Figure - available from: Frontiers in Surgery
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Background
The occurrence of postoperative complications of distal cholangiocarcinoma (dCCA) is an indicator of poor patient prognosis. This study aimed to determine the immune-nutritional indexes (INIs) that can predict short-term postoperative complications.
Methods
A retrospective analysis of 148 patients with dCCA who were operated radical pan...
Citations
... Postoperative complications are among the adverse prognostic factors in cancer care. Their occurrence prolongs hospitalization duration, increases economic burden, and leads to unfavorable prognoses (4,5). The incidence of postoperative complications in patients with gastric cancer can be as high as 40%, and early complications appear within 30 days after surgery (6,7). ...
Background
Preoperative nutritional status in patients with gastric cancer after surgery has attracted considerable interest. The nutritional risk index (NRI) has been widely used as a convenient and effective nutritional assessment index, but the relationship between preoperative NRI and postoperative complications in patients with gastric cancer has not been adequately studied. Our study aimed to investigate the effects of preoperative NRI on 30-day postoperative complications in patients with gastric cancer.
Methods
This retrospective analysis investigated 578 patients with gastric cancer. Preoperative NRI calculations were based on serum albumin levels and body weight, and receiver operating characteristic curves were used in analyzing NRI values and establishing optimal cutoff points. Patients were categorized into two groups according to cutoff value: low NRI group (NRI<96.7) and high NRI group (NRI≥96.7). The hazard ratio (HR) for postoperative complications was calculated through Cox regression analysis and adjusted for potential confounders, and the effects of NRI on postoperative complications in patients with gastric cancer were examined. In addition, we conducted subgroup analyses to examine whether there was an interaction between the effect of NRI on the cumulative incidence of postoperative complications and other confounding factors.
Results
Of the 578 patients with gastric cancer who underwent radical surgery, 120 (20.8%) experienced postoperative complications. The optimal NRI threshold of 96.7 was identified using ROC curve analysis. Cox regression analysis demonstrated that preoperative NRI was independently associated with 30-day postoperative complications after adjusting for confounding factors (HR=0.93; 95%CI: 0.90–0.96; P <0.001). Patients in the low NRI group had significantly higher rates of postoperative complications than those in the high NRI group(HR=2.89, 95%CI:1.71–4.88; P <0.001). The cumulative incidence analysis revealed a higher risk of postoperative complications over time in the low NRI group compared with the high NRI group ( P <0.001). These associations remained robust in subgroup analyses.
Conclusions
NRI is an independent predictor of 30-day postoperative complications in gastric cancer patients and is a convenient and useful nutritional screening tool for identifying patients with gastric cancer at high risk of postoperative complications.
... In this study, we focused on assessing the prognostic significance of the preoperative PNI in patients with resectable and advanced BTCs. Although many primary studies have reported associations between the PNI and the prognosis of BTC [15], high-level evidence, such as meta-analyses that can be used to systematically review and consolidate the evidence for the prognostic value of the PNI in BTC, is lacking. This work is the first comprehensive meta-analysis to investigate the prognostic value of the preoperative PNI in BTC, offering valuable insights for prognostic prediction in these patients. ...
BACKGROUND
Biliary tract cancer (BTC) is a rare, aggressive malignancy with increasing incidence and poor prognosis. Identifying preoperative prognostic factors is crucial for effective risk-benefit assessments and patient stratification. The prognostic nutritional index (PNI), which reflects immune-inflammatory and nutritional status, has shown prognostic value in various cancers, but its significance in BTC remains unclear.
AIM
To assess the prognostic value of the preoperative PNI in BTC patients, with a focus on overall survival (OS) and disease-free survival (DFS).
METHODS
Comprehensive searches were conducted in the PubMed, EMBASE, and Web of Science databases from inception to April 2024. The primary outcomes of interest focused on the associations between the preoperative PNI and the prognosis of BTC patients, specifically OS and disease-free survival (DFS). Statistical analyses were conducted via STATA 17.0 software.
RESULTS
Seventeen studies encompassing 4645 patients met the inclusion criteria. Meta-analysis revealed that a low PNI was significantly associated with poorer OS [hazard ratio (HR) 1.91, 95%CI: 1.59-2.29; P < 0.001] and DFS (HR 1.93, 95%CI: 1.39-2.67; P < 0.001). Subgroup analyses revealed consistent results across BTC subtypes (cholangiocarcinoma and gallbladder cancer) and stages (resectable and advanced). Sensitivity analyses confirmed the robustness of these findings, and no significant publication bias was detected.
