Ma Nan, He Xiaobo, Nei Qiwei, Liu Zhenhua, Chen Xianda, Chang Hui, Yao Kai, Guo Shengjie
Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China.
State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China.
Discov Oncol. 2024 Dec 18;15(1):759. doi: 10.1007/s12672-024-01647-0.
Adrenal metastasectomy is a common local treatment for adrenal metastases, with a lack of serum prognostic factors. Here, we identified the prognostic significance of preoperative hemoglobin and albumin levels in patients undergoing adrenal metastasectomy.
Data from 93 patients who underwent adrenal metastasectomy were assessed retrospectively. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff values of hemoglobin and albumin for survival. Overall survival (OS) and disease-free survival (DFS) were evaluated using the Kaplan-Meier method, thereafter Cox regression models and subgroup analyses were applied to adjust confounding factors. A risk stratification developed by joint use of serum hemoglobin and albumin levels was also tested.
Optimal cut-off points were 130.5 g/L and 44.8 g/L for hemoglobin and albumin, respectively. Multivariate Cox regression analysis identified decreased hemoglobin (HR [95% CI]: 0.41 [0.18-0.91], P = 0.029) and albumin (HR [95% CI]: 0.12 [0.02-0.88], P = 0.038) levels as independent factors for poorer OS. Patient with both decreased hemoglobin and albumin levels had the worst OS (P = 0.001) and DFS (P = 0.001) than other risk groups. Subgroup analyses proved decreased hemoglobin and albumin levels predicted poorer OS independent of cancer types.
Preoperative hemoglobin and albumin levels may serve as prognostic predictors after adrenal metastasectomy. A prognostic model that combines hemoglobin and albumin can improve accuracy in predicting patient outcomes and be easily implemented in clinical practice.
肾上腺转移瘤切除术是治疗肾上腺转移瘤的一种常见局部治疗方法，但缺乏血清预后因素。在此，我们确定了接受肾上腺转移瘤切除术患者术前血红蛋白和白蛋白水平的预后意义。
回顾性评估93例行肾上腺转移瘤切除术患者的数据。采用受试者工作特征（ROC）曲线分析确定血红蛋白和白蛋白用于生存的最佳临界值。采用Kaplan-Meier法评估总生存期（OS）和无病生存期（DFS），然后应用Cox回归模型和亚组分析来调整混杂因素。还测试了联合使用血清血红蛋白和白蛋白水平建立的风险分层。
血红蛋白和白蛋白的最佳临界点分别为130.5 g/L和44.8 g/L。多因素Cox回归分析确定血红蛋白降低（HR [95% CI]：0.41 [0.18 - 0.91]，P = 0.029）和白蛋白降低（HR [95% CI]：0.12 [0.02 - 0.88]，P = 0.038）是OS较差的独立因素。血红蛋白和白蛋白水平均降低的患者的OS（P = 0.001）和DFS（P = 0.001）比其他风险组最差。亚组分析证明，血红蛋白和白蛋白水平降低可独立于癌症类型预测较差的OS。
术前血红蛋白和白蛋白水平可作为肾上腺转移瘤切除术后的预后预测指标。结合血红蛋白和白蛋白的预后模型可提高预测患者预后的准确性，并易于在临床实践中实施。
