Xue Guo-Qiang, Li Cheng-Peng, Lv Ang, Wu Jian-Hui, Tian Xiu-Yun, Qiu Hui, Hao Chunyi
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery/Sarcoma Center, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China.
Cancer Manag Res. 2024 Aug 13;16:1021-1030. doi: 10.2147/CMAR.S474801. eCollection 2024.
Extended surgery with multi-visceral resection is the standard treatment for retroperitoneal liposarcoma (RLPS). Malnutrition tends to result in increased surgical complications and reduced survival. The aim of this study was to identify the prognostic role of nutritional status in patients with RLPS.
Data from 189 consecutive patients with RLPS who underwent surgical treatment at the Peking University Cancer Hospital Sarcoma Center between April 2011 and August 2022 were retrospectively reviewed. The following nutritional parameters were calculated: nutritional risk index, prognostic nutritional index (PNI) and Nutrition Risk Screening 2002. Time-dependent receiver operating characteristic (time-ROC) curve analysis was conducted to compare the prognostic utility of nutritional indicators. The associations between nutritional indicators and major complications, local recurrence-free survival (LRFS) and overall survival (OS) were investigated.
Based on the time-ROC curve analysis, the PNI was superior to other nutritional indices at predicting OS. The optimal cut-off value of PNI was 41.2. The PNI was significantly inversely associated with tumor size, tumor grade, and histological subtype. Patients in the low PNI group (< 41.2) had significantly shorter LRFS and OS than those in the high PNI (≥ 41.2) group, with higher major morbidity and mortality rates. The PNI was found to be a unique nutritional predictor that independently predicted LRFS and OS in the multivariate analysis.
The PNI is an effective tool for nutritional assessment in patients with RLPS. A low PNI value in patients with RLPS predicts worse survival outcomes.
多脏器切除术的扩大手术是腹膜后脂肪肉瘤（RLPS）的标准治疗方法。营养不良往往会导致手术并发症增加和生存率降低。本研究的目的是确定营养状况在RLPS患者中的预后作用。
回顾性分析了2011年4月至2022年8月期间在北京大学肿瘤医院肉瘤中心接受手术治疗的189例连续性RLPS患者的数据。计算了以下营养参数：营养风险指数、预后营养指数（PNI）和营养风险筛查2002。进行了时间依赖性受试者操作特征（time-ROC）曲线分析，以比较营养指标的预后效用。研究了营养指标与主要并发症、无局部复发生存期（LRFS）和总生存期（OS）之间的关联。
基于time-ROC曲线分析，PNI在预测OS方面优于其他营养指标。PNI的最佳截断值为41.2。PNI与肿瘤大小、肿瘤分级和组织学亚型显著负相关。低PNI组（<41.2）患者的LRFS和OS明显短于高PNI组（≥41.2），主要发病率和死亡率更高。在多变量分析中，PNI被发现是一个独立预测LRFS和OS的独特营养预测指标。
PNI是RLPS患者营养评估的有效工具。RLPS患者PNI值低预示着生存结果较差。
