Predictive Value of Preoperative Controlling Nutritional Status Score Combined with Fibrinogen–Albumin Ratio in Postoperative Local Recurrence-Free Survival of Patients with Retroperitoneal Liposarcoma

Xue, Guoqiang; Chengpeng, Li; Lv, Ang; Tian, Xiuyun; Wu, Jianhui; Qiu, Hui; Hao, Chunyi

doi:10.2147/cmar.s307920

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…Also interesting is the finding that tumor size is an independent risk factor for CSS, not for OS. The 5-cm threshold used in the AJCC staging system is still limited about the value for RPLs because such small RPLs are uncommon in the present and other international studies ( 17 , 25 , 35 , 43 ). Meanwhile, several studies proposed that the optimal threshold in tumor sizes should be revised upward to 10 cm ( 25 , 36 ).…”

Section: Discussionmentioning

confidence: 72%

“…The finding is consistent with previous research showing that increased survival is directly associated with better histologic grade ( 35 , 37 – 40 ). Furthermore, previous analyses showed that completeness of resection is another important prognostic factor ( 17 , 40 – 43 ). We also found that the prognosis of patients who underwent resection was significantly better than that of patients without surgical resection, especially that of patients with radical surgery.…”

Section: Discussionmentioning

confidence: 99%

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Development and Validation of a Prognostic Model to Predict the Prognosis of Patients With Retroperitoneal Liposarcoma: A Large International Population-Based Cohort Study

Zhang

et al. 2022

Front. Oncol.

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BackgroundRetroperitoneal liposarcomas (RPLs), sarcoma of mesenchymal origin, are the most common soft tissue sarcomas (STS) of the retroperitoneum. Given the rarity of RPLs, the prognostic values of clinicopathological features in the patients remain unclear. The nomogram can provide a visual interface to aid in calculating the predicted probability that a patient will achieve a particular clinical endpoint and communication with patients.MethodsWe included a total of 1,392 RPLs patients diagnosed between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. For nomogram construction and validation, patients in the SEER database were divided randomly into the training cohort and internal validation cohort at a ratio of 7:3, while 65 patients with RPLs from our center between 2010 and 2016 served as the external validation cohort. The OS curves were drawn using the Kaplan–Meier method and assessed using the log-rank test. Moreover, Fine and Gray’s competing-risk regression models were conducted to assess CSS. Univariate and multivariate analyses were performed to select the prognostic factors for survival time. We constructed a predictive nomogram based on the results of the multivariate analyses.ResultsThrough univariate and multivariate analyses, it is found that age, histological grade, classification, SEER stage, surgery constitute significant risk factors for OS, and age, classification, SEER stage, AJCC M stage, surgery, and tumor size constitute risk factors for CSS. We found that the nomogram provided a good assessment of OS and CSS at 1, 3, and 5 years in patients with RPLs (1-year OS: (training cohort: AUC = 0.755 (95% CI, 0.714, 0.796); internal validation cohort: AUC = 0.754 (95% CI, 0.681, 0.827); external validation cohort: AUC = 0.793 (95% CI, 0.651, 0.935)); 3-year OS: (training cohort: AUC = 0.782 (95% CI, 0.752, 0.811); internal validation cohort: AUC = 0.788 (95% CI, 0.736, 0.841); external validation cohort: AUC = 0.863 (95% CI, 0.773, 0.954)); 5-year OS: (training cohort: AUC = 0.780 (95% CI, 0.752, 0.808); internal validation cohort: AUC = 0.783 (95% CI, 0.732, 0.834); external validation cohort: AUC = 0.854 (95% CI, 0.762, 0.945)); 1-year CSS: (training cohort: AUC = 0.769 (95% CI, 0.717, 0.821); internal validation cohort: AUC = 0.753 (95% CI, 0.668, 0.838); external validation cohort: AUC = 0.799 (95% CI, 0.616, 0.981)); 3-year CSS: (training cohort: AUC = 0.777 (95% CI, 0.742, 0.811); internal validation cohort: AUC = 0.787 (95% CI, 0.726, 0.849); external validation cohort: AUC = 0.808 (95% CI, 0.673, 0.943)); 5-year CSS: (training cohort: AUC = 0.773 (95% CI, 0.741, 0.805); internal validation cohort: AUC = 0.768 (95% CI, 0.709, 0.827); external validation cohort: AUC = 0.829 (95% CI, 0.712, 0.945))). The calibration plots for the training, internal validation, and external validation cohorts at 1-, 3-, and 5-year OS and CSS indicated that the predicted survival rates closely correspond to the actual survival rates.ConclusionWe constructed and externally validated an unprecedented nomogram prognostic model for patients with RPLs. The nomogram can be used as a potential, objective, and supplementary tool for clinicians to predict the prognosis of RPLs patients around the world.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Prognostic Model to Predict the Prognosis of Patients With Retroperitoneal Liposarcoma: A Large International Population-Based Cohort Study

Zhang

et al. 2022

Front. Oncol.

