Pretreatment Body Mass Index (BMI) as an Independent Prognostic Factor in Nasopharyngeal Carcinoma Survival: A Systematic Review and Meta-Analysis

Jin, Xin; Hu, Ren-Chong; Guo, Huan; Ding, Chenchen; Pi, Guoliang; Tian, Meng-Xing

doi:10.1080/01635581.2022.2084557

Cited by 5 publications

(4 citation statements)

References 36 publications

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“…[ 38 ] Related studies have shown that BMI, hemoglobin, total protein, albumin, and prealbumin are important indicators for evaluating malnutrition [ 39 ] ; and that changes in BMI are significant during synchronous radiotherapy in patients with cancer; that improving and maintaining body weight is an important requisite for ensuring efficacy; and that BMI is also an independent prognostic factor for survival in NPC. [ 40 , 41 ] The current study showed no significant difference in the change in BMI before and after the nutritional intervention during chemoradiotherapy, which is consistent with the findings of Bullock study, [ 34 ] wherein the author indicated no correlation between BMI and patient prognosis, a result that needs to be validated by expanding the sample size. Our results indicate that no significant difference was obtained in albumin and total protein levels before and after the nutritional intervention.…”

Section: Discussionsupporting

confidence: 89%

Nutritional intervention for the prognosis of nasopharyngeal carcinoma chemoradiotherapy patients: A meta-analysis

He,

Chen,

Yang

et al. 2023

Medicine

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Background: To conduct a meta-analysis to investigate the effects of different nutritional interventions on various serum nutritional indicators and patients’ prognosis during radiotherapy for nasopharyngeal carcinoma, to assess treatment safety and efficacy. Methods: A systematic literature search, mainly randomized controlled trials (RCTs), on the effects of nutritional support on patients undergoing radiotherapy for nasopharyngeal carcinoma was conducted between January 2010 and August 2022 using databases such as China National Knowledge Infrastructure, Wanfang Database, Web of Science, PubMed, Cochrane Library, and Embase. Risk of bias was assessed using the Cochrane Rob2 scale. The meta-analysis was performed using Stata 17.0 software, and the heterogeneity between studies was assessed using the I2 test, and funnel plots were used to qualitatively assess publication bias. Results: Overall, 10 RCTs with a total sample size of 879 cases were identified. The meta-analysis results showed that body mass index (BMI) (odds ratio = 0.026, 95% confidence interval[1]: −0.348 to 0.401, P > .05), albumin (standardized mean difference [SMD] = 0.13, 95% CI: −0.127 to 0.387, P > .05), and total protein levels were not significantly different between the nasopharyngeal cancer (NPC) radiotherapy group with nutritional support group (SMD = −0.262, 95% CI: −1.062 to 0.537, P > .05) and the control group; pre-albumin (SMD = 0.256, 95% CI: 0.022–0.491, P = .032), hemoglobin (SMD = 0.436, 95% CI: 0.26–0.612, P < .000), and lymphocyte count (SMD = 1.125, 95% CI: 0.868–1.381, P < .000) were significantly higher in the nutritional intervention group than in the control group. Conclusion: Compared with conventional diets, nutritional interventions can improve serum nutritional parameters, nutritional status, treatment tolerance, and prognosis of patients undergoing radiotherapy for nasopharyngeal carcinoma.

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Section: Discussionsupporting

confidence: 89%

Nutritional intervention for the prognosis of nasopharyngeal carcinoma chemoradiotherapy patients: A meta-analysis

He,

Chen,

Yang

et al. 2023

Medicine

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“…Second, weight loss is expected with negative cell-regulating mechanisms of cancer or in patients with aggressive cancers. Lower body weight and body mass index are well-established prognostic factors in patients with various types of cancer (28,29). Taken together, a low GNRI is a stable prognostic indicator for patients with GC.…”

Section: Discussionmentioning

confidence: 86%

Prognostic and clinicopathological value of the geriatric nutritional risk index in gastric cancer: A meta-analysis of 5,834 patients

Liu

et al. 2023

Front. Surg.

