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Han R, Zhang F, Hong Q, Visar D, Zhan C, Zhao C, Wang F, Zhang S, Li F, Li J, Mu J. NLR, MLR, and PLR are adverse prognostic variables for sleeve lobectomy within non-small cell lung cancer. Thorac Cancer 2024. [PMID: 39034535 DOI: 10.1111/1759-7714.15405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/25/2024] [Accepted: 07/01/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND The goal of the research was to examine the value of peripheral blood indicators in forecasting survival and recurrence among people suffering central-type non-small cell lung cancer (NSCLC) undergoing sleeve lobectomy (SL). METHODS Clinical information was gathered from 146 individuals suffering from NSCLC who had SL at our facility between January 2014 and May 2023. Peripheral blood neutrophil lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet lymphocyte ratio (PLR) levels were determined by receiver operating characteristic (ROC) curve to establish the threshold points. Kaplan-Meier survival analysis was employed to evaluate the prognostic value of different groupings, and both univariate and multivariate Cox proportional hazards model (referred to as COX) were performed. RESULTS The disease-free survival (DFS) and overall survival (OS) cutoff values were carried out via ROC analysis. Kaplan-Meier survival analysis revealed notable differences in OS for NLR (≥2.196 vs. <2.196, p = 0.0009), MLR (≥0.2763 vs. <0.2763, p = 0.0018), and PLR (≥126.11 vs. <126.11, p = 0.0354). Similarly, significant differences in DFS were observed for NLR (≥3.010 vs. <3.010, p = 0.0005), MLR (≥0.2708 vs. <0.2708, p = 0.0046), and PLR (≥126.11 vs. <126.11, p = 0.0028). Univariate Cox analysis showed that NLR (hazard ratio [HR]: 2.469; 95% confidence interval [CI]: 1.416-4.306, p < 0.001), MLR (HR: 2.192, 95% CI: 1.319-3.643, p = 0.002) and PLR (HR: 1.696, 95% CI: 1.029-2.795, p = 0.038) were correlated alongside OS. Multivariate Cox analysis showed that NLR (HR: 2.036, 95% CI: 1.072-3.864, p = 0.030) was a separate OS risk variable. Additionally, the pN stage (HR: 3.163, 95% CI: 1.660-6.027, p < 0.001), NLR (HR: 2.530, 95% CI: 1.468-4.360, p < 0.001), MLR (HR: 2.229, 95% CI: 1.260-3.944, p = 0.006) and PLR (HR: 2.249, 95% CI: 1.300-3.889, p = 0.004) were connected to DFS. Multivariate Cox analysis showed that pN stage (HR: 3.098, 95% CI: 1.619-5.928, p < 0.001) was a separate DFS risk variable. CONCLUSION The study demonstrates that NLR, MLR, and PLR play a convenient and cost-effective role in predicting survival and recurrence among individuals alongside central-type NSCLC having SL.
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Affiliation(s)
- Rui Han
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fan Zhang
- Department of Thoracic Surgery, Shandong Public Health Clinical Center, Shandong University, Shandong, China
| | - Qian Hong
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Djaferi Visar
- Department of Thoracic Surgery, Clinical Hospital Tetovo, University of Tetovo, Tetovo, North Macedonia
| | - Chang Zhan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chenguang Zhao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fuquan Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sining Zhang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang Li
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiagen Li
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Juwei Mu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Lv TR, Wang JK, Li FY, Hu HJ. Prognostic factors for resected cases with gallbladder carcinoma: a systematic review and meta-analysis. Int J Surg 2024; 110:4342-4355. [PMID: 38537060 PMCID: PMC11254228 DOI: 10.1097/js9.0000000000001403] [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: 12/07/2023] [Accepted: 03/11/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVE Current meta-analysis was performed to systematically evaluate the potential prognostic factors for overall survival among resected cases with gallbladder carcinoma. METHODS PubMed, EMBASE, and the Cochrane Library were systematically retrieved and hazard ratio (HR) and its 95% confidence interval were directly extracted from the original study or roughly estimated via Tierney's method. Standard Parmar modifications were used to determine pooled HRs. RESULTS A total of 36 studies with 11 502 cases were identified. Pooled results of univariate analyses indicated that advanced age (HR=1.02, P =0.00020), concurrent gallstone disease (HR=1.22, P =0.00200), elevated preoperative CA199 level (HR=1.93, P <0.00001), advanced T stage (HR=3.09, P <0.00001), lymph node metastasis (HR=2.78, P <0.00001), peri-neural invasion (HR=2.20, P <0.00001), lymph-vascular invasion (HR=2.37, P <0.00001), vascular invasion (HR=2.28, P <0.00001), poorly differentiated tumor (HR=3.22, P <0.00001), hepatic side tumor (HR=1.85, P <0.00001), proximal tumor (neck/cystic duct) (HR=1.78, P <0.00001), combined bile duct resection (HR=1.45, P <0.00001), and positive surgical margin (HR=2.90, P <0.00001) were well-established prognostic factors. Pathological subtypes ( P =0.53000) and postoperative adjuvant chemotherapy ( P =0.70000) were not prognostic factors. Pooled results of multivariate analyses indicated that age, gallstone disease, preoperative CA199, T stage, lymph node metastasis, peri-neural invasion, lymph-vascular invasion, tumor differentiation status, tumor location (peritoneal side vs hepatic side), surgical margin, combined bile duct resection, and postoperative adjuvant chemotherapy were independent prognostic factors. CONCLUSION Various prognostic factors have been identified beyond the 8th AJCC staging system. By incorporating these factors into a prognostic model, a more individualized prognostication and treatment regime would be developed. Upcoming multinational studies are required for the further refine and validation.
