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Xia X, Tan S, Zeng R, Ouyang C, Huang X. Lactate dehydrogenase to albumin ratio is associated with in-hospital mortality in patients with acute heart failure: Data from the MIMIC-III database. Open Med (Wars) 2024; 19:20240901. [PMID: 38584822 PMCID: PMC10996934 DOI: 10.1515/med-2024-0901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 04/09/2024] Open
Abstract
The effect of the lactate dehydrogenase to albumin ratio (LAR) on the survival of patients with acute heart failure (AHF) is unclear. We aimed to analyze the impact of LAR on survival in patients with AHF. We retrieved eligible patients for our study from the Monitoring in Intensive Care Database III. For each patient in our study, we gathered clinical data and demographic information. We conducted multivariate logistic regression modeling and smooth curve fitting to assess whether the LAR score could be used as an independent indicator for predicting the prognosis of AHF patients. A total of 2,177 patients were extracted from the database. Survivors had an average age of 69.88, whereas nonsurvivors had an average age of 71.95. The survivor group had a mean LAR ratio of 13.44, and the nonsurvivor group had a value of 17.38. LAR and in-hospital mortality had a nearly linear correlation, according to smooth curve fitting (P < 0.001). According to multivariate logistic regression, the LAR may be an independent risk factor in predicting the prognosis of patients with AHF (odd ratio = 1.09; P < 0.001). The LAR ratio is an independent risk factor associated with increased in-hospital mortality rates in patients with AHF.
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Affiliation(s)
- Xiangjun Xia
- Department of Cardiology, Yiyang Central Hospital, Yiyang, 410215, Hunan, China
- Hunan Province Clinical Medical Technology Demonstration Base for Complex Coronary Lesions, Yiyang, Hunan, China
| | - Suisai Tan
- Department of Vascular Surgery, Yiyang Central Hospital, Yiyang, 410215, Hunan, China
| | - Runhong Zeng
- Department of Cardiology, Yiyang Central Hospital, Yiyang, 410215, Hunan, China
| | - Can Ouyang
- The Traditional Chinese Medical Hospital of Xiangtan County, Xiangtan, Hunan, China
| | - Xiabin Huang
- The Traditional Chinese Medical Hospital of Xiangtan County, Xiangtan, Hunan, China
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Liang M, Ren X, Huang D, Ruan Z, Chen X, Qiu Z. The association between lactate dehydrogenase to serum albumin ratio and the 28-day mortality in patients with sepsis-associated acute kidney injury in intensive care: a retrospective cohort study. Ren Fail 2023; 45:2212080. [PMID: 37194715 DOI: 10.1080/0886022x.2023.2212080] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND The mortality rate of patients with sepsis-associated acute kidney injury (SA-AKI) in the intensive care unit (ICU) is high, and there is a need for early identification of SA-AKI patients with poor prognoses. This study investigated the relationship between the lactate dehydrogenase to serum albumin ratio (LAR) and prognosis in patients with SA-AKI. METHODS We performed a retrospective cohort study of patients with SA-AKI who are represented in the Medical Information Mart for Intensive Care IV (MIMIC-IV). We used multivariable Cox regression analysis to determine adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analysis, survival curves, and curve fitting were used to evaluate a connection between the LAR and prognosis in patients with SA-AKI. RESULTS There were a total of 6453 participants in this research. The average age of the participants was 63.9 ± 16.1 years, and the average LAR was 11.0 (7.6, 17.7)/IU/g. After controlling for variables, the HRs for 28-day mortality were 1.20 (HR: 1.20, 95% CI: 1.05-1.38, p = 0.008) and 1.61 (HR: 1.61, 95% CI: 1.41-1.84, p < 0.001) for Tertile 2 (T2, 8.59≤ LAR< 14.66) and Tertile 3 (T3, LAR ≥ 14.66), respectively, compared to Tertile 1 (T1, LAR < 8.59). The outcomes for 90-day mortality and in-hospital death rate were comparable. The Kaplan-Meier (KM) analysis revealed that the group with greater LAR had higher 28-day and 90-day death rates. CONCLUSION Our study shows that LAR is associated with poor prognosis in patients with SA-AKI. Higher LAR is associated with higher 28-day, 90-day, and in-hospital mortality.