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BackgroundRecent studies have explored the prognostic value of the geriatric nutritional risk index (GNRI) in patients with gastric cancer (GC), but the results are controversial. We aimed to systemically identify the association between the GNRI and prognosis in GC using a meta-analysis.MethodsThe databases of PubMed, Web of Science, Cochrane Library, and Embase were searched until September 25, 2022. Pooled hazard ratios and the corresponding 95% confidence intervals (CIs) were used to estimate the prognostic value of the GNRI in GC. Odds ratios (ORs) and 95% CIs were used to assess the correlation between the GNRI and clinicopathological characteristics of GC.ResultsTen studies including 5,834 patients with GC were included in this meta-analysis. The merged results indicated that a low pretreatment GNRI was associated with inferior overall survival (hazard ratio = 1.21, 95% CI = 1.12–1.30, P < 0.001) and worse cancer-specific survival (hazard ratio = 2.21, 95% CI = 1.75–2.80, P < 0.001) for GC. Moreover, a low GNRI was significantly associated with an advanced pathological stage (OR = 2.27, 95% CI = 1.33–3.85, P = 0.003), presence of adjuvant chemotherapy (OR = 1.25, 95% CI = 1.01–1.55, P = 0.040), and tumor location in the lower stomach (OR = 1.33, 95% CI = 1.06–1.65, P = 0.012) in GC. However, there was no significant association between GNRI and sex, tumor differentiation, or lymph node metastasis in patients with GC.ConclusionOur meta-analysis identified that the pretreatment GNRI level was a significant prognostic factor for patients with GC. A low GNRI is associated with worse overall survival and inferior cancer-specific survival in patients with GC.

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“…This may be because BMI does not accurately re ect the composition of body constituents and their changes: it cannot distinguish between fat and muscle mass, nor can it differentiate between uid volume accumulation in the interstitium and actual body tissue. 32 Pan et al…”

Section: Discussionmentioning

confidence: 99%

Predicting the risk of sarcopenia in Nasopharyngeal Carcinoma patients: Development and assessment of a new predictive nomogram

Liu,

Wang,

Chen

et al. 2024

Preprint

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Purpose Sarcopenia, as defined by the Global Leadership Initiative on Malnutrition (GLIM) consensus, serves as a diagnostic indicator for malnutrition and has been shown to influence cancer treatment and clinical results. However, the impact of sarcopenia on individuals diagnosed with nasopharyngeal carcinoma (NPC) remain insufficiently elucidated. The objective of this study was to investigate the prognostic significance of sarcopenia on the survival outcomes of NPC patients and to develop a nomogram. Patients and methods: 545 patients with stage III-IVa NPC were included in this retrospective study and randomly divided into training and validation cohort (381 and 164 patients, respectively). Sarcopenia was defined using the skeletal muscle index (SMI) determined at the C3 level based on baseline MRI. The nomogram was developed utilizing a multivariable Cox model with baseline variables from the training cohort, and validated with the validation cohort. The nomogram's discriminative ability and accuracy were evaluated using the consistency index (C-index), receiver operating characteristic curve (ROC), and calibration plots, while the net benefit was assessed and compared with the TNM clinical stage through decision curve analysis (DCA). Results The results of the multivariate analysis revealed that higher T stage (HR = 2.15, 95% CI: 1.3–3.57, P < 0.01), higher N stage (HR = 2.15, 95% CI: 1.56–2.95, P < 0.01), sarcopenia group (HR = 2.46, 95% CI: 1.58–3.83, P < 0.01), and a history of comorbidities (HR = 1.76, 95% CI: 1.16–2.67, P = 0.01) were identified as independent risk factors that significantly impacted both overall survival (OS). The C-index (0.731 for the training cohort and 0.72 for the validation cohort indicated satisfactory discriminative ability of the nomogram. The calibration plots showed favorable consistency between the prediction of the nomogram and actual observations in both the training and validation cohorts. Moreover, nomograms also showed higher outcomes of DCA and the area under the curve (AUC) compared to TNM clinical stage. Conclusion Sarcopenia, T stage, N stage, and comorbidities were identified as independent prognostic factors for locally advanced NPC (laNPC). The integration of these factors into a nomogram predictive model demonstrated enhanced predictive accuracy.

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Pretreatment Body Mass Index (BMI) as an Independent Prognostic Factor in Nasopharyngeal Carcinoma Survival: A Systematic Review and Meta-Analysis

Cited by 5 publications

References 36 publications

Nutritional intervention for the prognosis of nasopharyngeal carcinoma chemoradiotherapy patients: A meta-analysis

Nutritional intervention for the prognosis of nasopharyngeal carcinoma chemoradiotherapy patients: A meta-analysis

Prognostic and clinicopathological value of the geriatric nutritional risk index in gastric cancer: A meta-analysis of 5,834 patients

Predicting the risk of sarcopenia in Nasopharyngeal Carcinoma patients: Development and assessment of a new predictive nomogram

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