Postoperative BMI Loss at One Year Correlated with Poor Outcomes in Chinese Gastric Cancer Patients

Wang, Nan; Jiang, Jinling; Wu, Xi; Wu, Junwei; Zhou, Chenfei; Shi, Min; Wang, Chao; Zhu, Zhenggang; Liu, Jing; Zhang, Jun

doi:10.7150/ijms.46530

Cited by 17 publications

(13 citation statements)

References 31 publications

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“…In our study, BMI, prealbumin, and PNI represented patients' nutritional status, and NLR, PLR, and LMR represented patients' immune-inflammatory microenvironment. Interestingly, in line with our previous study and other researches (15,21), high-BMI patients showed better prognosis, which further confirmed a phenomenon called the "obesity paradox" in the prognosis of GC. Cancer-associated malnutrition also contributes to severe postoperative complications, decreased immunological function, and the activation of the systemic inflammatory response (SIR), leading to poor therapeutic efficacy (7,22).…”

Section: Discussionsupporting

confidence: 90%

“…The continuous variables (normal value), including CA12-5 (35 U/ml), CA19-9 (35 U/ml), CEA (5 ng/ml), AFP (8.78 ng/ml), hemoglobin (120 g/L), total protein (60 g/L), prealbumin (180 mg/L), albumin (35 g/L), albumin-globulin ratio (AGR, 1.25), neutrophil count (7×10 9 /L), lymphocyte count (0.8×10 9 /L), monocyte count (1×10 9 /L), and platelet count (320×10 9 /L), were grouped according to the standards developed by the clinical laboratory of Ruijin Hospital. The optimal cut-off of preoperative BMI(23 kg/m 2 ) was determined by Asian-specific criteria based on our previous study ( 15 ).…”

Section: Methodsmentioning

confidence: 99%

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A Novel Inflammatory-Nutritional Prognostic Scoring System for Stage III Gastric Cancer Patients With Radical Gastrectomy Followed by Adjuvant Chemotherapy

Wang

et al. 2021

Front. Oncol.

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PurposeThe present study was designed to explore the prognostic value of preoperative inflammatory and nutritional biomarkers in stage III gastric cancer (GC) patients with adjuvant chemotherapy and to develop a novel scoring system called the inflammatory-nutritional prognostic score (INPS).MethodsA total of 513 patients with pathological stage III GC undergoing radical gastrectomy followed by adjuvant chemotherapy from 2010 to 2017 were enrolled in the study. Clinicopathological characteristics and blood test parameters of individual patients were collected. The least absolute shrinkage and selection operator (LASSO) Cox regression model was used for feature selection to construct INPS. Survival curves were generated using the Kaplan-Meier method with log-rank tests. The nomogram was generated based on the result of the multivariate analysis using Cox’s proportional hazards model. The model was assessed by the concordance index (C-index) and was internally validated by bootstraps.ResultsAccording to the results of Lasso Cox regression and K-M survival curves, INPS was determined as follows: a low body mass index (BMI) (<23 kg/m2), a low prealbumin (<180 mg/L), a high neutrophil-lymphocyte ratio (NLR) (≥2.7), a high platelet-lymphocyte ratio (PLR) (≥209.4), a low lymphocyte-monocyte ratio (LMR) (<2.8), and a low prognostic nutritional index (PNI) (<45.1); each were scored as 1, and the remaining values were scored as 0. The individual scores were then summed up to construct the INPS and further divided into 4 groups: Low Risk (INPS 0); Low-medium Risk (INPS 1); High-medium Risk (INPS 2-4); and High Risk (INPS 5-6). In multivariate analysis, INPS was an independent predictor of overall survival (OS) in stage III GC, with the 5-year OS rates of 70.8%, 57.4%, 41.5%, and 30.6%, respectively. The nomogram based on INPS and other independent predictors (gender, pT stage, pN stage, lymphovascular invasion, and CEA level) showed good predicting performance with a C-index of 0.707, which was superior to the TNM stage alone (C-index 0.645, p=0.008) and was internally validated with the corrected C-index of 0.693.ConclusionPreoperative INPS was an independent prognostic factor of stage III GC patients with radical surgery followed by adjuvant chemotherapy. The nomogram based on INPS may serve as a simple and potential model in risk stratification and guiding treatment strategies in clinical practice.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

A Novel Inflammatory-Nutritional Prognostic Scoring System for Stage III Gastric Cancer Patients With Radical Gastrectomy Followed by Adjuvant Chemotherapy

Wang

et al. 2021

Front. Oncol.

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“…Consistent with our study, in a large study conducted in Chinese population to dynamically monitor the association between postoperative BMI and prognosis in GC patients, BMI loss of more than 10% within the first year after surgery was found to be associated with poor prognosis. 23 We speculate that BMI is more reflective of changes in the nutritional status of the body in the early postoperative period.…”

Section: Discussionmentioning

confidence: 88%

Development and validation of nomograms for predicting the prognosis of early and late recurrence of advanced gastric cancer after radical surgery