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Affiliation(s)
- Tian-Run Lv
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jun-Ke Wang
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fu-Yu Li
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hai-Jie Hu
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Velasco RN, Tan HNC, Juan MDS. Haematologic biomarkers and survival in gallbladder cancer: a systematic review and meta-analysis. Ecancermedicalscience 2024; 18:1660. [PMID: 38425767 PMCID: PMC10901636 DOI: 10.3332/ecancer.2024.1660] [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: 09/25/2023] [Indexed: 03/02/2024] Open
Abstract
Background Gallbladder cancer is a rare malignancy characterised by poor survival with lack of durable response to treatment. Thus, novel biomarkers are needed to prognosticate patients. This systematic review and meta-analysis sought to examine the role of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet count (PC) and serum immune inflammation index in predicting the survival of patients with gallbladder cancer. Materials and methods A systematic search was done using PubMed, Cochrane, ClinicalTrials.gov and Google Scholar for articles published from inception until 8 February 2022. Hazard ratios (HR) with 95% confidence intervals (CI) were pooled and subgroup analyses were conducted according to treatment, region and cut-offs. The primary outcome of interest was overall survival (OS). Data were summarised using RevMan version 5.4. Results Twenty studies comprising 5,183 patients were included in the analysis. High neutrophil-lymphocyte ratio (HR 1.72, 95% CI 1.47-2.02), platelet-lymphocyte ratio (HR 1.51, 95% CI 1.33-1.72), monocyte-lymphocyte ratio (HR 1.96, 95% CI 1.46-1.64), PC (HR 1.20, 95% CI 1.02-1.40) and serum inflammation index (HR 1.73, 95% CI 1.36-2.18) were all associated with worse survival. The association was consistent across most subgroups on race and cut-offs with a trend towards poor survival for PC above 252.5. Conclusion High neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, monocyte-lymphocyte ratio, PC and SII are associated with worse OS in gallbladder cancer and are potential biomarkers for prognostication. Prospective studies are recommended to further evaluate their use.
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Affiliation(s)
- Rogelio N Velasco
- Clinical Trial and Research Division, Philippine Heart Center, Quezon City 0850, Philippines
- Lung Center of the Philippines, Quezon City 1101, Philippines
| | - Harold Nathan C Tan
- Section of Medical Oncology, Makati Medical Center, Makati City 1229, Philippines
| | - Michael D San Juan
- Division of Medical Oncology, Philippine General Hospital, Manila 1000, Philippines
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Hai-Jing Y, Shan R, Jie-Qiong X. Prognostic significance of the pretreatment pan-immune-inflammation value in cancer patients: an updated meta-analysis of 30 studies. Front Nutr 2023; 10:1259929. [PMID: 37850085 PMCID: PMC10577316 DOI: 10.3389/fnut.2023.1259929] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/15/2023] [Indexed: 10/19/2023] Open
Abstract
Background The pan-immune-inflammation value (PIV) has been reported as a promising prognostic biomarker in multiple cancers but still remains inconclusive. The objective of this study is to systematically investigate the association of the pretreatment PIV with survival outcomes in cancer patients, based on available literature. Methods Online databases including PubMed, Embase and the Web of Science were thoroughly searched for studies evaluating the prognostic role of the pretreatment PIV in cancers from the inception to June 2023. Hazard ratios (HRs) with 95% confidence intervals (CIs) were always assessed using a random-effects model. Statistical analyses were performed using Stata 12.0. Results Thirty studies were finally included after comprehensively study searching. In total, 8,799 cancer patients were enrolled in this meta-analysis. The pooled results demonstrated that patients in the high PIV group had a significantly poorer overall survival (HR = 2.07; 95%CI: 1.77-2.41; I2 = 73.0%) and progression-free survival (HR = 1.83; 95%CI: 1.37-2.45; I2 = 98.2%) than patients in the low PIV group. The prognostic significance of the PIV score on overall survival and progression-free survival was observed across various geographical regions, tumor stages and treatment strategies. Sensitivity analyses supported the stability of the above combined results. Conclusion This meta-analysis demonstrated that the pretreatment PIV could be a non-invasive and efficacious prognostic biomarker for cancer patients.
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Affiliation(s)
| | | | - Xia Jie-Qiong
- Department of International Nursing School, Hainan Medical University, Haikou, Hainan, China
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Guo G, Hu X, Gao T, Zhou H, Li B, Zhou C, Yu B, Wang G. Potential impact of platelet-to-lymphocyte ratio on prognosis in patients with colorectal cancer: A systematic review and meta-analysis. Front Surg 2023; 10:1139503. [PMID: 37051571 PMCID: PMC10083474 DOI: 10.3389/fsurg.2023.1139503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/06/2023] [Indexed: 03/29/2023] Open
Abstract
BackgroundNumerous studies have confirmed that inflammation promotes the occurrence, development and prognosis of colorectal cancer (CRC).ObjectiveThis study focuses on the potentially prognostic value of the platelet-to-lymphocyte ratio (PLR) in CRC patients.Data SourcesThis study was registered at PROSPERO (ID: CRD42020219215). Relative studies were searched on PubMed, Cochrane Library, Embase, Web of Science, and clinical trial databases by two back-to-back reviewers. Study Selection and Intervention: Studies were screened according to the predetermined inclusion and exclusion criteria, comparing prognosis differences between low PLR levels and high PLR levels for CRC patients. Main Outcome Measures: Studies were integrated and compared to analyze the value of PLR in predicting overall survival (OS), progression-free survival (PFS), cancer-specific survival (CSS), disease-free survival (DFS) and recurrence-free survival (RFS) of CRC. Results: Outcomes were compared using Review Manager (version 5.4) software from Cochrane Collaboration. A total of 27 literary works, including 13,330 patients, were incorporated into our study. The final results showed that higher PLR levels had worse OS (hazard ratio [HR] = 1.40, 95% confidence interval [CI] = 1.21–1.62, P < 0.00001), DFS (HR = 1.44, 95% CI = 1.09–1.90, P = 0.01) and RFS (HR = 1.48, 95% CI = 1.13–1.94, P = 0.005) than lower PLR levels, respectively. However, there was no evidence of significance for PFS (HR = 1.14, 95% CI = 0.84–1.54, P = 0.40) and CSS (HR = 1.16, 95% CI = 0.88–1.53, P = 0.28) in the final meta-analysis.LimitationsOur study has the following limitations. First of all, we only included literature published in English, which means that some publication bias may be inevitable. In addition, our study used aggregate data, not individual data; furthermore, we did not define the exact cut-off value representing the PLR level.ConclusionAn elevated PLR seems to be an adverse prognostic factor affecting survival outcomes in patients with CRC. Meanwhile, more prospective studies are required to confirm our conclusion.PROSPERO ID: CRD42020219215.
