Jiang Jin, Zhao Tingxiao, Yao Longtao, Zhang Tao, Ji Lichen, Zhang Wei, Li Yanlei, Tian Jinlong, Ding Xiaoyan, Lin Yongqin, Han Liang
Department of Operation Room, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College) Hangzhou 310000, Zhejiang, China.
Department of Laboratory Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College) Hangzhou 310000, Zhejiang, China.
Am J Cancer Res. 2024 Oct 15;14(10):4946-4955. doi: 10.62347/MHXS8480. eCollection 2024.
To explore the value of preoperative prognostic nutritional index (PNI) and systemic immune inflammation index (SII) for predicting the efficacy and prognosis of patients with osteosarcoma undergoing neoadjuvant chemotherapy (NACT) combined with surgery.
A retrospective study was conducted on patients with osteosarcoma undergoing NACT combined with surgery in Sun Yat-sen University Cancer Center from January 2017 to May 2019. The patients were grouped into a remission group (pCR group, 85 patients) and a non-remission group (non-pCR, 79 patients), according to the treatment efficacy. The pathological data as well as clinical data were collected from patients, which were subsequently employed for statistical analysis to determine the factors affecting the efficacy of the treatment. The diagnostic value of PNI and SII for predicting the efficacy were assessed through following up the patients for 5 years to observe their overall survival rate. COX regression analysis was leveraged to identify risk factors affecting the survival time. The impact of different PNI and SII levels on the survival time was observed.
Multivariate regression analysis showed that factors including Enneking stage, PNI level and SII level were in association with poor efficacy after NATC combined with surgery. The mortality within 5 years was higher and the 5-year overall survival rate was lower in the non-pCR group than those in the pCR group (both P < 0.05). The COX regression analysis indicated that PNI and SII levels were risk factors for poor prognosis in patients with osteosarcoma following NACT combined with surgery. Further analysis showed that patients with low PNI and high SII levels had a lower 5-year survival rate (P < 0.05).
Enneking stage, PNI, and SII levels were risk factors for poor efficacy in patients with osteosarcoma after NACT combined with surgery. Patients whose PNI level was low and SII level was high presented poor prognosis following the treatment.
探讨术前预后营养指数（PNI）和全身免疫炎症指数（SII）对骨肉瘤患者新辅助化疗（NACT）联合手术疗效及预后的预测价值。
对2017年1月至2019年5月在中山大学肿瘤防治中心接受NACT联合手术的骨肉瘤患者进行回顾性研究。根据治疗效果将患者分为缓解组（pCR组，85例）和未缓解组（非pCR组，79例）。收集患者的病理资料及临床资料，随后进行统计分析以确定影响治疗效果的因素。通过对患者进行5年随访观察其总生存率，评估PNI和SII对预测疗效的诊断价值。利用COX回归分析确定影响生存时间的危险因素。观察不同PNI和SII水平对生存时间的影响。
多因素回归分析显示，Enneking分期、PNI水平和SII水平等因素与NATC联合手术后疗效不佳相关。非pCR组5年内死亡率较高，5年总生存率低于pCR组（均P<0.05）。COX回归分析表明，PNI和SII水平是骨肉瘤患者NACT联合手术后预后不良的危险因素。进一步分析显示，PNI水平低且SII水平高的患者5年生存率较低（P<0.05）。
Enneking分期、PNI和SII水平是骨肉瘤患者NACT联合手术后疗效不佳的危险因素。PNI水平低且SII水平高的患者治疗后预后较差。
