改良全身炎症评分对预测接受孤立肢体灌注治疗的皮肤黑色素瘤患者术后结局的诊断价值。
The diagnostic value of modified systemic ınflammation score in predicting post-operative outcomes of cutaneous melanoma patients who underwent ısolated limb perfusion.
机构信息
Department of Surgical Oncology, Ankara City Hospital, Ankara, Turkey.
Department of Surgical Oncology, Dr. Abdurrahman Yurtaslan Research and Training Hospital, Ankara, Turkey.
出版信息
World J Surg Oncol. 2021 Nov 16;19(1):327. doi: 10.1186/s12957-021-02437-6.
BACKGROUND
In-transit metastasis is considered a locoregional disease in cutaneous melanoma (CM) patients. Isolated limb perfusion (ILP) is among the treatment options in selected cases. The aim of this study was to determine the success of pre- and post-perfusion mSIS values in predicting the potential complications and the prognosis of the disease by investigating the early and long-term results of mSIS values calculated before and after ILP in CM cases with in-transit metastases.
MATERIALS AND METHODS
Patients who underwent ILP within the period from 2014 to 2020 in our department were retrospectively scanned. A total of 20 patients were found to undergo ILP. The scores obtained from modified inflammation score (mSIS) were formulated according to albumin (Alb) and lymphocyte to monocyte ratio (LMR) scores.
RESULTS
The mean follow-up time was 20.47 months. Complications requiring surgical intervention developed in three patients. According to the Wieberdink local toxicity classification, the majority (70%) of the patients were found to be grade II. Based on pre-perfusion mSIS values, 8 patients were classified as mSIS 0 while six patients were classified as mSIS 1 and 2. Based on post-perfusion mSIS values, 14 patients and one patient were classified as mSIS 2 (70%) and mSIS 0, respectively. Accordingly, univariate analysis showed that mSIS 1 and mSIS 2 were negative prognostic factors for mean survival in the pre-perfusion period (HR 0.162, 95% CI 0.036-0.729; p = 0.018 and HR: 0.223, 95% CI 0.049-1.019; p = 0.053) whereas albumin (Alb) and lymphocyte to monocyte ratio (LMR) were not independent prognostic factors for mean survival.
CONCLUSION
The mSIS values calculated in the pre-perfusion period can give an opinion about the OS of the patients whereas post-perfusion mSIS values may predict potential surgical complications and local toxicities.
背景
在转移性皮肤黑色素瘤（CM）患者中，转移途中的转移被认为是局部疾病。在某些情况下，孤立肢体灌注（ILP）是治疗选择之一。本研究旨在通过研究 ILP 前后 mSIS 值在 CM 伴转移中的早期和长期结果，确定 mSIS 值在预测疾病的潜在并发症和预后方面的作用，以确定在转移途中转移前和转移后 mSIS 值预测的成功。
材料和方法
回顾性扫描了 2014 年至 2020 年期间在我科接受 ILP 的患者。共发现 20 例患者接受 ILP。根据白蛋白（Alb）和淋巴细胞与单核细胞比值（LMR）评分，制定了改良炎症评分（mSIS）的评分。
结果
平均随访时间为 20.47 个月。有 3 名患者出现需要手术干预的并发症。根据 Wieberdink 局部毒性分类，大多数（70%）患者为 2 级。根据灌注前 mSIS 值，8 例患者被归类为 mSIS 0，6 例患者被归类为 mSIS 1 和 2。根据灌注后 mSIS 值，14 例患者和 1 例患者分别被归类为 mSIS 2（70%）和 mSIS 0。因此，单因素分析表明，灌注前 mSIS 1 和 mSIS 2 是平均生存的负预后因素（HR 0.162，95%CI 0.036-0.729；p = 0.018 和 HR：0.223，95%CI 0.049-1.019；p = 0.053），而白蛋白（Alb）和淋巴细胞与单核细胞比值（LMR）不是平均生存的独立预后因素。
结论
灌注前计算的 mSIS 值可以为患者的 OS 提供意见，而灌注后 mSIS 值可能预测潜在的手术并发症和局部毒性。
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