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Zhang XJ, Fei H, Sun CY, Li ZF, Li Z, Guo CG, Zhao DB. Novel prognostic score based on the preoperative total bilirubin-albumin ratio and fibrinogen-albumin ratio in ampullary adenocarcinoma. World J Gastrointest Surg 2023; 15:2247-2258. [PMID: 37969714 PMCID: PMC10642462 DOI: 10.4240/wjgs.v15.i10.2247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/22/2023] [Accepted: 09/04/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND The preoperative total bilirubin-albumin ratio (TBAR) and fibrinogen-albumin ratio (FAR) have been proven to be valuable prognostic factors in various cancers. AIM To detect the prognostic value of TBAR and FAR in ampullary adenocarcinoma (AC) patients who underwent curative pancreaticoduodenectomy. METHODS AC patients who underwent curative pancreaticoduodenectomy in the National Cancer Center of China between 1998 and 2020 were retrospectively reviewed. The prognostic cutoff values of TBAR and FAR were determined through the best survival separation model. Then, a novel prognostic score combining TBAR and FAR was calculated and validated through the logistic regression analysis and Cox regression analysis. RESULTS A total of 188 AC patients were enrolled in the current study. The best cutoff values of TBAR and FAR for predicting overall survival were 1.7943 and 0.1329, respectively. AC patients were divided into a TBAR-low group (score = 0) vs a TBAR-high group (score = 1) and a FAR-low group (score = 0) vs a FAR-high group (score = 1). The total score was calculated as a novel prognostic factor. Multivariable logistic regression analysis revealed that a high score was an independent protective factor for recurrence [score = 1 vs score = 0: Odds ratio (OR) = 0.517, P = 0.046; score = 2 vs score = 0 OR = 0.236, P = 0.038]. In addition, multivariable survival analysis also demonstrated that a high score was an independent protective factor in AC patients (score = 2 vs score = 0: Hazard ratio = 0.230, P = 0.046). CONCLUSION A novel prognostic score based on preoperative TBAR and FAR has been demonstrated to have good predictive power in AC patients who underwent curative pancreaticoduodenectomy. However, more studies with larger samples are needed to validate this conclusion.
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Affiliation(s)
- Xiao-Jie Zhang
- Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - He Fei
- Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Chong-Yuan Sun
- Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ze-Feng Li
- Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Zheng Li
- Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Chun-Guang Guo
- Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Dong-Bing Zhao
- Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Tan D, Li J, Lin T, Tan P, Zhang J, Xiong Q, Jiang J, Li Y, Zhang P, Wei Q. Prognostic Utility of the Modified Glasgow Prognostic Score in Urothelial Carcinoma: Outcomes from a Pooled Analysis. J Clin Med 2022; 11:jcm11216261. [PMID: 36362488 PMCID: PMC9655933 DOI: 10.3390/jcm11216261] [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: 09/19/2022] [Revised: 10/16/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Many studies explored the prognostic value of the modified Glasgow Prognostic Score (mGPS) in urothelial carcinoma (UC), but the results are controversial. This study aimed to quantify the relationship between pretreatment mGPS and survival in patients with UC. Methods: A systematic literature search was conducted using Embase, PubMed, and Web of Science to identify eligible studies published before August 2022. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the association between pretreatment mGPS and the prognosis of UC. Results: Thirteen eligible studies involving 12,524 patients were included. A high mGPS was significantly associated with poor overall survival (mGPS 1/0: HR = 1.33, 95% CI 1.12−1.58, p = 0.001; mGPS 2/0: HR = 2.02, 95% CI 1.43−2.84, p < 0.0001), progression-free survival (mGPS 1/0: HR = 1.26, 95% CI 1.03−1.53, p = 0.021; mGPS 2/0: HR = 1.76, 95% CI 1.12−2.77, p = 0.013), recurrence-free survival (mGPS 1/0: HR = 1.36, 95% CI 1.18−1.56, p < 0.0001; mGPS 2/0: HR = 1.70, 95% CI 1.44−2.000, p < 0.0001), and cancer-specific survival (mGPS 2/0: HR = 1.81, 95% CI 1.30−2.52, p < 0.0001). A subgroup analysis of OS also yielded similar results. Conclusions: Evidence suggests that high pretreatment mGPS in UC is closely related to poor survival. Pre-treatment mGPS is a powerful independent prognostic factor in patients with UC.