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Affiliation(s)
- Ganlin Guo
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuhua Hu
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tianyi Gao
- The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huixian Zhou
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Baokun Li
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chaoxi Zhou
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bin Yu
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guiying Wang
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Correspondence: Guiying Wang
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Preoperative lymphocyte to C-reactive protein ratio as a new prognostic indicator in patients with resectable gallbladder cancer. Hepatobiliary Pancreat Dis Int 2022; 21:267-272. [PMID: 34507896 DOI: 10.1016/j.hbpd.2021.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 08/11/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Inflammation is often related to cancer, and several inflammatory scores have been established to predict the prognosis of various types of cancer. Our study aimed to determine the prognostic value of the preoperative lymphocyte to C-reactive protein ratio (LCR) for predicting postoperative outcomes in patients with resectable gallbladder cancer (GBC). METHODS A retrospective analysis of 104 GBC patients who received curative surgery at Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine from January 2000 to December 2016 was performed. A time-dependent receiver operating characteristic curve was constructed to evaluate the accuracy of different markers. Univariate and multivariate Cox proportional hazard models were used to define factors associated with overall survival. RESULTS Among the assessed variables, the preoperative LCR showed the highest accuracy in predicting the overall survival of GBC patients (AUC: 0.736). Decreased preoperative LCR was significantly associated with advanced tumor stage, including tumor invasion (P = 0.018), lymph node metastasis (P = 0.011) and TNM stage (P = 0.022). A low preoperative LCR (cutoff threshold = 145.5) was an independent risk factor for overall survival in patients with resectable GBC (P < 0.001). CONCLUSIONS The preoperative LCR is a novel and valuable prognostic indicator of postoperative survival in patients with resectable GBC.
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Dai H, Xu J. Preoperative geriatric nutritional risk index is an independent prognostic factor for postoperative survival after gallbladder cancer radical surgery. BMC Surg 2022; 22:133. [PMID: 35392884 PMCID: PMC8991798 DOI: 10.1186/s12893-022-01575-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/28/2022] [Indexed: 12/04/2022] Open
Abstract
Background Currently, the surgical outcomes of gallbladder cancer (GBC) are not always satisfactory. The geriatric nutritional risk index (GNRI) can effectively assess nutritional status. This study intends to investigate whether the preoperative GNRI can predict the prognosis of GBC. Methods 202 consecutive GBC patients who underwent treatment from 2010 to 2017 were selected and analyzed retrospectively. By using the univariate and multivariate Cox regression analyses on overall survival (OS) and recurrence-free survival (RFS), the preoperative GNRI of GBC patients was evaluated. Results Among the 202 patients, the GNRI of the 86 patients (42.6%) was less than 98. The patients with low preoperative GNRI had the median OS of 26 months, which was less than the median OS of 39 months among those patients who had higher preoperative GNRI (P < 0.001). Univariate analysis showed that low GNRI was related to short survival time (HR 3.656, 95% CI 2.308–5.790, P < 0.001). In addition, the results of multivariate analysis revealed that, the patients with low GNRI showed a lower OS (HR 2.207, 95% CI 1.131–4.308, P = 0.020) and RFS (HR 2.964, 95% CI 1.577–5.571, P = 0.001) than those patients with higher GNRI. Conclusion GNRI is an independent indicator of poor prognosis in GBC patients after GBC radical surgery.
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Affiliation(s)
- Huifan Dai
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng District, Wenzhou, Zhejiang Province, People's Republic of China
| | - Jing Xu
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng District, Wenzhou, Zhejiang Province, People's Republic of China.
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Kattepur AK, Patkar S, Ramaswamy A, Ostwal V, Goel M. Red Cell Distribution Width and Gallbladder Cancer: Is It Really Useful? J Gastrointest Cancer 2021; 53:995-1005. [PMID: 34757580 DOI: 10.1007/s12029-021-00742-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE The data on the prognostic significance of red cell distribution width (RDW) in gallbladder cancers is sparse, especially in the potentially resectable cohort of patients. The aim was to assess the prognostic significance of RDW in gallbladder cancer patients undergoing surgery. METHODS Retrospective analysis of prospectively maintained database of gallbladder cancer patients undergoing surgery at a tertiary cancer institute from 2010 till 2018. Baseline values were collected. Patients were grouped as per the median RDW value and compared. Survival analysis was done using the Kaplan Meier method. RESULTS A total of 605 patients were included. The median follow up period was 23 months (range: 6-120 months). The median value of RDW was 14. Comparison between RDW > 14 and RDW < 14 groups showed no difference in outcomes. RDW did not predict overall survival or recurrences. However, in combined stages II and III, a statistically significant improvement in OS and DFS (p < 0.001) was noted in the RDW < 14 group. CONCLUSION RDW did not predict recurrence or survival in potentially resectable gallbladder cancer patients. However, in the subset of stages II and III in combination, lower RDW value was associated with better outcomes. More prospective studies are needed to conclusively establish the prognostic value of RDW.