Liu,

Lu,

2023

Preprint

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ObjectiveIn this study, we aimed to explore the risk factors influencing post recurrence survival (PRS) of early recurrence (ER) and late recurrence (LR) in stage advanced gastric cancer (AGC) patients after radical surgery, respectively, and to develop predictive models in turn.MethodsMedical records of 192 AGC patients who recurred after radical gastrectomy were retrospectively reviewed. They were randomly divided into the training and validation set at a ratio of 2:1. Nomograms were built based on risk factors influencing PRS of ER and LR explored by Cox regression analyses, respectively. Concordance index (C-index) values and calibration curves were used to evaluate predictive power of nomograms.ResultsBody mass index < 18.5 kg/m2, prealbumin level < 70.1 mg/l, positive lymph nodes ratio ≥ 0.486 and palliative treatment after recurrence were independent risk factors for the prognosis of ER. In contrast, prealbumin level < 170.1 mg/l, CEA ≥ 18.32 μg/l, tumor diameter ≥ 5.5 cm and palliative treatment after recurrence were independent risk factors for the prognosis of LR. The C-index value was 0.801 and 0.772 for ER and LR in the training set, respectively. The calibration curves of validation set showed a C-index value of 0.744 and 0.676 for ER and LR, respectively.ConclusionsNomograms which were constructed to predict the prognosis of ER and LR of AGC after surgery showed great predictive power and could provide reference for clinicians’ treatment strategies to some extent.

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“…Subgroup analysis was performed by age (<60 and≥60 years), BMI (<23 and≥23 kg/m 2 ) and ALT (<40 and≥40U/L). Specifically, age≥60 years was defined as “older” and <60 years as “young-middle-aged” ( 18 ); BMI≥23kg/m 2 was defined as “overweight/obese” and <23kg/m 2 as “normal/underweight” according to Asian-specific criteria ( 19 ); ALT≥40U/L was defined as “elevated” and <40U/L as “normal” ( 20 ). In addition, lipid profiles were grouped into quartiles as continuous variables.…”

Section: Methodsmentioning

confidence: 99%

Association of Lipid Levels With the Prevalence of Hypertension in Chinese Women: A Cross-Sectional Study Based on 32 Health Check Centers

Deng

Cheng

2022

Front. Endocrinol.

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BackgroundDyslipidemia is strongly associated with the development of hypertension. In our previous study, it was shown that elevated TC, LDL-c, and non-HDL-c were associated with the prevalence of hypertension in Chinese men, whereas the relationship between HDL-c and hypertension shifted from no association to a positive association after adjusting for the BMI. To further accumulate epidemiological evidence in Asian women, this study aimed to investigate the relationship between lipid profile and prevalence of hypertension in Chinese adult women.MethodsThis is a cross-sectional study including 54,099 Chinese women aged>20 years at 32 health screening centers in 11 cities from 2010-2016. The original data were obtained from DATADRYAD database (www.datadryad.org). Besides, the overall women were classified into non-hypertensive and hypertensive groups based on baseline blood pressure levels. Differences between the two groups were examined by Man-Whitney test or Chi-square test. Spearman’s correlation coefficient was employed to evaluate the correlation between systolic blood pressure (SBP), diastolic blood pressure (DBP) and lipid profiles. Multivariate logistic regression was performed to estimate the relationship between different lipid levels and the prevalence of hypertension. Odds ratios (ORs) and 95% confidence intervals (CIs) indicated the risk of lipid and hypertension. Bayesian model (BN) model was constructed to further assess the relationship between baseline characteristics and the prevalence of hypertension, as well as the importance of each variable for the prevalence of hypertension.ResultsCompared to the non-hypertensive population, the hypertensive population was older, and had the higher body mass index (BMI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), serum creatinine (Scr), fasting blood glucose (FPG), blood urea nitrogen (BUN), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and non-high-density lipoprotein cholesterol (non-HDL-c), but HDL-c and the presence concerning the family history of diabetes were lower. Multivariate logistic regression analysis revealed that TC, LDL-c, and non-HDL-c showed a positive trend with hypertension risk (p for trend < 0.05) whereas TC and HDL-c were not significantly associated with hypertension prevalence. Moreover, each 1 mg/dl increase in TC, LDL, and non-HDL hypertension prevalence increased by 0.2% [1.002 (1.000-1.003)], 0.2% [1.002 (1.000-1.004)], and 0.2% [1.002(1.001-1.004)], respectively. BN suggested that the importance of age, BMI, FPG, non-HDL-c on the prevalence of hypertension was 52.73%, 24.98%, 11.22%, and 2.34%, respectively.ConclusionOverall, in Chinese adult women, TC, LDL-c and non-HDL-c levels were higher and HDL-c level was lower in the hypertensive population, whereas TG did not differ significantly from the non-hypertensive population. Meanwhile, TC, LDL-c, and non-HDL-c were positively associated with prevalence of hypertension, and HDL-c was negatively associated with prevalence of hypertension but became nonsignificant after full adjustment for variables. Moreover, BN model suggested that age, BMI, FPG, and non-HDL-c had a greater effect on the development of hypertension.

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Postoperative BMI Loss at One Year Correlated with Poor Outcomes in Chinese Gastric Cancer Patients

Cited by 17 publications

References 31 publications

A Novel Inflammatory-Nutritional Prognostic Scoring System for Stage III Gastric Cancer Patients With Radical Gastrectomy Followed by Adjuvant Chemotherapy

A Novel Inflammatory-Nutritional Prognostic Scoring System for Stage III Gastric Cancer Patients With Radical Gastrectomy Followed by Adjuvant Chemotherapy

Development and validation of nomograms for predicting the prognosis of early and late recurrence of advanced gastric cancer after radical surgery

Association of Lipid Levels With the Prevalence of Hypertension in Chinese Women: A Cross-Sectional Study Based on 32 Health Check Centers

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