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Affiliation(s)
- Daqing Tan
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
- Department of Urology, Minda Hospital of Hubei Minzu University, Enshi 445000, China
| | - Jinze Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Tianhai Lin
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ping Tan
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jiapeng Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiao Xiong
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jinjiang Jiang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yifan Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Peng Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence: (P.Z.); (Q.W.)
| | - Qiang Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence: (P.Z.); (Q.W.)
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Barone B, Napolitano L, Reccia P, De Luca L, Morra S, Turco C, Melchionna A, Caputo VF, Cirillo L, Fusco GM, Mastrangelo F, Calace FP, Amicuzi U, Morgera V, Romano L, Trivellato M, Mattiello G, Sicignano E, Passaro F, Ferretti G, Giampaglia G, Capone F, Manfredi C, Crocetto F. Preoperative Fibrinogen-to-Albumin Ratio as Potential Predictor of Bladder Cancer: A Monocentric Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101490. [PMID: PMID: 36295649 PMCID: PMC9607175 DOI: 10.3390/medicina58101490] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Background and objective: Fibrinogen and albumin are two proteins widely used, singularly and in combination, in cancer patients as biomarkers of nutritional status, inflammation and disease prognosis. The aim of our study was to investigate the preoperative fibrinogen-to-albumin ratio (FAR) as a preoperative predictor of malignancy as well as advanced grade in patients with bladder cancer. Materials and Methods: A retrospective analysis of patients who underwent TURBT at our institution between 2017 and 2021 was conducted. FAR was obtained from preoperative venous blood samples performed within 30 days from scheduled surgery and was analyzed in relation to histopathological reports, as was the presence of malignancy. Statistical analysis was performed using a Kruskal−Wallis Test, and univariate and multivariate logistic regression analysis, assuming p < 0.05 to be statistically significant. Results: A total of 510 patients were included in the study (81% male, 19% female), with a mean age of 71.66 ± 11.64 years. The mean FAR was significantly higher in patients with low-grade and high-grade bladder cancer, with values of 80.71 ± 23.15 and 84.93 ± 29.96, respectively, compared to patients without cancer (75.50 ± 24.81) (p = 0.006). Univariate regression analysis reported FAR to be irrelevant when considered as a continuous variable (OR = 1.013, 95% CI = 1.004−1.022; p = 0.004), while when considered as a categorical variable, utilizing a cut-off set at 76, OR was 2.062 (95% CI = 1.378−3.084; p < 0.0001). Nevertheless, the data were not confirmed in the multivariate analysis. Conclusions: Elevated preoperative FAR is a potential predictor of malignancy as well as advanced grade in patients with bladder cancer. Further data are required to suggest a promising role of the fibrinogen-to-albumin ratio as a diagnostic biomarker for bladder tumors.