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Affiliation(s)
- Minghao Liang
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xiuhong Ren
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Di Huang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhishen Ruan
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xianhai Chen
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhanjun Qiu
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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He J, Tong L, Wu P, Wu Y, Shi W, Chen L. Prognostic Significance of Preoperative Lactate Dehydrogenase to Albumin Ratio in Breast Cancer: A Retrospective Study. Int J Gen Med 2023; 16:507-514. [PMID: 36789133 PMCID: PMC9922482 DOI: 10.2147/ijgm.s396871] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/31/2023] [Indexed: 02/10/2023] Open
Abstract
Purpose We explored the relationship between platelet count to lymphocyte count ratio (PLR), monocyte count to lymphocyte count ratio (MLR), lactate dehydrogenase to albumin ratio (LAR), and long-term survival in patients with breast cancer. Patients and Methods We retrospectively analyzed the clinical and follow-up data of 134 patients with breast cancer. The receiver operating characteristic curve (ROC curve) was used to distinguish between the low and high ratio groups. The chi-square test or Fisher's exact test was used to calculate the differences among the investigation factors. The Kaplan-Meier method was used to draw the survival curves. Log rank test was used for univariate analysis, and Cox proportional hazards regression model was used for multivariate analysis. A P value of <0.05 was considered statistically significant. Results The median follow-up time was 45 months. The PFS rates in the low group (LAR≤3.4066) at 18 months, 24 months, and 36 months were 100%, 100%, and 97.6%, and those in the high group (LAR > 3.4066) were 97.7%, 94.3%, and 87.3%, respectively. LAR was associated with Age (P=0.002) and BMI (body mass index) (P=0.002). Univariate analysis showed that Tumor size (P=0.027), Node positivity (P<0.001), TNM (tumor-node-metastasis) stage (P<0.001), PLR (P=0.034), MLR (P=0.038), and LAR (P=0.035) were significantly associated with PFS (progression-free survival) in breast cancer patients. Multivariate analysis showed that Node positivity (P<0.001) and LAR (P=0.035) were associated with PFS, while PLR and MLR were not independent prognostic indicators. Conclusion Preoperative high LAR will be an independent predictor of prognosis in patients with breast cancer.
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Affiliation(s)
- Jing He
- Department of Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China
| | - Ling Tong
- Human Reproductive Medicine Center, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China
| | - Ping Wu
- Department of Clinical Nutrition, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China
| | - Yibo Wu
- Human Reproductive Medicine Center, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China
| | - Weifeng Shi
- Department of Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China
| | - Ling Chen
- Department of Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China,Correspondence: Ling Chen; Weifeng Shi, Email ;
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Xu H, Lin T, Ai J, Zhang J, Zhang S, Li Y, Zheng X, Zhang P, Wei Q, Tan P, Yang L. Utilizing the Lactate Dehydrogenase-to-Albumin Ratio for Survival Prediction in Patients with Bladder Cancer After Radical Cystectomy. J Inflamm Res 2023; 16:1733-1744. [PMID: 37096127 PMCID: PMC10122464 DOI: 10.2147/jir.s384338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 01/18/2023] [Indexed: 04/26/2023] Open
Abstract
Purpose Previous studies have suggested that the preoperative lactate dehydrogenase-to-albumin ratio (LAR) is correlated with survival in several cancers except bladder cancer (BCa). This study aimed to determine the prognostic value of the LAR in patients with urothelial carcinoma of the bladder (UCB) after radical cystectomy (RC). Patients and Methods A total of 595 UCB patients with RC in West China Hospital from December 2010 to May 2020 were enrolled. A receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value of the LAR. Kaplan-Meier curves and Cox regression analyses were applied to evaluate the association of the LAR with overall survival (OS) and recurrence-free survival. Independent factors in multivariate analyses were selected to construct nomograms. Calibration curves, ROC curves, concordance index (C-index) and decision curve analyses were used to evaluate the performance of the nomograms. Results The optimal cutoff value of the LAR was determined to be 3.8. Preoperative low LAR was associated with decreased OS (P < 0.001) and RFS (P < 0.001), especially in patients with ≥ pT2 disease. LAR was an independent factor for OS (hazard ratio [HR]: 1.719; P <0.001) and RFS (HR: 1.429; P = 0.012). The addition of the LAR into nomograms could result in better prediction performance. The areas under the curves of the nomograms were 0.821 and 0.801 for the prediction of 3-year OS and RFS, respectively. The C-indexes of the nomograms were 0.760 and 0.741 for the prediction of OS and RFS, respectively. Conclusion The preoperative LAR is a novel and reliable independent prognostic biomarker for survival in UCB after RC.
