Prognostic Value of Routinely Measured Inflammatory Biomarkers in Older Cancer Patients: Pooled Analysis of Three Cohorts.
biomarkers
cancer
mortality
older patients
Journal
Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829
Informations de publication
Date de publication:
07 Dec 2021
07 Dec 2021
Historique:
received:
28
10
2021
revised:
25
11
2021
accepted:
29
11
2021
entrez:
24
12
2021
pubmed:
25
12
2021
medline:
25
12
2021
Statut:
epublish
Résumé
The prognostic assessment of older cancer patients is complicated by their heterogeneity. We aimed to assess the prognostic value of routine inflammatory biomarkers. A pooled analysis of prospective multicenter cohorts of cancer patients aged ≥70 was performed. We measured CRP and albumin, and calculated Glasgow Prognostic Score (GPS) and CRP/albumin ratio. The GPS has three levels (0 = CRP ≤ 10 mg/L, albumin ≥ 35 g/L, i.e., normal values; 1 = one abnormal value; 2 = two abnormal values). One-year mortality was assessed using Cox models. Discriminative power was assessed using Harrell's C index (C) and net reclassification improvement (NRI). Overall, 1800 patients were analyzed (mean age: 79 ± 6; males: 62%; metastases: 38%). The GPS and CRP/albumin ratio were independently associated with mortality in patients not at risk of frailty (hazard ratio [95% confidence interval] = 4.48 [2.03-9.89] for GPS1, 11.64 [4.54-29.81] for GPS2, and 7.15 [3.22-15.90] for CRP/albumin ratio > 0.215) and in patients at risk of frailty (2.45 [1.79-3.34] for GPS1, 3.97 [2.93-5.37] for GPS2, and 2.81 [2.17-3.65] for CRP/albumin ratio > 0.215). The discriminative power of the baseline clinical model (C = 0.82 [0.80-0.83]) was increased by adding GPS (C = 0.84 [0.82-0.85]; NRI events (NRI+) = 10% [2-16]) and CRP/albumin ratio (C = 0.83 [0.82-0.85]; NRI+ = 14% [2-17]). Routine inflammatory biomarkers add prognostic value to clinical factors in older cancer patients.
Sections du résumé
BACKGROUND
BACKGROUND
The prognostic assessment of older cancer patients is complicated by their heterogeneity. We aimed to assess the prognostic value of routine inflammatory biomarkers.
METHODS
METHODS
A pooled analysis of prospective multicenter cohorts of cancer patients aged ≥70 was performed. We measured CRP and albumin, and calculated Glasgow Prognostic Score (GPS) and CRP/albumin ratio. The GPS has three levels (0 = CRP ≤ 10 mg/L, albumin ≥ 35 g/L, i.e., normal values; 1 = one abnormal value; 2 = two abnormal values). One-year mortality was assessed using Cox models. Discriminative power was assessed using Harrell's C index (C) and net reclassification improvement (NRI).
RESULTS
RESULTS
Overall, 1800 patients were analyzed (mean age: 79 ± 6; males: 62%; metastases: 38%). The GPS and CRP/albumin ratio were independently associated with mortality in patients not at risk of frailty (hazard ratio [95% confidence interval] = 4.48 [2.03-9.89] for GPS1, 11.64 [4.54-29.81] for GPS2, and 7.15 [3.22-15.90] for CRP/albumin ratio > 0.215) and in patients at risk of frailty (2.45 [1.79-3.34] for GPS1, 3.97 [2.93-5.37] for GPS2, and 2.81 [2.17-3.65] for CRP/albumin ratio > 0.215). The discriminative power of the baseline clinical model (C = 0.82 [0.80-0.83]) was increased by adding GPS (C = 0.84 [0.82-0.85]; NRI events (NRI+) = 10% [2-16]) and CRP/albumin ratio (C = 0.83 [0.82-0.85]; NRI+ = 14% [2-17]).
CONCLUSIONS
CONCLUSIONS
Routine inflammatory biomarkers add prognostic value to clinical factors in older cancer patients.