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Affiliation(s)
- Abhay K Kattepur
- Department of Surgical Oncology, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
| | - Shraddha Patkar
- Division of HPB and Gastrointestinal Oncology Services, Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Dr Ernst Borges Marg, Parel, Mumbai, India.
| | - Anant Ramaswamy
- Division of HPB and Gastrointestinal Oncology Services, Department of Medical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Dr Ernst Borges Marg, Parel, Mumbai, India
| | - Vikas Ostwal
- Division of HPB and Gastrointestinal Oncology Services, Department of Medical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Dr Ernst Borges Marg, Parel, Mumbai, India
| | - Mahesh Goel
- Division of HPB and Gastrointestinal Oncology Services, Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Dr Ernst Borges Marg, Parel, Mumbai, India
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Kucuk S, Mızrak S. Diagnostic Value of Inflammatory Factors in Patients with Gallbladder Cancer, Dysplasia, and Cholecystitis. Cancer Control 2021; 28:10732748211033746. [PMID: 34348499 PMCID: PMC8358487 DOI: 10.1177/10732748211033746] [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] [Indexed: 11/18/2022] Open
Abstract
Background Involving pre-sampled patients with cholecystitis, dysplasia, and adenocarcinoma, the present study aimed to compare the neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), platelet/lymphocyte (PLR) ratios, and plateletcrit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW) values and to determine their prognostic importance. Methods The present study involved 187 cholecystectomy specimens that were diagnosed as cholecystitis, dysplasia, and adenocarcinoma. Preoperative neutrophil, monocyte, lymphocyte, and platelet counts, NLR, MLR, and PLR ratios, and PCT, MPV, and PDW levels of the same patient groups were retrospectively recorded. Results In the present study, the cut-off values for dysplasia of NLR, PLR, and MLR were found as 1.61, 81.45, and .19, whereas those for cancer of NLR, PLR, and MLR were 2.65, 182.69, and .35, respectively. The NLR, PLR, and MLR values of the chronic cholecystitis and chronic calculous cholecystitis groups were statistically significantly lower than those of the chronic active calculous cholecystitis group (P < .01). The NLR and MLR values of the non-cancer and non-dysplasia groups were statistically lower than those of the cancer and dysplasia groups (P < .05). Conclusion According to the results of the present study, using additional imaging methods, acute-phase cholecystitis can be distinguished using preoperative neutrophil and monocyte counts, and NLR, PLR, and MLR cut-off values can be used to distinguish dysplasia, which is the antecedent of gallbladder cancer. It is thought that this might provide patients with an advantage in terms of early treatment and survival.
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Affiliation(s)
- Sirin Kucuk
- Department of Pathology, Faculty of Medicine, 175652Uşak University, Uşak, Turkey
| | - Soycan Mızrak
- Department of Biochemistry, Faculty of Medicine, 175652Uşak University, Uşak, Turkey
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Singh J, Shukla D, Gupta S, Shrivastav BR, Tiwari PK. Clinical epidemiology of gallbladder cancer in North-Central India and association of immunological markers, NLR, MLR and PLR in the diagnostic/prognostic prediction of GBC. Cancer Treat Res Commun 2021; 28:100431. [PMID: 34333247 DOI: 10.1016/j.ctarc.2021.100431] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/24/2021] [Accepted: 07/04/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The incidence of Gallbladder Cancer (GBC) is found to be increasing in the rural populations of north-central India. Role of multiple demographic factors, including poor socio-economic conditions, illiteracy and miserable primary healthcare services appear to be significant factors for this increase. Here, we aim to assess the present status of GBC in north-central India and evaluate the role of immunological markers in its management. METHODS A total of 1845 cases of different Gallbladder diseases, including GBC, from rural and urban areas both, registered at CHRI, Gwalior during 2009-2014 and 2018 were included in this study. The demographic and clinical information of the patients were analysed using various statistical tests. RESULTS Of all the cases (1845) included in this study, 1125 (60.97%) were diagnosed with GBC, of which, 707 (62.84%) were from rural background and 418 (37.15%) from urban settings. Mean age for GBC cases for both male and female was about 53.49 years. Females were more affected, being 70.37%, while male patients were only 29.63%. The pathological investigations showed elevated levels of total bilirubin and liver function enzymes both. The NLR, PLR and MLR were found to be significantly associated with different clinical parameters as well as OS. CONCLUSION We infer that the growing trend of GBC, particularly in rural areas, in north-central India is primarily associated with the lack of awareness, inadequate medical support and poor socio-economic conditions. Evaluation of haematological markers may help in the predictive diagnosis/ prognosis and or management of GBC cases in the studied population.
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Affiliation(s)
- Jyotsna Singh
- Centre for Genomics, Jiwaji University, Gwalior, Madhya Pradesh, India; School of Studies in Zoology, Jiwaji University, Gwalior, Madhya Pradesh, India
| | - Durgesh Shukla
- Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
| | - Sanjiv Gupta
- Cancer Hospital and Research Institute (CHRI), Gwalior, Madhya Pradesh, India
| | - Braj Raj Shrivastav
- Cancer Hospital and Research Institute (CHRI), Gwalior, Madhya Pradesh, India
| | - Pramod Kumar Tiwari
- Centre for Genomics, Jiwaji University, Gwalior, Madhya Pradesh, India; School of Studies in Zoology, Jiwaji University, Gwalior, Madhya Pradesh, India.