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Affiliation(s)
- Biagio Barone
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Luigi Napolitano
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
- Correspondence:
| | - Pasquale Reccia
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Luigi De Luca
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Simone Morra
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Carmine Turco
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Alberto Melchionna
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Vincenzo Francesco Caputo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Luigi Cirillo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Giovanni Maria Fusco
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Francesco Mastrangelo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Francesco Paolo Calace
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Ugo Amicuzi
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Vincenzo Morgera
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Lorenzo Romano
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Massimiliano Trivellato
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Gennaro Mattiello
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Enrico Sicignano
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Francesco Passaro
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Gianpiero Ferretti
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Gaetano Giampaglia
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Federico Capone
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
| | - Celeste Manfredi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Felice Crocetto
- Department of Neuroscience and Reproductive and Odontostomatological Sciences of University of Naples “Federico II”, 80131 Naples, Italy
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Li B, Deng H, Lei B, Chen L, Zhang X, Sha D. The prognostic value of fibrinogen to albumin ratio in malignant tumor patients: A meta-analysis. Front Oncol 2022; 12:985377. [PMID: 36249067 PMCID: PMC9556778 DOI: 10.3389/fonc.2022.985377] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/12/2022] [Indexed: 12/24/2022] Open
Abstract
BackgroundRecent studies have shown that the fibrinogen to albumin ratio (FAR) is closely related to the prognosis of various cancers. The aim of this systematic review and meta-analysis was to investigate the prognostic value of FAR in malignancies based on the available evidence.MethodTo systematically search the Cochrane Library, Embase, PubMed, Google Scholar, Baidu scholars, CNKI and VIP databases for relevant studies published before April 1, 2022, and to evaluate the fibrinogen-to-albumin ratio (FAR) and survival of patients with malignant tumors through a meta-analysis relationship between the results. Results. This meta-analysis included 19 eligible studies involving 5926 cancer patients. We found that high FAR was associated with poor overall survival (HR=2.25, 95%CI 1.86-2.74, p<0.001), recurrence-free survival (HR=2.29, 95%CI 1.91-2.76, P<0.001), progression-free survival (HR: 2.10, 95%CI 1.58-2.79, p<0.001), disease-free survival (HR=1.52, 95%CI 1.17-1.96, p=0.001), and time to recurrence (HR: 1.555, 95%CI 1.031-2.346, P=0.035) was significantly correlated.ConclusionsHigh FAR is significantly associated with poor clinical outcomes in cancer, suggesting that it may be an important predictor of prognosis in patients with malignancies.
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Affiliation(s)
- Baibei Li
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Huachu Deng
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Biao Lei
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Leijie Chen
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xinyuan Zhang
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Dingran Sha
- Department of Urology Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- *Correspondence: Dingran Sha,
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Busetto GM, D’Agostino D, Colicchia M, Palmer K, Artibani W, Antonelli A, Bianchi L, Bocciardi A, Brunocilla E, Carini M, Carrieri G, Cormio L, Falagario UG, De Berardinis E, Sciarra A, Leonardo C, Del Giudice F, Maggi M, de Cobelli O, Ferro M, Musi G, Ercolino A, Di Maida F, Gallina A, Introini C, Mearini E, Cochetti G, Minervini A, Montorsi F, Schiavina R, Serni S, Simeone C, Parma P, Serao A, Mangano MS, Pomara G, Ditonno P, Simonato A, Romagnoli D, Crestani A, Porreca A. Robot-Assisted, Laparoscopic, and Open Radical Cystectomy: Pre-Operative Data of 1400 Patients From The Italian Radical Cystectomy Registry. Front Oncol 2022; 12:895460. [PMID: 35600337 PMCID: PMC9117739 DOI: 10.3389/fonc.2022.895460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/06/2022] [Indexed: 12/16/2022] Open
Abstract
Introduction The Italian Radical Cystectomy Registry (RIC) is an observational prospective study aiming to understand clinical variables and patient characteristics associated with short- and long-term outcomes among bladder cancer (BC) patients undergoing radical cystectomy (RC). Moreover, it compares the effectiveness of three RC techniques - open, robotic, and laparoscopic. Methods From 2017 to 2020, 1400 patients were enrolled at one of the 28 centers across Italy. Patient characteristics, as well as preoperative, postoperative, and follow-up (3, 6, 12, and 24 months) clinical variables and outcomes were collected. Results Preoperatively, it was found that patients undergoing robotic procedures were younger (p<.001) and more likely to have undergone preoperative neoadjuvant chemotherapy (p<.001) and BCG instillation (p<.001). Hypertension was the most common comorbidity among all patients (55%), and overall, patients undergoing open and laparoscopic RC had a higher Charlson Comorbidities Index (CCI) compared to robotic RC (p<.001). Finally, laparoscopic patients had a lower G-stage classification (p=.003) and open patients had a higher ASA score (p<.001). Conclusion The present study summarizes the characteristic of patients included in the RIC. Future results will provide invaluable information about outcomes among BC patients undergoing RC. This will inform physicians about the best techniques and course of care based on patient clinical factors and characteristics.
