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脑转移瘤患者营养不良的发生率和预后意义。

Prevalence and Prognostic Significance of Malnutrition in Patients with Brain Metastasis.

机构信息

Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Department of Neurosurgery, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.

出版信息

Cancer Epidemiol Biomarkers Prev. 2023 May 1;32(5):718-725. doi: 10.1158/1055-9965.EPI-22-0918.

Abstract

BACKGROUND

Malnutrition is a severe but modifiable risk factor for cancers. However, the relationship between malnutrition and the survival of patients with brain metastases has not been fully revealed. We aimed to evaluate the prevalence of malnutrition and assess its prognostic value on patients with brain metastases.

METHODS

We retrospectively recruited 2,633 patients with brain metastases between January 2014 and September 2020. Three malnutrition scores were used to evaluate patients' malnutrition status at their first admission, including controlling nutritional status, the nutritional risk index, and the prognostic nutritional index. The association between malnutrition and overall survival (OS) was estimated.

RESULTS

The three malnutrition scores were associated with each other and with body mass index (BMI). Malnutrition assessed by any of the three scores was significantly associated with poor OS. All three malnutrition scores were better indicators than BMI, and adding malnutrition scores to the Graded Prognostic Assessment (GPA) scoring system could significantly improve the accuracy of prognosis prediction.

CONCLUSIONS

Malnutrition monitoring using any of the three malnutrition scores on patients' first admission could be a better survival indicator for patients with brain metastases compared with BMI alone.

IMPACT

Malnutrition is a more significant indicator of survival stratification compared with BMI. Adding malnutrition to the GPA score system achieves better survival prediction.

摘要

背景

营养不良是癌症的一个严重但可改变的危险因素。然而,营养不良与脑转移患者生存之间的关系尚未完全揭示。我们旨在评估营养不良的患病率,并评估其对脑转移患者的预后价值。

方法

我们回顾性招募了 2014 年 1 月至 2020 年 9 月期间的 2633 名脑转移患者。使用三种营养不良评分来评估患者首次入院时的营养不良状况,包括控制营养状况评分、营养风险指数和预后营养指数。评估营养不良与总生存期(OS)之间的关联。

结果

这三种营养不良评分相互关联,并与体重指数(BMI)相关。任何一种评分评估的营养不良与较差的 OS 显著相关。所有三种营养不良评分均优于 BMI,将营养不良评分添加到分级预后评估(GPA)评分系统中可以显著提高预后预测的准确性。

结论

与单独 BMI 相比,使用三种营养不良评分中的任何一种在患者首次入院时监测营养不良都可能是脑转移患者更好的生存指标。

影响

与 BMI 相比,营养不良是生存分层的更重要指标。将营养不良添加到 GPA 评分系统中可实现更好的生存预测。

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