Yang Yuhan, Zhou Chen, Ma Xuelei
West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
Department of Biotherapy and Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Nutr Cancer. 2022;74(10):3564-3573. doi: 10.1080/01635581.2022.2081342. Epub 2022 May 28.
To evaluate the prognostic values of nutrition-associated indicators and develop nutritional models for prediction of different clinical outcomes in patients with high-grade osteosarcoma receiving surgical resection. Patients diagnosed as high-grade osteosarcomas were included between 2008 and 2018. Body mass index (BMI), Glasgow prognostic score (GPS), systematic inflammatory index (SII), and controlling nutritional score (CONUT) were calculated as nutrition-associated indicators. The primary outcome was overall survival (OS) as the long-term outcome, and the secondary outcome was the postoperative hospitalization duration as the short-term outcome. The prognostic values of nutrition-associated indicators were evaluated by univariate and multivariate analyses to recognize the potential predictors for construction of nomogram model with validation. High GPS and CONUT yielded poor OS independently [GPS: HR (95% CI): 3.262 (2.035-5.229), < 0.001; CONUT: HR (95% CI): 2.445 (1.508-3.964), < 0.001]. The nomogram model for OS showed great prediction abilities and moderate calibration performance after integrating GPS and CONUT. CONUT was also identified as the independent predictor for hospitalization duration [OR (95% CI): 1.950 (1.145-3.321), = 0.014]. The CONUT score was considered as the significant predictor in prediction of OS and hospitalization duration. Appropriate management for nutritional status might optimize patients' prognoses with reference to nutrition-associated indicators.
评估营养相关指标的预后价值,并建立营养模型以预测接受手术切除的高级别骨肉瘤患者的不同临床结局。纳入2008年至2018年期间诊断为高级别骨肉瘤的患者。计算体重指数(BMI)、格拉斯哥预后评分(GPS)、全身炎症指数(SII)和控制营养状况评分(CONUT)作为营养相关指标。主要结局为作为长期结局的总生存期(OS),次要结局为作为短期结局的术后住院时间。通过单因素和多因素分析评估营养相关指标的预后价值,以识别用于构建并验证列线图模型的潜在预测因素。高GPS和CONUT独立导致较差的OS [GPS:HR(95%CI):3.262(2.035 - 5.229),<0.001;CONUT:HR(95%CI):2.445(1.508 - 3.964),<0.001]。整合GPS和CONUT后,OS的列线图模型显示出良好的预测能力和中等的校准性能。CONUT也被确定为住院时间的独立预测因素[OR(95%CI):1.950(1.145 - 3.321),=0.014]。CONUT评分被认为是OS和住院时间预测的重要预测因素。参考营养相关指标对营养状况进行适当管理可能会优化患者的预后。