Value of the Controlling Nutritional Status score in predicting the prognosis of patients with lung cancer: A multicenter, retrospective study

Zhang

J cachexia sarcopenia muscle

et al. 2022

Self Cite

Backgrounds Malnutrition and systemic inflammatory responses are associated with poor overall survival (OS) in lung cancer patients, but it remains unclear which biomarkers are better for predicting their prognosis. This study tried to determine the best one among the existing common nutrition/inflammation-based indicators of OS for patients with lung cancer. Materials and methods There were 16 nutrition or systemic inflammation-based indicators included in this study. The cut-off points for the indicators were calculated using maximally selected rank statistics. The OS was evaluated using the Kaplan-Meier estimator, and univariate and multivariate Cox proportional hazard models were used to determine the relationship between the indicators and OS. A time-dependent receiver operating characteristic curves (time-ROC) and C-index were calculated to assess the predictive ability of the different indicators. Results There were 1772 patients with lung cancer included in this study. In univariate analysis, all 16 indicators were significantly associated with OS of the patients (all P < 0.001). Except for platelet-to-lymphocyte ratio, all other indicators were independent predictors of OS in multivariate analysis (all P < 0.05). Low advanced lung cancer inflammation index (ALI) was associated with higher mortality risk of lung cancer [hazard ratio, 1.30; 95% confidence interval (CI), 1.13-1.49]. The results of the time-AUC and C-index analyses indicated that the ALI (C-index: 0.611) had the best predictive ability on the OS in patients with lung cancer. In different sub-groups, the ALI was the best indicator for predicting the OS of lung cancer patients regardless of sex (C-index, 0.609 for men and 0.613 for women) or smoking status (C-index, 0.629 for non-smoker and 0.601 for smoker) and in patients aged <65 years (C-index, 0.613). However, the modified Glasgow prognostic score was superior to the other indicators in non-small cell lung cancer patients (C-index, 0.639) or patients aged ≥65 years (C-index, 0.610), and the glucose-to-lymphocyte ratio performed better prognostic ability in patients with small cell lung cancer (C-index, 0.601). Conclusions The prognostic ability of the ALI is superior to the other inflammation/nutrition-based indicators for all patients with lung cancer.

“…Previous studies reported that LCR, 26 ALI, NLR, PLR, 6 SII, 27 CAR, 28 mGPS, 29 CONUT score, 30 AGR, 14 PNI, 31 NRI, GNRI, 32 and CRP 7 were useful as predictors of the prognosis of patients with lung cancer. Consistent with previous studies, Figure 3 The time-dependent ROC of inflammation and nutrition-relative indicators for diagnosing overall survival in patients with lung cancer.…”

Section: Discussionmentioning

confidence: 98%

“…Previous studies reported that LCR, 26 ALI, NLR, PLR, 6 SII, 27 CAR, 28 mGPS, 29 CONUT score, 30 AGR, 14 PNI, 31 NRI, GNRI, 32 and CRP 7 were useful as predictors of the prognosis of patients with lung cancer. Consistent with previous studies, our study found that PLR, ALI, NLR, SII, CAR, CONUT score, mGPS, GNRI, AGR, PNI, NRI, LCR, and CRP were all associated with OS in univariate analysis; each of these indicators except the PLR was an independent prognostic indicators of lung cancer patients and that GLR, mGNRI, and LCS, which were not examined in previous study, were also independent predictors of prognosis in patients with lung cancer.…”

Section: Discussionmentioning

confidence: 98%

The advanced lung cancer inflammation index is the optimal inflammatory biomarker of overall survival in patients with lung cancer

Zhang

J cachexia sarcopenia muscle

et al. 2022

Self Cite

“…The results showed that the TNM stage, age, sex, and PG‐SGA were the mediating factors that contributed the most. TNM stage is currently a clinically accepted index for evaluating tumor progression, and its grading needs to be determined based on postoperative pathology and systemic examination, which are more limited in use 24–26 . Age and sex are natural factors that cannot be changed.…”

