GLIM标准作为胆道癌辅助S-1化疗患者的预后因素

GLIM Criteria as Prognostic Factor in Patients Undergoing Adjuvant S-1 Chemotherapy for Biliary Tract Cancer.

作者信息

Konaka Ryunosuke, Yanagimoto Hiroaki, Tsugawa Daisuke, Akita Masayuki, Mizumoto Takuya, Yoshida Toshihiko, Sou Shinichi, Ishida Jun, Nanno Yoshihide, Urade Takeshi, Fukushima Kenji, Gon Hidetoshi, Komatsu Shohei, Asari Sadaki, Kido Masahiro, Toyama Hirochika, Fukumoto Takumi

机构信息

Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery,Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.

出版信息

Cancer Diagn Progn. 2025 Sep 1;5(5):557-565. doi: 10.21873/cdp.10470. eCollection 2025 Sep-Oct.

DOI:10.21873/cdp.10470

PMID:40900892

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12401029/

Abstract

BACKGROUND/AIM: Biliary tract cancers (BTCs) have poor prognoses, with limited curative options beyond surgical resection. Adjuvant S-1 chemotherapy has shown survival benefits in Japanese patients undergoing resection for BTC. However, prognostic factors influencing survival in these patients remain uncertain. In this study, we aimed to investigate the efficacy of preoperative nutritional status using the Global Leadership Initiative on Malnutrition (GLIM) criteria as a prognostic factor in patients receiving adjuvant S-1 chemotherapy for BTC.

PATIENTS AND METHODS

In this retrospective study, excluding intrahepatic cholangiocarcinoma, we evaluated 58 patients who underwent curative surgery for BTC at Kobe University from 2013 to 2022, followed by adjuvant S-1 chemotherapy. Nutritional status was classified by GLIM criteria into normal/moderate and severe malnutrition groups. Overall (OS) and recurrence-free (RFS) survival were analyzed using Kaplan-Meier and Cox proportional hazards models.

RESULTS

Of the 58 patients, 3.4% had no malnutrition, 72.5% had moderate malnutrition, and 24.1% had severe malnutrition. Patients with severe malnutrition had significantly worse 5-year OS (24.7% 52.5%, =0.0014) and RFS (34.3% 52.0%, =0.0066). Severe malnutrition was an independent prognostic factor for poorer OS (hazard ratio=3.40, 95% confidence interval=1.46-7.94; =0.0047) and RFS (hazard ratio=2.48, 95% confidence interval=1.07-5.76; =0.035). No significant difference in S-1 completion rates was observed.

CONCLUSION

Severe malnutrition, as defined by GLIM criteria, is a poor prognostic factor in patients with BTCs undergoing adjuvant S-1 chemotherapy.

摘要

背景/目的：胆管癌（BTC）预后较差，除手术切除外，治愈选择有限。辅助性S-1化疗已显示对接受BTC切除术的日本患者有生存益处。然而，影响这些患者生存的预后因素仍不确定。在本研究中，我们旨在调查使用全球营养不良领导倡议（GLIM）标准评估的术前营养状况作为接受BTC辅助性S-1化疗患者的预后因素的疗效。

患者与方法

在这项回顾性研究中，排除肝内胆管癌，我们评估了2013年至2022年在神户大学接受BTC根治性手术并随后接受辅助性S-1化疗的58例患者。根据GLIM标准将营养状况分为正常/中度和重度营养不良组。使用Kaplan-Meier法和Cox比例风险模型分析总生存期（OS）和无复发生存期（RFS）。

结果

58例患者中，3.4%无营养不良，72.5%为中度营养不良，24.1%为重度营养不良。重度营养不良患者的5年总生存率（24.7%对52.5%，P=0.0014）和无复发生存率（34.3%对52.0%，P=0.0066）明显更差。重度营养不良是总生存期较差（风险比=3.40，95%置信区间=1.46-7.94；P=0.0047）和无复发生存期较差（风险比=2.48，95%置信区间=1.07-5.76；P=0.035）的独立预后因素。未观察到S-1完成率有显著差异。