结直肠癌肝转移患者术前化疗中预后营养指数的变化。

Dynamics of the prognostic nutritional index in preoperative chemotherapy in patients with colorectal liver metastases.

机构信息

Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.

出版信息

Surg Oncol. 2023 Aug;49:101966. doi: 10.1016/j.suronc.2023.101966. Epub 2023 Jun 30.

DOI:10.1016/j.suronc.2023.101966

PMID:37419043

Abstract

BACKGROUND

Identifying the prognostic indicators that reflect the efficacy of preoperative chemotherapy is necessary. In this study, we investigated the prognostic indicators targeting the systemic inflammatory response for the administration of preoperative chemotherapy in patients with colorectal liver metastases.

METHODS

Data for 192 patients were retrospectively analyzed. The relationship between overall survival and clinicopathological variables, including biomarkers such as the prognostic nutritional index, was investigated in patients who underwent upfront surgery or preoperative chemotherapy.

RESULTS

In the upfront surgery group, extrahepatic lesion (p=0.01) and low prognostic nutritional index (p < 0.01) were significant prognostic indicators, whereas a decrease in the prognostic nutritional index (p=0.01) during preoperative chemotherapy were independent poor prognostic factors in the preoperative chemotherapy group. In particular, a decrease in the prognostic nutritional index was a significant prognostic marker in patients aged <75 years (p=0.04). In patients with a low prognostic nutritional index aged <75 years, preoperative chemotherapy significantly prolonged overall survival (p=0.02).

CONCLUSION

A decrease in the prognostic nutritional index during preoperative chemotherapy predicted overall survival of patients with colorectal liver metastases after hepatic resection, and preoperative chemotherapy may be effective for patients aged <75 years with a low prognostic nutritional index.

摘要

背景

识别反映术前化疗疗效的预后指标是必要的。在这项研究中，我们研究了针对全身炎症反应的预后指标，以指导结直肠癌肝转移患者进行术前化疗。

方法

回顾性分析了 192 例患者的数据。在接受直接手术或术前化疗的患者中，研究了总生存期与临床病理变量（包括预后营养指数等生物标志物）之间的关系。

结果

在直接手术组中，肝外病变（p=0.01）和低预后营养指数（p<0.01）是显著的预后指标，而术前化疗期间预后营养指数下降（p=0.01）是术前化疗组的独立不良预后因素。特别是，在年龄<75 岁的患者中，预后营养指数下降是显著的预后标志物（p=0.04）。在年龄<75 岁且预后营养指数低的患者中，术前化疗显著延长了总生存期（p=0.02）。