Department of Thoracic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.
Asian Cardiovasc Thorac Ann. 2021 Oct;29(8):763-771. doi: 10.1177/02184923211014002. Epub 2021 May 6.
We investigated whether preoperative nutritional indicators predicted the prognosis for patients with early-stage non-small cell lung cancer.
Data for stage I or stage IIA non-small cell lung cancer without lymph node metastasis patients who received anatomical lung resection and were followed-up at least five years after surgery ( = 286) were analyzed. We calculated geriatric nutritional risk index, prognostic nutritional index, controlling nutritional status score, and modified Glasgow prognostic score. Multivariate Cox proportional hazard model adjusting for age, BMI, complication, pathological stage, histology of squamous cell carcinoma, T factor, diffusing capacity for carbon monoxide, surgery and smoking status was fitted to evaluate the association between these nutritional indicators and mortality and recurrence within five years.
After adjusted for covariates other than type of surgery and diffusing capacity for carbon monoxide, controlling nutritional status of ≥3 was significantly associated with mortality (hazard ratio (HR) = 2.68, 95% confidence interval (CI) = 1.02, 7.01). The association remained marginally significant by adjusting for type of surgery and diffusing capacity for carbon monoxide (HR = 2.44, 95% CI = 0.92, 6.45). controlling nutritional status of ≥3 was significantly associated with recurrence (HR = 2.60; 95% CI: 1.20, 5.61) after adjusting for all covariates. Other nutritional indices did not predict the prognosis in multivariate analysis.
Preoperative high controlling nutritional status score was marginally and significantly associated with mortality and recurrence of non-small cell lung cancer patients after lung resection.
本研究旨在探讨术前营养指标是否可预测早期非小细胞肺癌患者的预后。
分析了行解剖性肺切除术且术后随访至少 5 年（n=286）的Ⅰ期或ⅡA 期无淋巴结转移的非小细胞肺癌患者的资料。计算了老年营养风险指数、预后营养指数、控制营养状况评分和改良格拉斯哥预后评分。使用多变量 Cox 比例风险模型，在调整年龄、BMI、并发症、病理分期、鳞癌组织学、T 因素、一氧化碳弥散量、手术方式和吸烟状况等因素后，评估这些营养指标与 5 年内死亡率和复发率的关系。
在调整手术方式和一氧化碳弥散量以外的其他因素后，控制营养状况评分≥3 与死亡率显著相关（HR=2.68，95%CI：1.02，7.01）。在校正手术方式和一氧化碳弥散量后，该相关性仍具有统计学意义（HR=2.44，95%CI：0.92，6.45）。在校正所有协变量后，控制营养状况评分≥3 与复发显著相关（HR=2.60；95%CI：1.20，5.61）。其他营养指标在多变量分析中未预测预后。
术前高控制营养状况评分与肺切除术后非小细胞肺癌患者的死亡率和复发率相关。