Identifiants
pubmed: 34944774
pii: cancers13246154
doi: 10.3390/cancers13246154
pmc: PMC8699299
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Am J Clin Nutr. 2006 Apr;83(4):735-43
pubmed: 16600922
Ann Oncol. 2012 Aug;23(8):2166-2172
pubmed: 22250183
J Clin Oncol. 2014 Jan 1;32(1):19-26
pubmed: 24276775
Gan To Kagaku Ryoho. 2016 Nov;43(12):1532-1534
pubmed: 28133047
J Clin Oncol. 2011 Sep 20;29(27):3636-42
pubmed: 21709194
J Palliat Med. 2015 Mar;18(3):270-3
pubmed: 25210851
J Clin Oncol. 2011 Sep 20;29(27):3620-7
pubmed: 21859998
J Cancer Res Clin Oncol. 2016 May;142(5):1069-77
pubmed: 26758276
Br J Cancer. 2003 Sep 15;89(6):1028-30
pubmed: 12966420
Cancer. 2018 Sep 15;124(18):3764-3775
pubmed: 30298906
Onco Targets Ther. 2017 Jun 19;10:3059-3070
pubmed: 28790840
Cancer. 1950 Jan;3(1):32-5
pubmed: 15405679
J Clin Oncol. 2013 Nov 1;31(31):3877-82
pubmed: 24062399
Sci Rep. 2017 Dec 1;7(1):16717
pubmed: 29196718
PLoS One. 2014 Dec 11;9(12):e115060
pubmed: 25503576
Cancer. 2018 Sep 15;124(18):3753-3763
pubmed: 30299540
Ann Surg Oncol. 2018 Oct;25(11):3239-3247
pubmed: 30069658
J Am Geriatr Soc. 2009 Nov;57(11):2070-6
pubmed: 19793154
Stat Med. 2008 Jan 30;27(2):157-72; discussion 207-12
pubmed: 17569110
J Clin Oncol. 2014 Aug 20;32(24):2595-603
pubmed: 25071125
J Clin Med. 2018 Oct 08;7(10):
pubmed: 30297655
Nutr Cancer. 2001;39(2):210-3
pubmed: 11759282
Eur J Cancer. 2017 Sep;83:211-219
pubmed: 28750273
Int J Colorectal Dis. 2007 Aug;22(8):881-6
pubmed: 17245566
Surg Today. 2017 Jul;47(7):836-843
pubmed: 27853867
Eur J Cardiothorac Surg. 2015 Apr;47(4):e140-5
pubmed: 25548132
Expert Rev Respir Med. 2020 May;14(5):521-525
pubmed: 32093491
Future Oncol. 2010 Jan;6(1):149-63
pubmed: 20021215
Epidemiology. 2014 Jan;25(1):114-21
pubmed: 24240655
Eur J Cancer. 2018 Sep;100:65-74
pubmed: 30014882
J Gastroenterol. 2014 Jun;49(6):1040-6
pubmed: 23821018
Eur J Epidemiol. 2020 May;35(5):381-388
pubmed: 32418023
Carcinogenesis. 2009 Jul;30(7):1073-81
pubmed: 19468060
Sci Rep. 2021 Jul 22;11(1):14989
pubmed: 34294776
J Gerontol A Biol Sci Med Sci. 2015 Sep;70(9):1148-55
pubmed: 25834194
Eur J Cancer. 2018 Feb;90:10-18
pubmed: 29268140
Crit Rev Oncol Hematol. 2017 Aug;116:134-146
pubmed: 28693795
Lupus Sci Med. 2021 Jul;8(1):
pubmed: 34253648
Stat Med. 1996 May 30;15(10):969-86
pubmed: 8783436
Med Clin (Barc). 2021 Mar 26;:
pubmed: 33781570
Nature. 2002 Dec 19-26;420(6917):860-7
pubmed: 12490959
Asian J Surg. 2021 Nov;44(11):1427-1428
pubmed: 34315665
Nutr J. 2010 Dec 22;9:69
pubmed: 21176210
Oncologist. 2016 Feb;21(2):188-95
pubmed: 26764250
Oncologist. 2019 Dec;24(12):e1351-e1359
pubmed: 31324663
Diagnostics (Basel). 2021 Jul 26;11(8):
pubmed: 34441278
Stat Med. 2011 Jan 15;30(1):11-21
pubmed: 21204120
Nutrition. 2021 Nov-Dec;91-92:111465
pubmed: 34600222