Validation of Different Nutritional Assessment Tools in Predicting Prognosis of Patients with Soft Tissue Spindle-Cell Sarcomas

Abstract

Predicting outcomes in patients with soft tissue sarcoma (STS) is challenging. To improve these predictions, we retrospectively analyzed common nutritional assessment systems, including Glasgow prognostic score (GPS), Geriatric Nutritional Risk Index (GNRI), neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and controlling nutritional (CONUT) score against outcomes in 103 patients with STS, of whom 15 (14.6%) died within 1 year of diagnosis. GPS, GNRI, NLR, PLR, and CONUT scores significantly differed between patients who died within one year and patients who lived longer. Binomial logistic regression analysis showed that male sex, older age at diagnosis, higher GPS, higher stage, and unresectable STS were risk factors for death within a year of diagnosis. Overall survival was evaluated by Cox proportional hazards models, which correlated higher NLR, higher PLR, larger maximum diameter of tumor, higher stage, and unresectable STS with poor prognosis. We next examined prognostic factors in the 93 patients with resectable STS, and found male sex, higher GPS, and higher stage were correlated with poor prognosis in these patients. Our findings suggest that GPS, NLR, and PLR are simple predictors of outcome in patients with STS. Nutritional therapies might improve their GPS and prognosis.

The Prognostic Role of Glasgow Prognostic Score and C-reactive Protein to Albumin Ratio for Sarcoma: A System Review and Meta-Analysis

“…This exceptional study was excluded because the data cannot be adequately transformed. Finally, 12 eligible studies with 2695 patients were included in this meta-analysis [30][31][32][33][34][35][36][37][38][39][40][41]. There is no disagreement among the two investigators during the data extraction process.…”

“…The main features of the 12 included studies are summarized in Table 1. In short, four studies were conducted in Europe (1 in UK and 3 in Denmark) [30,32,35,40], while the other eight were in Asia (6 in China and 2 in Japan) [31,33,34,[36][37][38][39][40][41]. The sample size ranged from 83 to 888, while the follow-up time ranged from 20.3 months to 19 years.…”

“…All the 12 included studies were retrospectively designed. Five studies focused on bone sarcoma patients [30,31,33,34,41], another five focused on soft tissue sarcoma patients [35][36][37][38][39], and the other two focused on both bone and soft tissue sarcoma patients [32,40]. Five of the 12 included studies declared that patients with medical conditions known to affect systemic inflammation status were excluded [31,33,34,36,38].…”

“…Eleven studies investigated the prognostic value of GPS for sarcoma patients. Seven of them reported the prognostic role of GPS for OS [30,31,33,34,36,38,39], four of them reported the prognostic role of GPS for DSS [30,32,35,40], and another four reported the prognostic role of GPS for DFS [32,[36][37][38]. Nine of the eleven studies evaluated traditional GPS, one [32] evaluated mGPS (modified GPS), two [36,37] evaluated Hs-mGPS (high sensitive modified GPS), and the other one [38] evaluated both traditional GPS and mGPS.…”

“…The prognostic significance of GPS and CAR has also been investigated in sarcoma patients, and controversial results have also been reported [30][31][32][33][34][35][36][37][38][39][40][41][42]. To our knowledge, no system review or meta-analysis has been conducted on this subject for sarcoma.…”