A combined prediction model for biliary tract cancer using the prognostic nutritional index and pathological findings: a single-center retrospective study.
Biliary tract cancer
Inflammation-based prognostic score
Prognosis
Prognostic nutritional index
Surgical resection
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
13 Oct 2021
13 Oct 2021
Historique:
received:
24
05
2021
accepted:
05
10
2021
entrez:
14
10
2021
pubmed:
15
10
2021
medline:
16
10
2021
Statut:
epublish
Résumé
The prognostic nutritional index, a marker of nutritional status and systemic inflammation, is a known biomarker for various cancers. However, few studies have evaluated the predictive value of the prognostic nutritional index in patients with biliary tract cancer. Therefore, we investigated the prognostic significance of the prognostic nutritional index, and developed a risk-stratification system to identify prognostic factors in patients with biliary tract cancer. Between July 2010 and March 2021, 117 patients with biliary tract cancer were recruited to this single-center, retrospective study. The relationship between clinicopathological variables, including the prognostic nutritional index, and overall survival was analyzed using univariate and multivariate analyses. A P < 0.05 was considered statistically significant. The median age was 75 (range 38-92) years. Thirty patients had intrahepatic cholangiocarcinoma; 29, gallbladder carcinoma; 27, distal cholangiocarcinoma; 17, ampullary carcinoma; and 13, perihilar cholangiocarcinoma. Curative (R0) resection was achieved in 99 patients. In univariate analysis, the prognostic nutritional index (< 42), lymph node metastasis, carbohydrate antigen 19-9 level (> 20 U/mL), preoperative cholangitis, tumor differentiation, operation time (≥ 360 min), and R1-2 resection were significant risk factors for overall survival. The prognostic nutritional index (P = 0.027), lymph node metastasis (P = 0.040), and tumor differentiation (P = 0.006) were independent prognostic factors in multivariate analysis. A combined score of the prognostic nutritional index and pathological findings outperformed each marker alone, in terms of discriminatory power. The prognostic nutritional index, lymph node metastasis, and tumor differentiation were independent prognostic factors after surgical resection in patients with biliary tract cancer. A combined prediction model using the prognostic nutritional index and pathological findings accurately predicted prognosis, and can be used as a novel prognostic factor in patients with biliary tract cancer.
Sections du résumé
BACKGROUND
BACKGROUND
The prognostic nutritional index, a marker of nutritional status and systemic inflammation, is a known biomarker for various cancers. However, few studies have evaluated the predictive value of the prognostic nutritional index in patients with biliary tract cancer. Therefore, we investigated the prognostic significance of the prognostic nutritional index, and developed a risk-stratification system to identify prognostic factors in patients with biliary tract cancer.
METHODS
METHODS
Between July 2010 and March 2021, 117 patients with biliary tract cancer were recruited to this single-center, retrospective study. The relationship between clinicopathological variables, including the prognostic nutritional index, and overall survival was analyzed using univariate and multivariate analyses. A P < 0.05 was considered statistically significant.
RESULTS
RESULTS
The median age was 75 (range 38-92) years. Thirty patients had intrahepatic cholangiocarcinoma; 29, gallbladder carcinoma; 27, distal cholangiocarcinoma; 17, ampullary carcinoma; and 13, perihilar cholangiocarcinoma. Curative (R0) resection was achieved in 99 patients. In univariate analysis, the prognostic nutritional index (< 42), lymph node metastasis, carbohydrate antigen 19-9 level (> 20 U/mL), preoperative cholangitis, tumor differentiation, operation time (≥ 360 min), and R1-2 resection were significant risk factors for overall survival. The prognostic nutritional index (P = 0.027), lymph node metastasis (P = 0.040), and tumor differentiation (P = 0.006) were independent prognostic factors in multivariate analysis. A combined score of the prognostic nutritional index and pathological findings outperformed each marker alone, in terms of discriminatory power.
CONCLUSIONS
CONCLUSIONS
The prognostic nutritional index, lymph node metastasis, and tumor differentiation were independent prognostic factors after surgical resection in patients with biliary tract cancer. A combined prediction model using the prognostic nutritional index and pathological findings accurately predicted prognosis, and can be used as a novel prognostic factor in patients with biliary tract cancer.
Identifiants
pubmed: 34645392
doi: 10.1186/s12876-021-01957-5
pii: 10.1186/s12876-021-01957-5
pmc: PMC8513195
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
375Informations de copyright
© 2021. The Author(s).
Références
J Natl Cancer Inst. 2014 May 29;106(6):dju124
pubmed: 24875653
HPB (Oxford). 2017 Aug;19(8):735-740
pubmed: 28549744
CA Cancer J Clin. 2019 Jan;69(1):7-34
pubmed: 30620402
Ann Surg Oncol. 2021 Jan;28(1):430-438
pubmed: 32548755
Nutrition. 2014 Nov-Dec;30(11-12):1267-71
pubmed: 24973198
Cancers (Basel). 2019 Sep 30;11(10):
pubmed: 31575023
Br J Surg. 2011 Feb;98(2):268-74
pubmed: 20960457
Dig Surg. 1999;16(6):459-67
pubmed: 10805544
Br J Cancer. 2010 Sep 7;103(6):870-6
pubmed: 20717110
J Surg Oncol. 2015 Jun;111(7):868-74
pubmed: 25865111
PLoS One. 2020 Mar 3;15(3):e0229597
pubmed: 32126069
J Surg Oncol. 2018 Sep;118(3):422-430
pubmed: 30084163
J Clin Oncol. 2013 Mar 20;31(9):1188-95
pubmed: 23358969
Nutr Cancer. 2021;73(10):1872-1881
pubmed: 32933337
Cancer. 1950 Jan;3(1):32-5
pubmed: 15405679
J Clin Med. 2019 Aug 14;8(8):
pubmed: 31416154
Tumour Biol. 2016 Oct 8;:
pubmed: 27722987
Clin Med (Lond). 2009 Feb;9(1):30-3
pubmed: 19271597
Cancer Immunol Immunother. 2011 Jun;60(6):819-27
pubmed: 21373990
Clinics (Sao Paulo). 2013 May;68(5):686-93
pubmed: 23778417
Surgery. 2016 Jul;160(1):228-236
pubmed: 26965712
J Hepatobiliary Pancreat Surg. 2005;12(5):351-5
pubmed: 16258801
J Hepatol. 2012 Nov;57(5):1013-20
pubmed: 22732513
Am J Surg. 2009 Apr;197(4):466-72
pubmed: 18639229
World J Surg. 2015 Jun;39(6):1501-9
pubmed: 25670038
World J Surg. 2007 Jun;31(6):1256-63
pubmed: 17453285
Med Oncol. 2012 Sep;29(3):1817-26
pubmed: 21678026
Int J Cancer. 2009 Oct 1;125(7):1640-8
pubmed: 19569243
J Gastrointest Surg. 2019 Mar;23(3):510-517
pubmed: 30076591
Surgery. 2016 Mar;159(3):842-51
pubmed: 26683498
Ann Surg Oncol. 2013 Aug;20(8):2647-54
pubmed: 23463091
Ann Surg. 2009 Aug;250(2):187-96
pubmed: 19638912
Cancer Manag Res. 2019 Oct 30;11:9107-9119
pubmed: 31802940
Nihon Geka Gakkai Zasshi. 1984 Sep;85(9):1001-5
pubmed: 6438478
Langenbecks Arch Surg. 2014 Aug;399(6):693-705
pubmed: 24841192