CONCLUSION
This study demonstrated that a low preoperative PNI predicts poor OS and DFS in BTC patients, highlighting its potential as a valuable prognostic tool. Further prospective studies are needed to validate these findings and enhance BTC patient management.
... In fact, PLR, NLR, and LMR are superior inflammatory markers for predicting tumor prognosis than individual markers, such as CRP, WBC, neutrophil, and procalcitonin based on many valuable studies [10,37,38]. Moreover, SIRI, SII, and prognostic nutritional index, which combine inflammation markers, are even more effective [35,39]. In contrast to other inflammatory markers, SIRI integrates neutrophil, lymphocyte, and monocyte counts, reflecting both inflammation and immune status. ...
BACKGROUND
The relationship between preoperative inflammation status and tumorigenesis as well as tumor progression is widely acknowledged.
AIM
To assess the prognostic significance of preoperative inflammatory biomarkers in patients with distal cholangiocarcinoma (dCCA) who underwent pancreatoduodenectomy (PD).
METHODS
This single-center study included 216 patients with dCCA after PD between January 1, 2011, and December 31, 2022. The individuals were categorized into two sets based on their systemic inflammatory response index (SIRI) levels: A low SIRI group (SIRI < 1.5, n = 123) and a high SIRI group (SIRI ≥ 1.5, n = 93). Inflammatory biomarkers were evaluated for predictive accuracy using receiver operating characteristic curves. Both univariate and multivariate Cox proportional hazards analyses were performed to estimate SIRI for overall survival (OS) and recurrence-free survival (RFS).
RESULTS
The study included a total of 216 patients, with 58.3% being male and a mean age of 65.6 ± 9.6 years. 123 patients were in the low SIRI group and 93 were in the high SIRI group after PD for dCCA. SIRI had an area under the curve value of 0.674 for diagnosing dCCA, showing better performance than other inflammatory biomarkers. Multivariate analysis indicated that having a SIRI greater than 1.5 independently increased the risk of dCCA following PD, leading to lower OS [hazard ratios (HR) = 1.868, P = 0.006] and RFS (HR = 0.949, P < 0.001). Additionally, survival analysis indicated a significantly better prognosis for patients in the low SIRI group (P < 0.001).
CONCLUSION
It is determined that a high SIRI before surgery is a significant risk factor for dCCA after PD.
... In fact, PLR, NLR, and LMR are superior inflammatory markers for predicting tumor prognosis than individual markers, such as CRP, WBC, neutrophil, and procalcitonin based on many valuable studies [10,37,38]. Moreover, SIRI, SII, and prognostic nutritional index, which combine inflammation markers, are even more effective [35,39]. In contrast to other inflammatory markers, SIRI integrates neutrophil, lymphocyte, and monocyte counts, reflecting both inflammation and immune status. ...
... Subsequently, 13 studies were included for further screening. Among them, the studies by He (11) and Miyamoto (12) lacked survival outcome information related to the CONUT score. The study by Utsumi did not provide HRs data associated with the CONUT score (13). ...
Background
Biliary tract cancer (BTC) is a malignancy associated with unfavorable outcomes. Advanced BTC patients have a propensity to experience compromised immune and nutritional status as a result of obstructive jaundice and biliary inflammation. Currently, there is a lack of consensus on the impact of the Controlling Nutritional Status (CONUT) score in the context of BTC prognosis. The purpose of this study is to conduct a meta-analysis on the association between CONUT and the prognosis of patients suffering from BTC.
Methods
A defined search strategy was implemented to search the PubMed, Embase, and Web of Science databases for eligible studies published until March 2023, with a focus on overall survival (OS), relapse-free survival/recurrence-free survival(RFS), and relevant clinical characteristics. The prognostic potential of the CONUT score was evaluated using hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs).
Results
In this meta-analysis, a total of 1409 patients from China and Japan were involved in 9 studies. The results indicated that the CONUT score was significantly correlated with worse OS (HR=2.13, 95% CI 1.61-2.82, P<0.0001) and RFS (HR=1.83, 95% CI 1.44–2.31, P<0.0001) in patients with BTC. And, the analysis showed that a high CONUT score was significantly associated with clinical characteristics such as jaundice (OR=1.60, 95% CI=1.14–2.25, P=0.006), poorly differentiated tumor (OR=1.43, 95% CI=1.03–1.99, P=0.03), pT3 and 4 stage of the tumor (OR=1.87, 95% CI=1.30–2.68, P=0.0007), and complications of Clavien-Dindo classification grade IIIa or higher (OR=1.79, 95% CI=1.03–3.12, P=0.04).
Conclusion
This meta-analysis indicates that a high CONUT score can serve as a significant prognostic indicator for survival outcomes among patients diagnosed with BTC.
