Watte Guilherme, Nunes Claudia Helena de Abreu, Sidney-Filho Luzielio Alves, Zanon Matheus, Altmayer Stephan Philip Leonhardt, Pacini Gabriel Sartori, Barros Marcelo, Moreira Ana Luiza Schneider, Alves Rafael José Vargas, Zelmanowicz Alice de Medeiros, Matata Bashir Mnene, Moreira Jose da Silva
. Programa de Pós-Graduação em Ciências Pneumológicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil.
. Department of Clinical Research and Radiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom.
J Bras Pneumol. 2018 Nov-Dec;44(6):505-509. doi: 10.1590/S1806-37562018000000023.
To evaluate different weight loss (WL) cut-off points as prognostic markers of 3-month survival after diagnosis of stage IV non-small cell lung cancer (NSCLC).
This was a prospective study involving 104 patients with metastatic (stage IV) NSCLC who were admitted to a cancer treatment center in southern Brazil between January of 2014 and November of 2016. We evaluated total WL and WL per month, as well as WL and WL per month in the 6 months preceding the diagnosis. The patients were followed for 3 months after diagnosis. A Cox proportional hazards regression model and Kaplan-Meier curves were used in order to evaluate 3-month survival.
The median WL in the 6 months preceding the diagnosis was 6% (interquartile range, 0.0-12.9%). Patients with WL ≥ 5% had a median survival of 78 days, compared with 85 days for those with WL < 5% (p = 0.047). Survival at 3 months was 72% for the patients with WL ≥ 5% (p = 0.047), 61% for those with WL ≥ 10% (p < 0.001), and 45% for those with WL ≥ 15% (p < 0.001). In the multivariate analysis, the hazard ratio for risk of death was 4.51 (95% CI: 1.32-15.39) for the patients with WL ≥ 5%, 6.34 (95% CI: 2.31-17.40) for those with WL ≥ 10%, and 14.17 (95% CI: 5.06-39.65) for those with WL ≥ 15%.
WL in the 6 months preceding the diagnosis of NSCLC is a relevant prognostic factor and appears to be directly proportional to the rate of survival at 3 months.
评估不同的体重减轻（WL）切点作为IV期非小细胞肺癌（NSCLC）诊断后3个月生存率的预后标志物。
这是一项前瞻性研究，纳入了2014年1月至2016年11月期间在巴西南部一家癌症治疗中心收治的104例转移性（IV期）NSCLC患者。我们评估了总体重减轻和每月体重减轻情况，以及诊断前6个月内的体重减轻和每月体重减轻情况。患者在诊断后随访3个月。使用Cox比例风险回归模型和Kaplan-Meier曲线来评估3个月生存率。
诊断前6个月的体重减轻中位数为6%（四分位间距，0.0 - 12.9%）。体重减轻≥5%的患者中位生存期为78天，而体重减轻<5%的患者为85天（p = 0.047）。体重减轻≥5%的患者3个月生存率为72%（p = 0.047），体重减轻≥10%的患者为61%（p < 0.001），体重减轻≥15%的患者为45%（p < 0.001）。在多变量分析中，体重减轻≥5%的患者死亡风险的风险比为4.51（95%CI：1.32 - 15.39），体重减轻≥10%的患者为6.34（95%CI：2.31 - 17.40），体重减轻≥15%的患者为14.17（95%CI：5.06 - 39.65）。
NSCLC诊断前6个月的体重减轻是一个相关的预后因素，并且似乎与3个月生存率直接相关。
