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基于控制营养状况(CONUT)评分的列线图预测接受根治性手术的胰腺癌患者的总生存。

Controlling nutritional status (CONUT) score-based nomogram to predict overall survival of patients with pancreatic cancer undergoing radical surgery.

机构信息

Department of Pancreatic-Biliary Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, China.

Department of Pancreatic-Biliary Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, China.

出版信息

Asian J Surg. 2022 Jun;45(6):1237-1245. doi: 10.1016/j.asjsur.2021.08.011. Epub 2021 Sep 4.

Abstract

BACKGROUND

/Objective: As a new immune-nutritional marker, the controlled nutritional status (CONUT) score has been reported to predict the prognosis of cancer patients. We aimed to elucidate the prognostic value of preoperative CONUT score in pancreatic cancer patients undergoing radical surgery, and to construct a nomogram based on CONUT score to predict individual survival.

METHODS

Preoperative CONUT scores were calculated prospectively in 382 patients with pancreatic cancer who underwent radical surgery. Evaluated the relationship between CONUT score and pancreatic cancer prognosis. Cox proportional hazard models were used to determine predictors of survival and a new nomogram was established to predict pancreatic cancer overall survival (OS).

RESULTS

The area under curve of CONUT score was higher than other immune-nutritional indexes. The OS of the high-CONUT group were significantly lower than that of low-CONUT group. Multivariate analysis showed that CONUT score, gender, AJCC stage, complications and reoperation were independent prognostic factors for OS. Nomogram based on these variables has better discriminant ability in predicting survival compared with other traditional staging systems.

CONCLUSIONS

Preoperative CONUT score is an effective independent predictor of OS in pancreatic cancer patients undergoing radical surgery. This new CONUT based nomogram provides accurate, individualized survival prediction for pancreatic cancer.

摘要

背景

目的:作为一种新的免疫营养标志物,控制营养状况(CONUT)评分已被报道可预测癌症患者的预后。我们旨在阐明术前 CONUT 评分在接受根治性手术的胰腺癌患者中的预后价值,并构建基于 CONUT 评分的列线图以预测个体生存。

方法

前瞻性地计算了 382 例接受根治性手术的胰腺癌患者的术前 CONUT 评分。评估 CONUT 评分与胰腺癌预后的关系。Cox 比例风险模型用于确定生存的预测因素,并建立新的列线图以预测胰腺癌总生存(OS)。

结果

CONUT 评分的曲线下面积高于其他免疫营养指标。高 CONUT 组的 OS 明显低于低 CONUT 组。多因素分析表明,CONUT 评分、性别、AJCC 分期、并发症和再次手术是 OS 的独立预后因素。基于这些变量的列线图在预测生存方面比其他传统分期系统具有更好的判别能力。

结论

术前 CONUT 评分是接受根治性手术的胰腺癌患者 OS 的有效独立预测因子。这种新的基于 CONUT 的列线图为胰腺癌提供了准确的个体化生存预测。

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