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Affiliation(s)
- Hang Xu
- Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Institute of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
| | - Tianhai Lin
- Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Institute of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
| | - Jianzhong Ai
- Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Institute of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
| | - Jiapeng Zhang
- Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Institute of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
| | - Shiyu Zhang
- Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Institute of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
| | - Yifan Li
- Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Institute of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
| | - Xiaonan Zheng
- Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Institute of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
| | - Peng Zhang
- Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Institute of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
| | - Qiang Wei
- Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Institute of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
| | - Ping Tan
- Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Institute of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Correspondence: Ping Tan; Lu Yang, Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China, Tel +86 18980606829; +86 15208212056, Email ;
| | - Lu Yang
- Department of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
- Institute of Urology, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
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Wu J, Wu A, Wang S, Zeng C, Wang R, Zhou J, Wang D. The value of lactate dehydrogenase to albumin ratio and immune inflammation biomarkers in colorectal cancer. Front Surg 2023; 10:1118403. [PMID: 36936656 PMCID: PMC10014997 DOI: 10.3389/fsurg.2023.1118403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/10/2023] [Indexed: 03/05/2023] Open
Abstract
Background Colorectal cancer (CRC) is one of the most prevalent gastrointestinal cancers. Evidence for the importance of inflammation and immunology in the development and progression of CRC is growing steadily. The purpose of this study was to determine the clinical importance of Lactic Dehydrogenase (LDH) to Albumin (ALB) Ratio (LAR) and immune-inflammation biomarkers (IIBs) in patients with CRC. Methods This study enrolled 382 CRC patients. The LAR was determined as the serum LDH(U/l) to ALB(g/l) ratio. We compared the levels of LAR and IIBs in different TNM stages and tumor differentiation. The relationship between LAR and IIBs and overall survival (OS) of CRC was determined by Cox regression models. A prognostic nomogram was created using the results of the multivariate analysis and the effectiveness of the nomogram was assessed using the ROC, calibration, and decision curves. We evaluated the relationship between LAR and IIBs and clinical features of CRC. Results The levels of LAR, SII, NLR and PLR in TNM IV stage group (LAR:5.92 (5.23-8.24); SII: 1040.02 (499.51-1683.54); NLR: 2.87 (2.07-5.3); PLR:187.08 (125.31-276.63)) were significantly higher than those in other groups. LAR and NLR showed no significant difference in different tumor differentiation groups, while SII and PLR in undifferentiated groups (SII:543.72 (372.63-1110.20); PLR: 147.06 (106.04-203.92)) were significantly higher than those in well and moderate groups (SII: 474.29 (323.75-716.01); PLR: 126.28 (104.31-167.88)). LAR (HR = 1.317, 95% CI = 1.019-1.454), TNM stage (HR = 2.895, 95% CI = 1.838-4.559), age (HR = 1.766, 95% CI = 1.069-2.922) and lymphocytes (HR = 0.663, 95% CI = 0.456-0.963) were predictors of OS. IIBs, including SII, NLR, and PLR are independent of OS. The LAR-based nomogram AUCs of 1-year, 3-year and 5-year survival probabilities in the training cohort were 0.86, 0.72, and 0.71, respectively, and the AUCs of the validation cohort were 0.85, 0.71, and 0.69 respectively. The LAR-based nomogram's ROC curves and calibration curves demonstrated higher OS discriminative performance. The decision curves demonstrated greater net benefit in the survival prediction. Conclusion Preoperative LAR is a potential prognostic marker in CRC patients, while SII, NLR, and PLR are independent of OS. LAR was associated with tumor stage in CRC patients, but not with tumor differentiation.