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“…Fibrinogen, acted as an important acute-phase protein, is closely associated with coagulation cascade reaction, tumor immune, and systemic inflammation. 28 Notably, fibrinogen was able to serve as a cytoskeleton to support the extracellular matrix of tumors for facilitating tumor angiogenesis and amplifying tumor cell adhesion and invasion, which might be the implying reasons that the level of fibrinogen is associated with poor prognosis with malignancies. 29 Furthermore, albumin acts as an important protein in body, commonly reflects the nutritional status of patients.…”

Section: Discussionmentioning

confidence: 99%

The Fibrinogen/Albumin Ratio Index as an Independent Prognostic Biomarker for Patients with Combined Hepatocellular Cholangiocarcinoma After Surgery

Xu¹,

Li²,

Ye³

et al. 2022

CMAR

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Purpose The fibrinogen/albumin ratio (FAR) is increasingly considered as a potential biomarker for predicting prognosis in various malignant tumors, whereas the value of the FAR in predicting the recurrence-free survival (RFS) in patients with combined hepatocellular cholangiocarcinoma (cHCC-CCA) after surgery has not been studied. Patients and Methods A total of 104 patients with surgical-pathologically proved cHCC-CCA were retrospectively analyzed. The best cut-off value of the FAR was calculated via receiver operating characteristic (ROC) curve analysis, and the cohort was then divided into two groups as high-FAR (H-FAR) group and low-FAR (L-FAR) group. The correlation between the preoperative FAR and clinicopathological characteristics was analyzed. Uni- and multi-variable analyses for RFS were evaluated using a Cox proportional hazards model to verify the predictive value of FAR on the RFS of cHCC-CCA. Additionally, a novel clinical nomogram based on FAR was developed to preoperatively predict the RFS of HCC-CCA. The C-index and calibration were conducted to evaluate the performance of the developed nomogram. Results According to the cut-off value of the FAR, the patients were grouped into the H-FARI (>0.075) and L-FARI (≤0.075) groups. FAR was significantly correlated with several clinical-pathological features, including age, cirrhosis, AFP, CA19-9, BCLC staging, NLR, and PLR. In the multi-variate analysis, FAR, cirrhosis and tumor size were independent prognostic predictors for poor RFS in cHCC-CCA patients after surgery. Moreover, the clinical nomogram based on FAR was constructed, showing well-predictive accuracy. Conclusion The preoperative FAR is a convenient and feasible serum biomarker for predicting the RFS of cHCC-CCA after surgery. Such developed FAR-based nomogram integrating tumor size and cirrhosis could be served as a feasible and convenient tool to assist the decision-making of clinical strategy.

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“…In addition, the peripheral blood platelet and fibrinogen increased significantly in patients with PS, while hemoglobin and albumin decreased significantly in patients with PS. Previous studies found that the peripheral blood platelet and fibrinogen are significantly related to the progress of malignant tumors ( 28 – 30 ), while the development of malignancies is related to the decrease in the hemoglobin and albumin ( 31 , 32 ). Thus, these changes may contribute to the progress of RPS as well.…”

Section: Discussionmentioning

confidence: 99%

Multidimensional characteristics, prognostic role, and preoperative prediction of peritoneal sarcomatosis in retroperitoneal sarcoma

et al. 2022

Front. Oncol.

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BackgroundPeritoneal sarcomatosis (PS) could occur in patients with retroperitoneal sarcomas (RPS). This study aimed to expand the understanding of PS on its characteristics and prognostic role, and develop a nomogram to predict its occurrence preoperatively.MethodsData of 211 consecutive patients with RPS who underwent surgical treatment between 2011 and 2019 was retrospectively reviewed. First, the clinicopathological characteristics of PS were summarized and analyzed. Second, the disease-specific survival (DSS) and recurrence-free survival (RFS) of patients were analyzed to evaluate the prognostic role of PS. Third, preoperative imaging, nearly the only way to detect PS preoperatively, was combined with other screened risk factors to develop a nomogram. The performance of the nomogram was assessed.ResultsAmong the 211 patients, 49 (23.2%) patients had PS with an incidence of 13.0% in the primary patients and 35.4% in the recurrent patients. The highest incidence of PS occurred in dedifferentiated liposarcoma (25.3%) and undifferentiated pleomorphic sarcoma (25.0%). The diagnostic sensitivity of the preoperative imaging was 71.4% and its specificity was 92.6%. The maximum standardized uptake value (SUVmax) was elevated in patients with PS (P<0.001). IHC staining for liposarcoma revealed that the expression of VEGFR-2 was significantly higher in the PS group than that in the non-PS group (P = 0.008). Survival analysis (n =196) showed significantly worse DSS in the PS group than in non-PS group (median: 16.0 months vs. not reached, P < 0.001). In addition, PS was proven as one of the most significant prognostic predictors of both DSS and RFS by random survival forest algorithm. A nomogram to predict PS status was developed based on preoperative imaging combined with four risk factors including the presentation status (primary vs. recurrent), ascites, SUVmax, and tumor size. The nomogram significantly improved the diagnostic sensitivity compared to preoperative imaging alone (44/49, 89.8% vs. 35/49, 71.4%). The C-statistics of the nomogram was 0.932, and similar C-statistics (0.886) was achieved at internal cross-validation.ConclusionPS is a significant prognostic indicator for RPS, and it occurs more often in recurrent RPS and in RPS with higher malignant tendency. The proposed nomogram is effective to predict PS preoperatively.

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Predictive Value of Preoperative Controlling Nutritional Status Score Combined with Fibrinogen–Albumin Ratio in Postoperative Local Recurrence-Free Survival of Patients with Retroperitoneal Liposarcoma

Cited by 5 publications

References 31 publications

Development and Validation of a Prognostic Model to Predict the Prognosis of Patients With Retroperitoneal Liposarcoma: A Large International Population-Based Cohort Study

Development and Validation of a Prognostic Model to Predict the Prognosis of Patients With Retroperitoneal Liposarcoma: A Large International Population-Based Cohort Study

The Fibrinogen/Albumin Ratio Index as an Independent Prognostic Biomarker for Patients with Combined Hepatocellular Cholangiocarcinoma After Surgery

Multidimensional characteristics, prognostic role, and preoperative prediction of peritoneal sarcomatosis in retroperitoneal sarcoma

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