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Affiliation(s)
- Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, Foggia, Italy
- *Correspondence: Gian Maria Busetto,
| | | | | | - Katie Palmer
- Department of Internal Medicine and Geriatrics, University Cattolica del Sacro Cuore, Rome, Italy
| | - Walter Artibani
- Department of Urology, Policlinico Abano Terme, Abano Terme, Italy
| | - Alessandro Antonelli
- Department of Urology, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), Verona, Italy
| | - Lorenzo Bianchi
- Department of Urology, University of Bologna, Bologna, Italy
| | | | | | - Marco Carini
- Department of Urology, University of Florence, Florence, Italy
| | | | - Luigi Cormio
- Department of Urology, Villa Salus Clinic, Mestre, Italy
| | | | - Ettore De Berardinis
- Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Alessandro Sciarra
- Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Costantino Leonardo
- Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Francesco Del Giudice
- Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Martina Maggi
- Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Ottavio de Cobelli
- Department of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Gennaro Musi
- Department of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Amelio Ercolino
- Department of Urology, University of Bologna, Bologna, Italy
| | | | - Andrea Gallina
- Department of Urology, San Raffaele Hospital and Scientific Institute, Milan, Italy
| | | | - Ettore Mearini
- Department of Urology, University of Perugia, Perugia, Italy
| | | | | | - Francesco Montorsi
- Department of Urology, San Raffaele Hospital and Scientific Institute, Milan, Italy
| | | | - Sergio Serni
- Department of Urology, University of Florence, Florence, Italy
| | - Claudio Simeone
- Department of Urology, University of Brescia, Brescia, Italy
| | - Paolo Parma
- Department of Urology, Azienda Socio Sanitaria Territoriale (ASST) Mantova, Mantova, Italy
| | - Armando Serao
- Department of Urology, Azienda Ospedaliera di Alessandria, Alessandria, Italy
| | | | - Giorgio Pomara
- Department of Urology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Alchiede Simonato
- Department of Surgical, Oncological and Oral Sciences, Section of Urology, University of Palermo, Palermo, Italy
| | | | - Alessandro Crestani
- Oncological Urology, Veneto Institute of Oncology (IOV) – Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy
| | - Angelo Porreca
- Oncological Urology, Veneto Institute of Oncology (IOV) – Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy
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Xu J, Li S, Feng Y, Zhang J, Peng Y, Wang X, Wang H. The Fibrinogen/Albumin Ratio Index as an Independent Prognostic Biomarker for Patients with Combined Hepatocellular Cholangiocarcinoma After Surgery. Cancer Manag Res 2022; 14:1795-1806. [PMID: 35637941 PMCID: PMC9143788 DOI: 10.2147/cmar.s361462] [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: 02/07/2022] [Accepted: 05/07/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose The fibrinogen/albumin ratio (FAR) is increasingly considered as a potential biomarker for predicting prognosis in various malignant tumors, whereas the value of the FAR in predicting the recurrence-free survival (RFS) in patients with combined hepatocellular cholangiocarcinoma (cHCC-CCA) after surgery has not been studied. Patients and Methods A total of 104 patients with surgical-pathologically proved cHCC-CCA were retrospectively analyzed. The best cut-off value of the FAR was calculated via receiver operating characteristic (ROC) curve analysis, and the cohort was then divided into two groups as high-FAR (H-FAR) group and low-FAR (L-FAR) group. The correlation between the preoperative FAR and clinicopathological characteristics was analyzed. Uni- and multi-variable analyses for RFS were evaluated using a Cox proportional hazards model to verify the predictive value of FAR on the RFS of cHCC-CCA. Additionally, a novel clinical nomogram based on FAR was developed to preoperatively predict the RFS of HCC-CCA. The C-index and calibration were conducted to evaluate the performance of the developed nomogram. Results According to the cut-off value of the FAR, the patients were grouped into the H-FARI (>0.075) and L-FARI (≤0.075) groups. FAR was significantly correlated with several clinical-pathological features, including age, cirrhosis, AFP, CA19-9, BCLC staging, NLR, and PLR. In the multi-variate analysis, FAR, cirrhosis and tumor size were independent prognostic predictors for poor RFS in cHCC-CCA patients after surgery. Moreover, the clinical nomogram based on FAR was constructed, showing well-predictive accuracy. Conclusion The preoperative FAR is a convenient and feasible serum biomarker for predicting the RFS of cHCC-CCA after surgery. Such developed FAR-based nomogram integrating tumor size and cirrhosis could be served as a feasible and convenient tool to assist the decision-making of clinical strategy.