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Liu F, Hu HJ, Regmi P, Jin YW, Ma WJ, Wang JK, Zou RQ, Li FY. Elevated Platelet Distribution Width Predicts Poor Prognosis in Gallbladder Carcinoma. Cancer Manag Res 2021; 13:4647-4655. [PMID: 34140810 PMCID: PMC8203277 DOI: 10.2147/cmar.s311061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/27/2021] [Indexed: 02/05/2023] Open
Abstract
Background Previous studies have demonstrated that platelet distribution width (PDW) is a reliable predictor of prognosis of a variety of tumors. Nevertheless, the prognostic value of PDW in gallbladder carcinoma (GBC) remains unknown. We aimed to explore the correlation between PDW and prognosis in patients with GBC. Methods A total of 303 patients with GBC who underwent curative surgery between January 2005 and February 2017 were enrolled. The relationship between PDW and clinicopathological features was analyzed. Receiver operating characteristic (ROC) curve was used to identify the optimal cutoff value of PDW. The overall survival (OS) rate was estimated by Kaplan–Meier method. Meanwhile, univariable and multivariable Cox regression model were used to evaluate the risk factors for OS. Results There was significant correlation between elevated PDW and AJCC stage. In addition, survival analysis revealed that the patients with PDW>14.95 have a worse prognosis than patients with PDW\documentclass[12pt]{minimal}
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\end{document}14.95 (P < 0.001). The multivariable Cox regression model analysis demonstrated that PDW was an independent prognostic factor in GBC patients (hazard ratio=1.976, 95% confidence interval:1.474–2.650, P<0.001). Conclusion Elevated PDW can predict poor prognosis in GBC patients, and further studies are needed to verify the reliability and clarify the exact molecular mechanistic of PDW in GBC.
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Affiliation(s)
- Fei Liu
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Hai-Jie Hu
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Parbatraj Regmi
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Yan-Wen Jin
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Wen-Jie Ma
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Jun-Ke Wang
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Rui-Qi Zou
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Fu-Yu Li
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
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Systemic Immune-Inflammation Index Is a Prognostic Predictor in Patients with Intrahepatic Cholangiocarcinoma Undergoing Liver Transplantation. Mediators Inflamm 2021; 2021:6656996. [PMID: 33628115 PMCID: PMC7899762 DOI: 10.1155/2021/6656996] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 02/07/2023] Open
Abstract
Background It was reported that systemic immune inflammation index (SII) was related to poor prognosis in a variety of cancers. We aimed to investigate the ability of the prognostic predictors of SII in patients with intrahepatic cholangiocarcinoma (iCCA) undergoing liver transplantation (LT). Methods The 28 iCCA patients who underwent LT at our hospital between 2013 and 2018 were reviewed. Kaplan–Meier survival curves and Cox regression analyses were used to evaluate the prognostic significance of SII. Patients were divided into the high and low SII groups according to the cut-off value. Results The 1-, 3-, and 5-year OS rates were significantly lower in the high SII group (85.7%, 28.6%, and 21.4%, respectively) than in the low SII group (92.9%, 71.4%, and 57.2%, respectively; P = 0.009). The 1-, 3-, and 5-year RFS rates were, respectively, 57.1%, 32.7%, and 21.8% in the high SII group and 85.7%, 61.1%, and 61.1% in the low SII group (P = 0.021). SII ≥ 447.48 × 109/L (HR 0.273, 95% CI 0.082–0.908; P = 0.034) was an independent prognostic factor for OS. Conclusions Our results showed that SII can be used to predict the survival of patients with iCCA who undergo LT.
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Cheng H, Zhou D, Wang S, Ding J, Ma F. The immunological characteristics of gallbladder carcinoma and advances in immunotherapy practices. Biosci Trends 2021; 15:9-15. [PMID: 33551416 DOI: 10.5582/bst.2020.01039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Gallbladder carcinoma (GBC) is one of the most common malignant tumors in the biliary system, ranking sixth among gastrointestinal malignancies. In addition, the incidence of GBC has recently increased in China. GBC metastasizes early and invades adjacent organs such as the liver, making patients with GBC ineligible for radical surgery and giving them a poor prognosis. What is more, GBC is more inclined to develop chemo-resistance, which requires new strategies for clinical intervention. Cancer immunotherapy has made great advances over the past few years, with improved clinical efficacy against multiple malignancies, including GBC. This review summarizes the immunological characteristics of GBC as well as current advances in immunotherapies for GBC in order to provide new insights into future treatment and prevention of GBC.
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Affiliation(s)
- Haihong Cheng
- Department of Oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Zhou
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shouhua Wang
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Ding
- Department of Biliary and Pancreatic Surgery, Shanghai Shuguang Hospital Affiliated with the Shanghai University of T.C.M., Shanghai, China
| | - Fei Ma
- Department of Oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute for Pediatric Research, Shanghai, China
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Peng D, Lu J, Hu H, Li B, Ye X, Cheng N. Lymphocyte to Monocyte Ratio Predicts Resectability and Early Recurrence of Bismuth-Corlette Type IV Hilar Cholangiocarcinoma. J Gastrointest Surg 2020; 24:330-340. [PMID: 30671792 PMCID: PMC7026310 DOI: 10.1007/s11605-018-04086-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 12/15/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND The objective of our research was to investigate the value of the lymphocyte to monocyte ratio (LMR) and its dynamic changes (LMRc) in predicting tumor resectability and early recurrence of radiologically resectable type IV hilar cholangiocarcinoma (HC). METHODS A total of 411 patients with radiologically resectable type IV HC were included. Data on their clinicopathologic characteristics, perioperative features, and survival outcomes were analyzed. Receiver operating characteristic (ROC) analysis was conducted to assess the ability of preoperative LMR (pre-LMR) to predict tumor resectability, and the ability of postoperative LMR (post-LMR) to discriminate between early and late recurrence. Survival curves were calculated using the Kaplan-Meier estimate. Univariate and multivariate logistic regression models were used to identify factors associated with resectability and early recurrence. RESULTS Of 411 patients with potentially curative type IV HC, 254 underwent curative surgery. The optimal cutoff value of pre-LMR as an indicator of resectability was 3.67, and the optimal cutoff value of post-LMR for detecting early recurrence was 4.10. In the multivariate logistic regression model, CA19-9 > 200 U/mL, pre-LMR ≤ 3.67, and tumor size > 3 cm were found to be independent risk factors for poor resectability. Moreover, multivariate analysis showed that LMRc, resection margin, AJCC N stage, and lymphovascular invasion were independent risk factors associated with early recurrence. DISCUSSION Pre-LMR is a valuable indicator of resectability and LMRc is a valuable predictor of early recurrence in patients with curative type IV HC.