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Affiliation(s)
- Jiali Wu
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ao Wu
- School of Cyber Science and Engineering, Southeast University, Nanjing, China
| | - Songzi Wang
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chunxian Zeng
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Guangzhou, China
- Shenzhen Key Laboratory of Viral Oncology, Clinical Innovation & Research Center (CIRC), Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Ruizhi Wang
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Correspondence: Ruizhi Wang Dong Wang . cn
| | - Juan Zhou
- Department of Oncology, General Hospital of the Southern Theatre Command, PLA, Guangzhou, China
| | - Dong Wang
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Correspondence: Ruizhi Wang Dong Wang . cn
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Hu Y, Zhou Y, Cao Y, Wang H, Yang Y, Jiang R, Gong Q, Zhou Q. Nomograms based on lactate dehydrogenase to albumin ratio for predicting survival in colorectal cancer. Int J Med Sci 2022; 19:1003-1012. [PMID: 35813299 PMCID: PMC9254365 DOI: 10.7150/ijms.71971] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 05/13/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose: We aimed to determine if lactate dehydrogenase to albumin ratio (LAR) might play a prognostic role for patients with operable colorectal cancer (CRC). Patients and Methods: 1334 operable CRC patients in Wuhan Union Hospital Between July 2013 and September 2017 were enrolled in this study and were randomly appointed them into training (n=954) and validation (n=380) sets. The relationship between LAR and overall survival (OS) and disease-free survival (DFS) were determined by restricted cubic splines (RCS) with Cox regression models. LAR was then divided into three categories based on the RCS and compared to the well-known TNM stage system. Finally, survival nomograms were developed by compounding the LAR and other clinical factors. Results: Baseline LAR values and the all-cause mortality were U shaped, which slowly decreased until around 4.50 and then started to increase rapidly when the LAR ranged from 4.50-6.68 and then became flat thereafter (P for non-linearity <0.001). LAR was superior to TNM stage for OS as well as DFS and LAR plus TNM stage could add more net benefit than clinical model alone. Moreover, the survival nomograms based on LAR achieved great predictive ability for OS and DFS in operable CRC patients. Conclusions: LAR could be served as a reliable prognostic factor for OS as well as DFS, with more accurate prognostic prediction than current TNM stage for patients with operable CRC.
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Affiliation(s)
- Yugang Hu
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China; 430061
| | - Yanxiang Zhou
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China; 430061
| | - Yinghao Cao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; 430022
| | - Hao Wang
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China; 430061
| | - Yuanting Yang
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China; 430061
| | - Riyue Jiang
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China; 430061
| | - Qincheng Gong
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China; 430061
| | - Qing Zhou
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China; 430061
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Peng RR, Liang ZG, Chen KH, Li L, Qu S, Zhu XD. Nomogram Based on Lactate Dehydrogenase-to-Albumin Ratio (LAR) and Platelet-to-Lymphocyte Ratio (PLR) for Predicting Survival in Nasopharyngeal Carcinoma. J Inflamm Res 2021; 14:4019-4033. [PMID: 34447260 PMCID: PMC8385134 DOI: 10.2147/jir.s322475] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/28/2021] [Indexed: 12/29/2022] Open
Abstract
Purpose The prognosis of inflammation-related indicators like lactate dehydrogenase/albumin ratio (LAR) and the platelet/lymphocyte ratio (PLR) in nasopharyngeal carcinoma (NPC) is not yet clear. Our objective is to establish and verify the nomogram using LAR and PLR ratio for the first time to explore the prognostic value in NPC. Patients and Methods This was a retrospective collection of 1661 patients with non-metastatic NPC admitted to our hospital from 2010 to 2017. The final variables of overall survival (OS) and progression-free survival (PFS) were selected by Cox regression analysis to establish nomograms, and the methods to verify the prediction precision and discriminative ability of the nomograms were concordance index (C index), the receiver operating characteristic (ROC) curve and calibration curve. The risk stratification was carried out through the nomograms and compared with the current staging system by the Kaplan–Meier methods. Results Multivariate Cox analysis resulted that age, plasma Epstein–Barr Virus (EBV) DNA, T stage, N stage, white blood cells (WBC), PLR and LAR were independent prognostic risk factors for OS and PFS, and sex is an independent prognostic risk factor for OS. The C-indexes of OS nomogram were 0.722 (95% CI: 0.706–0.738) and 0.747 (95% CI: 0.717–0.777) in the training cohort and validation cohort, which were statistically higher than the current 8th AJCC staging system (0.646 and 0.688). The C-indexes of PFS nomogram were 0.696 (95% CI: 0.680–0.713) and 0.690 (95% CI: 0.660–0.720), which were also statistically higher than the current 8th AJCC staging system (0.632 and 0.666). Otherwise, ROC curves and the calibration curve for probability also confirmed satisfied consistency with actual observations. Conclusion LAR is a novel useful independent factor in NPC. The proposed nomogram LAR and PLR resulted in more accurate prognostic prediction than current staging system for NPC patients.
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Affiliation(s)
- Ru-Rong Peng
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
| | - Zhong-Guo Liang
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
| | - Kai-Hua Chen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
| | - Ling Li
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
| | - Song Qu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
| | - Xiao-Dong Zhu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China.,Department of Oncology, Affiliated Wu-Ming Hospital of Guangxi Medical University, Nanning, People's Republic of China
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