Xue Guo-Qiang, Li Cheng-Peng, Lv Ang, Tian Xiu-Yun, Wu Jian-Hui, Qiu Hui, Hao Chun-Yi
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China.
Cancer Manag Res. 2021 Aug 6;13:6157-6167. doi: 10.2147/CMAR.S307920. eCollection 2021.
Previous studies have shown that nutrition and systemic inflammation plays an essential role in the development of soft tissue sarcoma. However, few studies have explored the association of clinicopathologic features and local recurrence with nutritional and inflammatory markers in retroperitoneal liposarcoma (RPLS). This study sought to evaluate the prognostic value of the preoperative nutritional and inflammatory markers for local recurrence-free survival (LRFS) among surgical RPLS patients.
The study included 111 RPLS patients who underwent surgery between May 2010 and June 2019 at the Peking University Cancer Hospital Sarcoma Center. Time-dependent receiver operating characteristic (time-ROC) curve analysis was conducted to evaluate the ability of markers to predict LRFS. The associations of the CONUT-FAR score with clinicopathological variables and LRFS were evaluated.
In the time-ROC curve analysis, the CONUT-FAR score was superior to other nutritional and inflammatory markers in predicting LRFS. The CONUT-FAR score was the only nutritional and inflammatory marker that independently predicted LRFS in the multivariate analysis, and patients with a high CONUT-FAR score (> 11) showed significantly decreased LRFS. Although the CONUT-FAR score failed to discriminate patients with low grade (G1) (p = 0.327) or undergoing incomplete (R2) resection (p = 0.072), it stratified patients with high grade (G2 and G3) or undergoing complete resection (R0/R1) into subgroups with significantly distinct LRFS (p < 0.001). The CONUT-FAR score also showed good clinical utility among patients with different clinical characteristics.
The preoperative CONUT-FAR score reflects both nutritional and inflammatory factors and is an effective predictor of LRFS for surgical RPLS patients.
既往研究表明,营养和全身炎症在软组织肉瘤的发生发展中起重要作用。然而,很少有研究探讨腹膜后脂肪肉瘤(RPLS)的临床病理特征及局部复发与营养和炎症标志物之间的关联。本研究旨在评估术前营养和炎症标志物对接受手术治疗的RPLS患者无局部复发生存期(LRFS)的预后价值。
本研究纳入了2010年5月至2019年6月期间在北京肿瘤医院肉瘤中心接受手术治疗的111例RPLS患者。采用时间依赖性受试者工作特征(time-ROC)曲线分析来评估标志物预测LRFS的能力。评估CONUT-FAR评分与临床病理变量及LRFS之间的关联。
在time-ROC曲线分析中,CONUT-FAR评分在预测LRFS方面优于其他营养和炎症标志物。CONUT-FAR评分是多变量分析中唯一独立预测LRFS的营养和炎症标志物,CONUT-FAR评分高(>11)的患者LRFS显著降低。尽管CONUT-FAR评分未能区分低级别(G1)患者(p = 0.327)或接受不完全(R2)切除的患者(p = 0.072),但它将高级别(G2和G3)或接受完全切除(R0/R1)的患者分层为LRFS明显不同的亚组(p < 0.001)。CONUT-FAR评分在具有不同临床特征的患者中也显示出良好的临床实用性。
术前CONUT-FAR评分反映了营养和炎症因素,是接受手术治疗的RPLS患者LRFS的有效预测指标。