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Affiliation(s)
- Dingzhong Peng
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 614100 Sichuan Province China
| | - Jiong Lu
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 614100 Sichuan Province China
| | - Haijie Hu
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 614100 Sichuan Province China
| | - Bei Li
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 614100 Sichuan Province China
| | - Xiwen Ye
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 614100 Sichuan Province China
| | - Nansheng Cheng
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 614100 Sichuan Province China
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Abstract
Gallbladder cancer (GBC) is a rare biliary malignancy. The relationship between red blood cell distribution width (RDW) and cancer prognosis has been confirmed by many studies, however, the relationship between RDW and gallbladder cancer is rarely reported. Therefore, we aimed to assess the correlation between RDW and the advancements of GBC in this study.A retrospective study was performed on 108 GBC patients and 119 age and gender-matched individuals who were admitted to the First Affiliated Hospital of Guangxi Medical University from January 2012 to December 2018.The GBC patients had significantly higher RDW(%) levels compared to the healthy controls group (15.7 ± 2.4 vs 13.5 ± 0.6; P = .000). In addition, GBC patients with stage III+IV had higher levels of RDW(%) than stage I+II (16.1 ± 2.5 vs 14.9 ± 2.0, P = .011). Correlation analysis showed that RDW had positive correlations with TNM stage (correlation coefficient = 0.302, P = .002). The cut-off value of RDW was observed to be 14.5% in patients with GBC (area under the curve = 0.757, 95% confidence interval = 0.677-0.838, P = .000). Univariate logistic regression and multivariate logistic regression analysis showed that RDW was an independent risk factor for GBC lymph node metastasis.Our results suggest that elevated levels of RDW are independently associated with GBC patients and may serve as potential markers for the advancements of GBC.
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Affiliation(s)
- Youjun Xie
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University
| | - Lingling Zhang
- Department of Clinical Laboratory, Children's Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lingling Zhan
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University
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Glucose to Lymphocyte Ratio as a Prognostic Marker in Patients With Resected pT2 Gallbladder Cancer. J Surg Res 2019; 240:17-29. [PMID: 30909062 DOI: 10.1016/j.jss.2019.02.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/31/2019] [Accepted: 02/22/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND We designed a clinical application of glucose to lymphocyte ratio (GLR) as it might be a sensitive parameter to determine the glucose metabolism and behavior of the cancer (i.e., its aggressiveness), and the immunologic status of a patient with cancer. Thus, we investigated the association of GLR with the overall survival (OS) and disease-free survival (DFS) of patients with T2 gallbladder (GB) cancer after curative-intent surgery. METHODS The medical records of patients with T2 GB cancer who underwent surgery were retrospectively reviewed. The clinicopathologic characteristics, preoperative complete blood counts, fasting blood glucose, albumin, cholesterol, and follow-up information were collected. RESULTS A total of 197 patients were included in the study. In multivariate analysis, high GLR (>69.3) was associated with poor OS (HR = 15.249, 95% CI: 4.090-56.849, P = 0.0001) along with R1 status (HR = 1.755, 95% CI: 0.033-0.910, P = 0.033), >3 metastatic lymph nodes (HR = 2.809, 95% CI: 1.403-5.625; P = 0.004), and lymphovascular invasion (HR = 8.041, 95% CI: 2.881-22.442; P = 0.0001). Moreover, high GLR (HR = 3.666, 95% CI: 1.145-11.737, P = 0.029), adjuvant chemotherapy (HR = 6.306, 95% CI: 1.921-20.699; P = 0.002), lymphovascular invasion (HR = 5.464, 95% CI: 1.783-16.746; P = 0.003), and high-grade tumor (HR = 2.143, 95% CI: 1.042-4.407; P = 0.038) were independently associated with DFS. CONCLUSIONS Preoperative GLR is an independent predictor of OS and DFS in T2 GB cancer. Further studies are required to validate these findings.
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Zheng P, Wang X, Hong Z, Shen F, Zhang Q. Preoperative fasting hyperglycemia is an independent prognostic factor for postoperative survival after gallbladder carcinoma radical surgery. Cancer Manag Res 2019; 11:1425-1432. [PMID: 30863153 PMCID: PMC6388958 DOI: 10.2147/cmar.s192273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Preoperative high blood glucose levels are closely associated with poor performance and high mortality in cancer patients. This study was designed to investigate the relationship between preoperative fasting hyperglycemia and the prognosis of patients with gallbladder cancer (GBC) after undergoing GBC radical surgery. PATIENTS AND METHODS A retrospective analysis of 83 eligible patients who underwent GBC radical surgery between 2007 and 2016 was performed. Factors affecting overall survival (OS) and recurrence-free survival (RFS) were analyzed by univariate and multivariate analyses. RESULTS Of the 83 patients, 35 (42.2%) had preoperative fasting hyperglycemia. The median OS of the enrolled patients was 12 months. The median OS in patients with fasting hyperglycemia before surgery was 18 months, which was shorter than for patients with normal fasting blood glucose levels before surgery (47 months, P<0.001). Preoperative fasting hyperglycemia was associated with shorter survival times in univariate analyses (HR, 3.215; 95% CI, 1.846-5.601; P<0.001). Multivariate analysis showed that patients with preoperative fasting hyperglycemia had a lower OS (HR, 2.832; 95% CI, 1.480-5.418; P=0.002) and RFS (HR, 2.051; 95% CI, 1.127-3.733; P=0.019) than patients with normal preoperative fasting blood glucose levels. CONCLUSION Preoperative fasting hyperglycemia is an independent indicator of poor prognosis in GBC patients after GBC radical surgery.
