治疗前营养/炎症因子作为早期和晚期头颈癌患者生存的预测指标。

Pretherapeutic nutritional/inflammatory factors as predictors for survival of both early and advanced staged head and neck cancer patients.

作者信息

Yamahara Kohei, Mizukoshi Akifumi, Lee Kana, Ikegami Satoshi

机构信息

Department of Otolaryngology, Head and Neck Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, 10-93 Oute-cho, Aoi-ku, Shizuoka 420-8630, Japan.

出版信息

Auris Nasus Larynx. 2021 Aug;48(4):731-737. doi: 10.1016/j.anl.2020.11.007. Epub 2020 Nov 29.

DOI:10.1016/j.anl.2020.11.007

PMID:33261982

Abstract

OBJECTIVES

Malnutrition and inflammation are common in patients with head and neck cancer and are closely associated with prognosis. Although several parameters for evaluating nutritional/inflammatory status have been assessed in relation to the prognosis of patients with head and neck cancer, previous studies primarily included patients with advanced-stage disease. To date, there is no consensus regarding the most reliable parameter for predicting the prognosis of early and advanced-stage head and neck cancer. This study sought to evaluate nutritional/inflammatory prognostic factors before treatment in patients with early and advanced-stage head and neck cancer.

METHODS

We retrospectively reviewed medical records of patients treated between 2008 and 2015 at our institution in order to evaluate the effects of nutritional/inflammatory parameters, including C-reactive protein/albumin ratio, modified Glasgow prognostic score, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and Geriatric Nutritional Risk Index, on overall survival. Effects of potential risk factors on overall survival were analyzed by computing Kaplan-Meier estimates; curves were compared using the log-rank test.

RESULTS

A total of 164 patients were enrolled. C-reactive protein/albumin ratio, modified Glasgow prognostic score, platelet/lymphocyte ratio, and Geriatric Nutritional Risk Index were found to be statistically significantly correlated with overall survival. Only the Geriatric Nutritional Risk Index remained statistically significant in the multivariate analysis. The three-year survival rates according to the four-group Geriatric Nutritional Risk Index scores for normal, low, moderate, and high risk were 95.5%, 84.3%, 53.8%, and 23.4%, respectively.

CONCLUSION

The Geriatric Nutritional Risk Index is therefore a useful prognostic factor for patients with early and advanced-stage head and neck cancer.

摘要

目的

营养不良和炎症在头颈癌患者中很常见，且与预后密切相关。尽管已经评估了几个用于评估营养/炎症状态的参数与头颈癌患者预后的关系，但先前的研究主要纳入了晚期疾病患者。迄今为止，对于预测早期和晚期头颈癌预后的最可靠参数尚无共识。本研究旨在评估早期和晚期头颈癌患者治疗前的营养/炎症预后因素。

方法

我们回顾性分析了2008年至2015年在我院接受治疗的患者的病历，以评估包括C反应蛋白/白蛋白比值、改良格拉斯哥预后评分、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值和老年营养风险指数在内的营养/炎症参数对总生存期的影响。通过计算Kaplan-Meier估计值分析潜在风险因素对总生存期的影响；使用对数秩检验比较曲线。

结果

共纳入164例患者。发现C反应蛋白/白蛋白比值、改良格拉斯哥预后评分、血小板/淋巴细胞比值和老年营养风险指数与总生存期在统计学上显著相关。在多变量分析中，只有老年营养风险指数仍具有统计学意义。根据老年营养风险指数四分位评分，正常、低、中、高风险组的三年生存率分别为95.5%、84.3%、53.8%和23.4%。