:8589-8597. [PMID: 32982451 PMCID: PMC7509334 DOI: 10.2147/cmar.s266821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/21/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose To investigate the predictive effect of the combined markers of haemoglobin and prognostic nutritional index (PNI) on the long-term survival of patients undergoing postoperative radiotherapy for esophageal squamous cell carcinoma (ESCC). Patients and Methods A total of 238 patients were included in this retrospective analysis. PNI was calculated as the serum albumin level (g/L) + 5 × absolute lymphocyte count, and the cut-off values of PNI and haemoglobin were calculated by receiver operating characteristic (ROC) curve analysis. Then, we combined haemoglobin and PNI, named the H-PNI score, as a predictor of tumour prognosis. The patients were divided into three groups: H-PNI score of 2 (having both hyper-haemoglobin and high PNI), H-PNI score of 1 (having one of these haematological abnormalities), and H-PNI score of 0 (having neither hyper-haemoglobin nor high PNI). The overall survival (OS) rate was calculated using the Kaplan–Meier method, and survival differences between groups were evaluated using the Log rank test. Cox proportional hazards models were used for univariate and multivariate analyses. P values <0.05 indicated statistical significance. Results The cut-off values of haemoglobin and PNI were 132.5 (g/L) and 46.55, respectively. Kaplan–Meier analysis showed that patients with high haemoglobin and PNI levels had a significantly better prognosis than those with low haemoglobin and PNI levels (P = 0.015 and P = 0.002, respectively). Similarly, the survival rate was significantly lower in patients with an H-PNI score of 0 than in those with an H-PNI score of 1–2 (P=0.000). Univariate analysis indicated that differentiation, T and N classification, and H-PNI score were significantly associated with OS. Finally, differentiation (P=0.002), T and N classification (P=0.000), and H-PNI score (P=0.01) were independent prognostic factors for ESCC patients undergoing postoperative radiotherapy. Conclusion The H-PNI score was an independent prognostic factor for ESCC patients undergoing postoperative radiotherapy.
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Affiliation(s)
- Bei Wang
- Department of Radiotherapy Oncology, The Affiliated Yancheng First Hospital of Nanjing University Medical School, The First People's Hospital of Yancheng, Yancheng 224000, Jiangsu Province, People's Republic of China
| | - Xiao-Wen Jiang
- Department of Radiotherapy Oncology, The Affiliated Yancheng First Hospital of Nanjing University Medical School, The First People's Hospital of Yancheng, Yancheng 224000, Jiangsu Province, People's Republic of China
| | - Da-Long Tian
- Department of Radiotherapy Oncology, The Affiliated Yancheng First Hospital of Nanjing University Medical School, The First People's Hospital of Yancheng, Yancheng 224000, Jiangsu Province, People's Republic of China
| | - Ning Zhou
- Department of Radiotherapy Oncology, The Affiliated Yancheng First Hospital of Nanjing University Medical School, The First People's Hospital of Yancheng, Yancheng 224000, Jiangsu Province, People's Republic of China
| | - Wei Geng
- Department of Radiotherapy Oncology, The Affiliated Yancheng First Hospital of Nanjing University Medical School, The First People's Hospital of Yancheng, Yancheng 224000, Jiangsu Province, People's Republic of China
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Wang B, Jiang X, Tian D, Geng W. Enteral nutritional support in patients undergoing chemoradiotherapy for esophageal carcinoma. Future Oncol 2020; 16:2949-2957. [PMID: 32857598 DOI: 10.2217/fon-2020-0181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Esophageal cancer patients are at a high risk of malnutrition. Both the disease itself and chemoradiotherapy will lead to the deterioration of nutritional status. The development of nutritional oncology promotes the application of enteral nutrition in tumor patients. Through nutritional support, prognosis is improved and the incidence of adverse chemoradiotherapy reactions is reduced, especially in those with head and neck or esophageal cancer. This review summarizes enteral nutritional support in esophageal cancer patients undergoing chemoradiotherapy in recent years, including a selection of nutritional assessment tools, the causes and consequences of malnutrition in esophageal cancer patients, types of access and effects of enteral nutrition. More patients with esophageal cancer will benefit from the development of enteral nutrition technology in the future.
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Affiliation(s)
- Bei Wang
- Department of Radiotherapy Oncology, The Affiliated Yancheng First Hospital of Nanjing University Medical School, The First people's Hospital of Yancheng, 66 South People's Road, Yancheng, 224000, Jiangsu Province, PR China
| | - Xiaowen Jiang
- Department of Radiotherapy Oncology, The Affiliated Yancheng First Hospital of Nanjing University Medical School, The First people's Hospital of Yancheng, 66 South People's Road, Yancheng, 224000, Jiangsu Province, PR China
| | - Dalong Tian
- Department of Radiotherapy Oncology, The Affiliated Yancheng First Hospital of Nanjing University Medical School, The First people's Hospital of Yancheng, 66 South People's Road, Yancheng, 224000, Jiangsu Province, PR China
| | - Wei Geng
- Department of Radiotherapy Oncology, The Affiliated Yancheng First Hospital of Nanjing University Medical School, The First people's Hospital of Yancheng, 66 South People's Road, Yancheng, 224000, Jiangsu Province, PR China
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