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术前控制营养状况评分在手术治疗非转移性肾细胞癌中的预后价值:一项单机构回顾性研究。

The prognostic value of preoperative controlling nutritional status score in non-metastatic renal cell carcinoma treated with surgery: a retrospective single-institution study.

作者信息

Song Haifeng, Xu Ben, Luo Cheng, Zhang Zhenan, Ma Binglei, Jin Jie, Zhang Qian

机构信息

Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.

Institute of Urology, Peking University, Beijing 100034, People's Republic of China.

出版信息

Cancer Manag Res. 2019 Aug 9;11:7567-7575. doi: 10.2147/CMAR.S209418. eCollection 2019.

Abstract

PURPOSE

This study aimed to investigate the significance of the controlling nutritional status (CONUT) score as a predictor for survival outcomes for non-metastatic renal cell carcinoma (RCC) patients.

METHODS

We retrospectively reviewed 325 patients who received surgical treatment for renal cell carcinoma between 2010 and 2012 at Peking University First Hospital. Patients were divided into two groups according to the optimal cut-off value of CONUT score. Kaplan-Meier method and log-rank test were used for survival analysis according to different CONUT groups. Cox proportional hazards regression models were performed to assess the prognostic value of clinicopathological parameters for overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS) respectively.

RESULTS

The optimal cut-off value of CONUT score was 3. High CONUT score significantly correlated to higher tumor grade (<0.001), later pathological T stage (<0.001) and tumor necrosis (<0.001). Patients with higher CONUT score had worse OS (HR 5.34, 95% CI 2.29-12.46, <0.001), CSS (HR 5.51, 95% CI 2.12-14.33, <0.001) and DFS (HR 4.23, 95% CI 2.16-8.29, <0.001). In multivariable analysis, high CONUT score was an independent risk factor for OS, CSS and DFS (OS: HR=3.36, 95% CI 1.73-6.56, <0.001; CSS: HR=3.34, 95% CI 1.59-6.98, =0.001; DFS: HR=1.85, ]95% CI 1.07-3.21, =0.029).

CONCLUSION

Preoperative CONUT score was an independent prognostic factor for OS, CSS and DFS in non-metastatic RCC patients treated with surgery.

摘要

目的

本研究旨在探讨控制营养状况(CONUT)评分作为非转移性肾细胞癌(RCC)患者生存结局预测指标的意义。

方法

我们回顾性分析了2010年至2012年期间在北京大学第一医院接受肾细胞癌手术治疗的325例患者。根据CONUT评分的最佳临界值将患者分为两组。采用Kaplan-Meier法和对数秩检验对不同CONUT组进行生存分析。分别进行Cox比例风险回归模型,以评估临床病理参数对总生存(OS)、癌症特异性生存(CSS)和无病生存(DFS)的预后价值。

结果

CONUT评分的最佳临界值为3。高CONUT评分与更高的肿瘤分级(<0.001)、更晚的病理T分期(<0.001)和肿瘤坏死(<0.001)显著相关。CONUT评分较高的患者OS(HR 5.34,95%CI 2.29-12.46,<0.001)、CSS(HR 5.51,95%CI 2.12-14.33,<0.001)和DFS(HR 4.23,95%CI 2.16-8.29,<0.001)更差。在多变量分析中,高CONUT评分是OS、CSS和DFS的独立危险因素(OS:HR=3.36,95%CI 1.73-6.56,<0.001;CSS:HR=3.34,95%CI 1.59-6.98,=0.001;DFS:HR=1.85,95%CI 1.07-3.21,=0.029)。

结论

术前CONUT评分是接受手术治疗的非转移性RCC患者OS、CSS和DFS的独立预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0b3/6693320/56a76ddb1558/CMAR-11-7567-g0001.jpg

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