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Affiliation(s)
- Peng Zheng
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xiaoqian Wang
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China,
| | - Zhong Hong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Feixia Shen
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China,
| | - Qiyu Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China,
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Inflammation-based prognostic scores in patients with extrahepatic bile duct lesions treated by percutaneous transhepatic biliary stenting combined with 125I seeds intracavitary irradiation. Clin Transl Oncol 2018; 21:665-673. [PMID: 30368724 DOI: 10.1007/s12094-018-1969-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/16/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE This study aimed at investigating the efficacy of percutaneous transhepatic biliary stenting (PTBS) combined with 125I seeds intracavitary irradiation in the treatment of extrahepatic cholangiocarcinoma (EHC) and to preliminarily explore the prognostic values of inflammation-based scores in these patients. METHODS A total of 113 clinically/pathologically diagnosed cases of EHC who received PTBS combined with 125I seeds implantation were retrospectively analyzed. The postoperative changes of clinical symptoms and serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total serum bilirubin (TBIL), direct bilirubin (DBIL), and albumin (ALB) were observed. Preoperative clinical data were extracted to calculate inflammation-based scores, including systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelets-to-lymphocyte ratio (PLR). Kaplan-Meier survival curves and Cox regression analyses were used to evaluate the prognostic significance of inflammation-based scores. RESULTS After operation, clinical symptoms such as jaundice and fever significantly improved in all patients. At 1 month and 3 months postoperatively, serum levels of ALT, AST, ALP, TBIL, and DBIL significantly reduced, and ALB significantly increased, compared with preoperative values. The median survival time of the patients was 12 months and the 1-year survival rate was 56.8%. Univariate analysis revealed that factors related to overall survival were CA19-9, TBIL, ALB, SII, and NLR. Multivariate analysis further identified SII and NLR as independent prognostic models. CONCLUSION The combination of PTBS and 125I seeds intracavitary irradiation is an effective palliative treatment for advanced EHC. Elevated SII and NLR can be used to predict poor survival.
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Xu WY, Zhang HH, Yang XB, Bai Y, Lin JZ, Long JY, Xiong JP, Zhang JW, Sang XT, Zhao HT. Prognostic significance of combined preoperative fibrinogen and CA199 in gallbladder cancer patients. World J Gastroenterol 2018; 24:1451-1463. [PMID: 29632426 PMCID: PMC5889825 DOI: 10.3748/wjg.v24.i13.1451] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/07/2018] [Accepted: 03/10/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the prognostic value of the combination of preoperative plasma fibrinogen and CA199 in patients with gallbladder carcinoma (GBC).
METHODS The clinicopathological data of 154 GBC patients were retrospectively reviewed after surgery. A receiver operating characteristic (ROC) curve was plotted to verify the optimum cut-off values for plasma fibrinogen and CA199. Univariate and multivariate survival analyses were performed to identify the factors associated with GBC prognosis. Based on the HRs calculated via multivariate survival analyses, patients with elevated plasma fibrinogen and CA199 levels were allocated a score of 2.1; those with an elevated plasma fibrinogen level only were allocated a score of 1, those with an elevated CA199 level only were allocated a score of 1.1, and those with neither of these abnormalities were allocated a score of 0.
RESULTS ROC curve analysis showed that the optimum cut-off values for preoperative plasma fibrinogen and CA199 were 3.47 g/L and 25.45 U/mL, respectively. Multivariate analysis indicated that elevated preoperative plasma fibrinogen and CA199 levels were significantly correlated with worse overall survival (OS) (HR = 1.711, 95%CI: 1.114-2.627, P = 0.014, and HR = 1.842, 95%CI: 1.111-3.056, P = 0.018). When we combined these two parameters, the area under the ROC curve increased from 0.735 (for preoperative plasma fibrinogen only) and 0.729 (for preoperative CA199 only) to 0.765. When this combined variable was added to the multivariate analysis, the combination of plasma fibrinogen and CA199 (P < 0.001), resection margin (P < 0.001) and TNM stage (P = 0.010) were independent prognostic factors for GBC.
CONCLUSION The combination of plasma fibrinogen and CA199 may serve as a more efficient independent prognostic biomarker for postoperative GBC patients than either parameter alone.
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Affiliation(s)
- Wei-Yu Xu
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hao-Hai Zhang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiao-Bo Yang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yi Bai
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jian-Zhen Lin
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jun-Yu Long
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jian-Ping Xiong
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jun-Wei Zhang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xin-Ting Sang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hai-Tao Zhao
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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The role of the systemic inflammatory response in predicting outcomes in patients with operable cancer: Systematic review and meta-analysis. Sci Rep 2017; 7:16717. [PMID: 29196718 PMCID: PMC5711862 DOI: 10.1038/s41598-017-16955-5] [Citation(s) in RCA: 198] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 11/17/2017] [Indexed: 02/06/2023] Open
Abstract
Cancer remains a leading causes of death worldwide and an elevated systemic inflammatory response (SIR) is associated with reduced survival in patients with operable cancer. This review aims to examine the evidence for the role of systemic inflammation based prognostic scores in patients with operable cancers. A wide-ranging literature review using targeted medical subject headings for human studies in English was carried out in the MEDLINE, EMBASE, and CDSR databases until the end of 2016. The SIR has independent prognostic value, across tumour types and geographical locations. In particular neutrophil lymphocyte ratio (NLR) (n = 158), platelet lymphocyte ratio (PLR) (n = 68), lymphocyte monocyte ratio (LMR) (n = 21) and Glasgow Prognostic Score/ modified Glasgow Prognostic Score (GPS/mGPS) (n = 60) were consistently validated. On meta-analysis there was a significant relationship between elevated NLR and overall survival (OS) (p < 0.00001)/ cancer specific survival (CSS) (p < 0.00001), between elevated LMR and OS (p < 0.00001)/CSS (p < 0.00001), and elevated PLR and OS (p < 0.00001)/CSS (p = 0.005). There was also a significant relationship between elevated GPS/mGPS and OS (p < 0.00001)/CSS (p < 0.00001). These results consolidate the prognostic value of the NLR, PLR, LMR and GPS/mGPS in patients with resectable cancers. This is particularly true for the NLR/GPS/mGPS which should form part of the routine preoperative and postoperative workup.