Section: Discussionmentioning

confidence: 99%

“…TNM stage is currently a clinically accepted index for evaluating tumor progression, and its grading needs to be determined based on postoperative pathology and systemic examination, which are more limited in use. 24 , 25 , 26 Age and sex are natural factors that cannot be changed. As age increases, the incidence of cancer increases, and physical function decreases, leading to a poor patient prognosis and quality of life.…”

Section: Discussionmentioning

confidence: 99%

Relationship between educational level and survival of patients with cancer: A multicentre cohort study

Liu,

Zhang,

Ruan

et al. 2024

Cancer Medicine

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BackgroundAlthough socioeconomic factors are important determinants of population mortality, the effect of educational level on the survival of patients with cancer in China is unclear. This study aimed to assess whether educational level is associated with the prognosis of patients with cancer and to explore the mediators of this association.MethodsThis multicentre cohort study included 18,251 patients diagnosed with cancer between May 2013 and December 2018. The main parameters measured were overall survival (OS) and all‐cause mortality. The relationship between educational level and all‐cause mortality was assessed using multifactor‐corrected Cox survival analysis. Logistic regression was used to analyze the association between educational level and patient‐generated subjective global assessment (PG‐SGA).ResultsThe mean age of the 18,251 participants (men, 9939 [54.4%]) was 57.37 ± 11.66 years. Multifactorial survival analysis showed that patients survived longer with increasing education (university and above vs. elementary school and below; p = p = <0.001, HR = 0.84, 95% CI: 0.77–0.92), and the differences were statistically significant in different subgroups. The potential impact factors included sex, age, TNM stage, and PG‐SGA score. Logistic regression showed a significant negative association between educational level and the modifiable factor PG‐SGA (secondary vs. primary and below; p = 0.004, HR = 0.90, 95% CI: 0.83–0.97; university and above vs. primary and below; p < 0.001, HR = 0.79, 95% CI: 0.71–0.88).ConclusionsEducational level was a significant prognostic factor for patients with cancer, independent of other known prognostic factors. This association was further improved by modifying the nutritional status.

“…By applying the COUNT score, clinicians can easily and comprehensively assess nutritional status. At present, extensive research supports the important role of the CONUT score in the prognosis of gastric cancer, esophageal cancer, lung cancer, hepatocellular carcinoma, and other surgical tumors (20)(21)(22)(23)(24). In recent years, CONUT scores have also shown good effects in predicting short-term postoperative complications (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 96%

Preoperative controlling nutritional status score (CONUT) predicts postoperative complications of patients with bronchiectasis after lung resections

Cai

Li²,

Ye³

et al. 2023

Front. Nutr.

BackgroundThe Controlled Nutritional Status (CONUT) score is a valid scoring system for assessing nutritional status and has been shown to correlate with clinical outcomes in many surgical procedures; however, no studies have reported a correlation between postoperative complications of bronchiectasis and the preoperative CONUT score. This study aimed to evaluate the value of the CONUT score in predicting postoperative complications in patients with bronchiectasis.MethodsWe retrospectively analyzed patients with localized bronchiectasis who underwent lung resection at our hospital between April 2012 and November 2021. The optimal nutritional scoring system was determined by receiver operating characteristic (ROC) curves and incorporated into multivariate logistic regression. Finally, independent risk factors for postoperative complications were determined by univariate and multivariate logistic regression analyses.ResultsA total of 240 patients with bronchiectasis were included, including 101 males and 139 females, with an average age of 49.83 ± 13.23 years. Postoperative complications occurred in 59 patients (24.6%). The incidence of complications, postoperative hospital stay and drainage tube indwelling time were significantly higher in the high CONUT group than in the low CONUT group. After adjusting for sex, BMI, smoking history, lung function, extent of resection, intraoperative blood loss, surgical approach and operation time, multivariate analysis showed that the CONUT score remained an independent risk factor for postoperative complications after bronchiectasis.ConclusionsThe preoperative CONUT score is an independent predictor of postoperative complications in patients with localized bronchiectasis.