恶病质指数是接受全身化疗的转移性尿路上皮癌患者的一个预后指标。

Cachexia Index Is a Prognostic Indicator in Patients With Metastatic Urothelial Carcinoma Treated With Systemic Chemotherapy.

作者信息

Mimura Yoshihisa, Naiki Taku, Sugiyama Yosuke, Tasaki Yoshihiko, Odagiri Kunihiro, Etani Toshiki, Nagai Takashi, Iida Moeko, Kimura Yuka, Ito Nanami, Hotta Yuji, Yasui Takahiro, Furukawa-Hibi Yoko

机构信息

Department of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.

Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.

出版信息

Cancer Diagn Progn. 2024 Jul 3;4(4):475-481. doi: 10.21873/cdp.10351. eCollection 2024 Jul-Aug.

DOI:10.21873/cdp.10351

PMID:38962546

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11215442/

Abstract

BACKGROUND/AIM: Cancer cachexia is associated with poor prognosis in patients with metastatic urothelial carcinoma (mUC). The objective of the study was to assess the cachexia index (CXI), which is a new indicator assessing the status of cancer cachexia, as a prognostic indicator for mUC patients treated with gemcitabine plus cisplatin (GC) chemotherapy.

PATIENTS AND METHODS

The study included 55 patients with mUC who underwent GC chemotherapy between 2008 and 2022 as first-line chemotherapy. The CXI at the start of chemotherapy was determined as follows: CXI=(serum albumin × skeletal muscle mass index)/ (neutrophil count/lymphocyte count). Patients were categorized into two groups based on a median CXI value (CXI-high and CXI low). We used Kaplan-Meier curves and multivariate Cox proportional hazards regression models to assess the association between the CXI and overall survival (OS).

RESULTS

At the start of GC chemotherapy, significant differences were not found in patients' characteristics. The median OS was significantly shorter in the CXI-low group [10.0 months (95% confidence interval (CI)=5.1-12.8)] than in the CXI-high group [22.3 months (95% CI=13.6-NA), p<0.05]. Multivariate analysis revealed that low CXI was a predictor of a poor prognosis [hazard ratio (HR)=2.25, 95% CI=1.12-4.52, p<0.05].

CONCLUSION

CXI might be useful as a prognostic indicator for patients with mUC undergoing first-line GC chemotherapy.

摘要

背景/目的：癌症恶病质与转移性尿路上皮癌（mUC）患者的不良预后相关。本研究的目的是评估恶病质指数（CXI），这是一种评估癌症恶病质状态的新指标，作为接受吉西他滨联合顺铂（GC）化疗的mUC患者的预后指标。

患者与方法

本研究纳入了55例在2008年至2022年间接受GC化疗作为一线化疗的mUC患者。化疗开始时的CXI计算如下：CXI =（血清白蛋白×骨骼肌质量指数）/（中性粒细胞计数/淋巴细胞计数）。根据CXI中位数将患者分为两组（CXI高和CXI低）。我们使用Kaplan-Meier曲线和多变量Cox比例风险回归模型来评估CXI与总生存期（OS）之间的关联。

结果

在GC化疗开始时，患者特征方面未发现显著差异。CXI低组的中位OS [10.0个月（95%置信区间（CI）=5.1 - 12.8）]显著短于CXI高组[22.3个月（95% CI = 13.6 - NA），p<0.05]。多变量分析显示，低CXI是预后不良的预测因素[风险比（HR）=2.25，95% CI = 1.12 - 4.52，p<0.05]。