Role of nutritional status in the early postoperative prognosis of patients operated for retroperitoneal liposarcoma (RLS): A single center experience

Kirov, K.; Xu, Hao; Crenn, Pascal; Goater, Philippe; Tzanis, Dimitri; Bouhadiba, Mohammed Toufik; Abdelhafidh, Khoubeyb; Kirova, Youlia; Bonvalot, Sylvie

doi:10.1016/j.ejso.2018.07.001

Cited by 35 publications

(29 citation statements)

References 25 publications

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“…Similar to other studies that have analyzed factors predicting perioperative morbidity after major surgery including RPS, 12,13 preoperative albumin levels were predictive of postoperative complications in the present study. Additionally, the present study found an increased incidence of complications with larger and incompletely resected tumors, findings which are similar to past studies of patients undergoing incomplete resection for RPS 8,14,15 .…”

Section: Discussionsupporting

confidence: 85%

Outcomes of palliative‐intent surgery in retroperitoneal sarcoma—Results from the US Sarcoma Collaborative

Thalji

Tsai

Gamblin

et al. 2020

Journal of Surgical Oncology

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Background and Objectives: Outcomes of palliative-intent surgery in retroperitoneal sarcomas (RPS) are not well understood. This study aims to define indications for and outcomes after palliative-intent RPS resection. Methods: Using a retrospective 8-institution database, patients undergoing resection of primary/recurrent RPS with palliative intent were identified. Logistic regression and Cox-proportional hazards models were constructed to analyze factors associated with postoperative complications and overall survival (OS). Results: Of 3088 patients, 70 underwent 87 palliative-intent procedures. Most common indications were pain (26%) and bowel obstruction (21%). Dedifferentiated liposarcoma (n = 17, 24%), leiomyosarcoma (n = 13, 19%) were predominant subtypes. Median OS was 10.69 months (IQR, 3.91-23.23). R2 resection (OR, 8.60; CI, 1.42-52.15; P = .019), larger tumors (OR, 10.87; CI, 1.44-82.11; P = .021) and low preoperative albumin (OR, 0.14; CI, 0.04-0.57; P = .006) were associated with postoperative complications. Postoperative complications (HR, 1.95; CI, 1.02-3.71; P = .043) and high-grade histology (HR, 6.56; CI, 1.72-25.05; P = .006) rather than resection status were associated with reduced OS. However, in R2-resected patients, development of postoperative complications significantly reduced survival (P = .042).Conclusions: Postoperative complications and high-grade histology rather than resection status impacts survival in palliative-intent RPS resections. Given the higher incidence of postoperative complications which may diminish survival, palliative-intent R2 resection should be offered only after cautious consideration.

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Section: Discussionsupporting

confidence: 85%

Outcomes of palliative‐intent surgery in retroperitoneal sarcoma—Results from the US Sarcoma Collaborative

Thalji

Tsai

Gamblin

et al. 2020

Journal of Surgical Oncology

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“…In this context, the advantage of the NLR and CRP lies in their ability to be derived from routine preoperative laboratory blood tests. A recent study analyzed the prognostic utility of CRP as part of the prognostic and inflammatory nutritional index, and showed that it was associated with increased hospitalization time, however, the effect of CRP on oncological outcomes was not reported 20 . Further studies with larger patient cohorts will be needed to evaluate the prognostic contribution of other cytokines as well as their additive value to the NLR for expanding our knowledge of the pathogenesis of RPS.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study analyzed the prognostic utility of CRP as part of the prognostic and inflammatory nutritional index, and showed that it was associated with increased hospitalization time, however, the effect of CRP on oncological outcomes was not reported. 20 Further studies with larger patient cohorts will be needed to evaluate the prognostic contribution of other cytokines as well as their additive value to the NLR for expanding our knowledge of the pathogenesis of RPS. The therapeutic potential of modulating this sarcoma-induced inflammatory response, as was suggested for other tumors, 9 should also be further explored.…”

Section: Comparison Of Diagnostic Accuracy Of Preoperative Biopsy Amentioning

confidence: 99%

Innate inflammatory markers for predicting survival in retroperitoneal sarcoma

Netanyahu

Gerstenhaber

Shamai

et al. 2020

Journal of Surgical Oncology

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Introduction: Existing prognostic tools for retroperitoneal sarcomas (RPS) utilize parameters that can be accurately determined only postoperatively. This study evaluated the application of the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels for predicting prognosis in primary RPS. Materials and Methods: We retrospectively analyzed our database of patients with primary RPS operated between 2008 and 2018. The NLR was calculated from preoperative blood tests and its association with outcomes was determined. Results: The NLR values of 78 suitable patients were analyzed. Patients were classified in the NLR-high group if the NLR was ≥2.1. High-grade tumors were more common in the NLR-high group (71.6% vs 48%, P = .02). NLR-high patients had impaired overall survival (OS) and progression-free survival (PFS) compared to NLRlow patients (median OS not reached vs 74 months 95% confidence interval [CI]:

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“…RPLS tends to present as a large, painless mass that compresses the gastrointestinal tract, which can lead to elevated systemic inflammation and malnutrition. 5 , 6 Therefore, the nutritional and inflammatory status play critical roles in tumor progression and prognosis. 5 , 7 Peripheral blood parameters such as neutrophil count, lymphocyte count, platelet count, serum albumin (ALB) levels, fibrinogen levels, and total cholesterol (TC) are prognostic determinants and have clinical utility according to several studies.…”

Section: Introductionmentioning

confidence: 99%

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

Chengpeng

et al. 2021

CMAR

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Background Previous studies have shown that nutrition and systemic inflammation plays an essential role in the development of soft tissue sarcoma. However, few studies have explored the association of clinicopathologic features and local recurrence with nutritional and inflammatory markers in retroperitoneal liposarcoma (RPLS). This study sought to evaluate the prognostic value of the preoperative nutritional and inflammatory markers for local recurrence-free survival (LRFS) among surgical RPLS patients. Methods The study included 111 RPLS patients who underwent surgery between May 2010 and June 2019 at the Peking University Cancer Hospital Sarcoma Center. Time-dependent receiver operating characteristic (time-ROC) curve analysis was conducted to evaluate the ability of markers to predict LRFS. The associations of the CONUT-FAR score with clinicopathological variables and LRFS were evaluated. Results In the time-ROC curve analysis, the CONUT-FAR score was superior to other nutritional and inflammatory markers in predicting LRFS. The CONUT-FAR score was the only nutritional and inflammatory marker that independently predicted LRFS in the multivariate analysis, and patients with a high CONUT-FAR score (> 11) showed significantly decreased LRFS. Although the CONUT-FAR score failed to discriminate patients with low grade (G1) (p = 0.327) or undergoing incomplete (R2) resection (p = 0.072), it stratified patients with high grade (G2 and G3) or undergoing complete resection (R0/R1) into subgroups with significantly distinct LRFS (p < 0.001). The CONUT-FAR score also showed good clinical utility among patients with different clinical characteristics. Conclusion The preoperative CONUT-FAR score reflects both nutritional and inflammatory factors and is an effective predictor of LRFS for surgical RPLS patients.

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Role of nutritional status in the early postoperative prognosis of patients operated for retroperitoneal liposarcoma (RLS): A single center experience

Cited by 35 publications

References 25 publications

Outcomes of palliative‐intent surgery in retroperitoneal sarcoma—Results from the US Sarcoma Collaborative

Outcomes of palliative‐intent surgery in retroperitoneal sarcoma—Results from the US Sarcoma Collaborative

Innate inflammatory markers for predicting survival in retroperitoneal sarcoma

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

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