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Affiliation(s)
- Jiake Xu
- Department of Gastroenterology, Kunshan Second People’s Hospital, Kunshan, People’s Republic of China
| | - Shaochun Li
- Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Ye Feng
- Department of Gastroenterology, Kunshan Second People’s Hospital, Kunshan, People’s Republic of China
| | - Jie Zhang
- Department of Gastroenterology, Kunshan Second People’s Hospital, Kunshan, People’s Republic of China
| | - Youduo Peng
- Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Xiaohong Wang
- Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Hongwei Wang
- Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
- Correspondence: Hongwei Wang, Tel +86 15021133649, Email
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Peng L, Du C, Meng C, Li J, You C, Li X, Zhao P, Cao D, Li Y. Controlling Nutritional Status Score Before Receiving Treatment as a Prognostic Indicator for Patients With Urothelial Cancer: An Exploration Evaluation Methods. Front Oncol 2021; 11:702908. [PMID: 34722249 PMCID: PMC8548688 DOI: 10.3389/fonc.2021.702908] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/13/2021] [Indexed: 02/05/2023] Open
Abstract
Introduction This meta-analysis aims to assess whether the Controlling nutritional status (CONUT) score before treatment can be an independent predictor of the prognosis of patients with urothelial cancer (UC). Methods The system searches Web of Science, PubMed, MEDLINE, China National Knowledge Infrastructure (CNKI), and Cochrane Library, and the search time is up to April 2021. Use STATA 16.0 and Engauge Digitizer 4.1 software for data processing and statistical analysis. Results A total of 8 studies were included in this meta-analysis. The meta-analysis results show that compared with the low CONUT group, the high CONUT group has worse over survival (OS) [HR=1.58, 95%CI (1.34, 1.86), P=0.001], cancer-specific survival (CSS) [HR=2.03, 95%CI (1.25-3.29), P=0.04] and recurrence-free survival (RFS) [HR=1.97, 95%CI (1.15, 3.40), P=0.014]; for progression-free survival (PFS), or disease-free survival (DFS), the difference between the two groups was not statistically significant [HR=2.30, 95%CI (0.72, 7.32), P=0.158]. According to different carcinoma types, cut-off value, and region, subgroup analysis of OS was performed, and similar results were obtained. Conclusions Based on current evidence, this meta-analysis proves that the CONUT score of UC patients before treatment is an independent prognostic predictor. It performs well on OS, CSS, and RFS, but the conclusions on DFS/PFS need to be treated with caution. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021251890, identifier CRD42021251890.
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Affiliation(s)
- Lei Peng
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, China
| | - Chunxiao Du
- Department of Clinical Pharmacy, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Chunyang Meng
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, China
| | - Jinze Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Chengyu You
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, China
| | - Xianhui Li
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, China
| | - Pan Zhao
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, China
| | - Dehong Cao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Yunxiang Li
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, China
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