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Zhou LH, Luo XF. Platelet to lymphocyte ratio in biliary tract cancer: Review and meta-analysis. Clin Chim Acta 2017; 474:102-107. [DOI: 10.1016/j.cca.2017.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/06/2017] [Accepted: 09/09/2017] [Indexed: 02/07/2023]
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Soliz JM, Ifeanyi IC, Katz MH, Wilks J, Cata JP, McHugh T, Fleming JB, Feng L, Rahlfs T, Bruno M, Gottumukkala V. Comparing Postoperative Complications and Inflammatory Markers Using Total Intravenous Anesthesia Versus Volatile Gas Anesthesia for Pancreatic Cancer Surgery. Anesth Pain Med 2017; 7:e13879. [PMID: 29344445 PMCID: PMC5750426 DOI: 10.5812/aapm.13879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/23/2017] [Accepted: 08/07/2017] [Indexed: 12/30/2022] Open
Abstract
Objectives The objective of this study is to evaluate postoperative complications and inflammatory profiles when using a total intravenous anesthesia (TIVA) or volatile gas-opioid (VO) based anesthesia in patients undergoing pancreatic cancer surgery. Methods Design, retrospective propensity score matched cohort; Setting, major academic cancer hospital; Patients, all patients who had pancreatic surgery between November 2011 and August 2014 were retrospectively reviewed. Propensity score matched patient pairs were formed. A total of 134 patients were included for analysis with 67 matched pairs; Interventions, Patients were categorized according to type of anesthetic used (TIVA or VO). Patients in the TIVA group received preoperative celecoxib, tramadol, and pregabalin in addition to intraoperative TIVA with propofol, lidocaine, ketamine, and dexmedetomidine. The VO-group received a volatile-opioid based anesthetic; Measurements, demographic, perioperative clinical data, platelet lymphocyte ratios, and neutrophil lymphocyte ratios were collected. Complications were graded and collected prospectively and later reviewed retrospectively. Results Patients receiving TIVA were more likely to have no complication or a lower grade complication than the VO-group (P = 0.014). There were no differences in LOS or postoperative inflammatory profiles noted between the TIVA and VO groups. Conclusions In this retrospective matched analysis of patients undergoing pancreatic cancer surgery, TIVA was associated with lower grade postoperative complications. Length of hospital stay (LOS) and postoperative inflammatory profiles were not significantly different.
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Affiliation(s)
- Jose M Soliz
- Department of Anesthesiology and Perioperative Medicine, Houston, TX, USA
- Corresponding author: Jose M Soliz, MD, Department of Anesthesiology and Perioperative Medicine University of Texas M.D., Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX 77030, E-mail:
| | - Ifeyinwa C Ifeanyi
- Department of Anesthesiology and Perioperative Medicine, Houston, TX, USA
| | | | - Jonathan Wilks
- Department of Anesthesiology and Perioperative Medicine, Houston, TX, USA
| | - Juan P Cata
- Department of Anesthesiology and Perioperative Medicine, Houston, TX, USA
| | - Thomas McHugh
- Department of Anesthesiology and Perioperative Medicine, Houston, TX, USA
| | | | - Lei Feng
- Department of Biostatistics, Houston, TX, USA
| | - Thomas Rahlfs
- Department of Anesthesiology and Perioperative Medicine, Houston, TX, USA
| | - Morgan Bruno
- Department of Surgical Oncology, Houston, TX, USA
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Peng HX, Lin K, He BS, Pan YQ, Ying HQ, Hu XX, Xu T, Wang SK. Platelet-to-lymphocyte ratio could be a promising prognostic biomarker for survival of colorectal cancer: a systematic review and meta-analysis. FEBS Open Bio 2016; 6:742-50. [PMID: 27398314 PMCID: PMC4932454 DOI: 10.1002/2211-5463.12083] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 01/04/2023] Open
Abstract
Inflammation is one of the most important causes leading to colorectal carcinogenesis, and inflammatory biomarkers such as the platelet-to-lymphocyte ratio (PLR) might predict survival in colorectal cancer (CRC). However, the prognostic value of PLR in CRC patients remains controversial. The prognostic value of PLR was comprehensively analyzed in 12 articles including 3541 CRC patients (10 for overall survival (OS), seven for disease-free survival (DFS), three for recurrence-free survival (RFS), and three for cancer-specific survival (CSS)) in this study. The overall pooled hazard ratios (HRs) of PLR for OS, DFS, and CSS were significant at 1.29 (95% confidence interval, CI = 1.13-1.47, P H = 0.149), 1.43 (95% CI = 1.03-1.97, P H = 0.025), and 1.26 (95% CI = 1.04-1.52, P H = 0.223), respectively. However, there was no evidence of significance for RFS (HR = 1.29, 95% CI = 0.98-1.70, P H = 0.231) in our study. Stratified analyses indicated elevated PLR was a predictor of poor OS (metastatic patients) and DFS (Caucasian population) and was also significantly associated with OS in univariate analysis (HR = 1.35, 95% CI = 1.14-1.60, P H = 0.532) and those only treated surgically (HR = 1.37, 95% CI = 1.10-1.70, P H = 1.080). However, our findings indicated that elevated PLR is a promising prognostic biomarker for colorectal cancer, especially in metastatic Caucasian CRC patients.
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Affiliation(s)
- Hong-Xin Peng
- Medical School of Southeast University Nanjing Jiangsu China; Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Kang Lin
- Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Bang-Shun He
- Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Yu-Qin Pan
- Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Hou-Qun Ying
- Medical School of Southeast University Nanjing Jiangsu China; Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Xiu-Xiu Hu
- Medical School of Southeast University Nanjing Jiangsu China; Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Tao Xu
- Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Shu-Kui Wang
- Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
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