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Zhang X, Gu M, Zhu J, Gu R, Yang B, Ji S, Zhao Y, Gu K. Prognostic value of Naples Prognostic Score in locally advanced cervical cancer patients undergoing concurrent chemoradiotherapy. BIOMOLECULES & BIOMEDICINE 2025; 25:986-999. [PMID: 39151098 PMCID: PMC11984364 DOI: 10.17305/bb.2024.10989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Revised: 08/14/2024] [Accepted: 08/14/2024] [Indexed: 08/18/2024]
Abstract
This study aimed to investigate the prognostic value of the Naples Prognostic Score (NPS) in patients with locally advanced cervical cancer (LACC) who received curative concurrent chemoradiotherapy (CCRT). Clinicopathological data from 213 (training set) and 106 (validation set) LACC cases undergoing CCRT were retrospectively analyzed. The receiver operating characteristic curve (ROC) was used to compare the predictive ability of NPS and other indicators for survival. Cox proportional hazard regression was conducted for overall survival (OS) and progression-free survival (PFS). A prediction model using a nomogram was developed with independent prognostic factors in the training set and validated in the validation set. The 5-year OS for the NPS = 1, 2, and 3 groups was 56.8%, 45.4%, and 28.9% (P < 0.001), and the 5-year PFS for the NPS = 1, 2, and 3 groups was 44.9%, 36.7%, and 28.4% (P = 0.001), respectively. NPS showed better predictive ability for OS and PFS compared to other indicators. Multivariate regression analysis identified NPS as an independent prognostic factor for OS (P < 0.001) and PFS (P < 0.001). A predictive nomogram based on NPS was established and validated. The C-indices of the nomogram in the training set were 0.722 for OS and 0.683 for PFS, while in the validation set the C-indices were 0.731 for OS and 0.693 for PFS. This study confirmed that preoperative NPS could serve as a useful independent prognostic factor in LACC patients treated with CCRT.
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Affiliation(s)
- Xiaojun Zhang
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Mengxuan Gu
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jiahao Zhu
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Ruike Gu
- Department of Rehabilitation Medical, Suzhou Rehabilitation Hospital (Suzhou Municipal Hospital Rehabilitation Medical Center), Suzhou, China
| | - Bo Yang
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Shengjun Ji
- Department of Radiotherapy and Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, China
| | - Yutian Zhao
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Ke Gu
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, China
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Zhang Y, Xing W, Liang X, Yang Z, Ma Y, Chen Y, Zhu W. Relationship between nutritional-inflammatory markers and postoperative outcomes in ovarian cancer: a retrospective study. Front Oncol 2025; 15:1531987. [PMID: 40134604 PMCID: PMC11932915 DOI: 10.3389/fonc.2025.1531987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Accepted: 02/10/2025] [Indexed: 03/27/2025] Open
Abstract
Background Elevated inflammatory markers are commonly linked to poor prognoses in cancer patients, while optimal nutritional status correlates with improved survival outcomes. This study aimed to explore the interplay between nutritional and inflammatory markers and their impact on postoperative outcomes in ovarian cancer patients through a retrospective analysis. Methods Data were retrospectively retrieved from patients diagnosed with ovarian cancer who required surgical intervention at the Department of Obstetrics and Gynecology. Overall survival (OS) and cancer-specific survival (CSS) were monitored during follow-up. Kaplan-Meier survival curves were employed to assess OS and CSS across different patient cohorts, evaluating the prognostic significance of nutritional and inflammatory markers. Nomograms for predicting OS and CSS at one, three, and five years postoperatively were constructed, followed by external validation. Results The prognostic nutritional index (PNI) and Naples prognostic score (NPS) exhibited a significant correlation with OS and CSS in postoperative ovarian cancer patients (p < 0.05). Analysis indicated that patients with a PNI > 51.2 demonstrated the most favorable survival outcomes. Furthermore, those with a low-NPS (L-NPS) had notably better survival rates compared to their high-NPS (H-NPS) counterparts. Independent OS predictors included age, PNI, NPS, histological type, tumor size, targeted therapy, and diabetes. Similarly, the CSS prediction model incorporated age, NPS, tumor size, targeted therapy, and diabetes. The nomograms demonstrated robust predictive accuracy for three- and five-year survival, though one-year calibration curves showed limited agreement. Despite slightly reduced external validation performance compared to the initial sample, the model maintained strong predictive capability. Conclusions The nutritional inflammatory index serves as a key independent prognostic marker for OS and CSS in ovarian cancer patients. Nomograms based on PNI and NPS provide valuable prognostic insights for postoperative management. Incorporating these indices into clinical practice could improve patient stratification and guide personalized treatment plans.
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Affiliation(s)
| | | | | | | | | | - Ying Chen
- *Correspondence: Weipei Zhu, ; Ying Chen,
| | - Weipei Zhu
- *Correspondence: Weipei Zhu, ; Ying Chen,
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Tatar S, Kan H, Sahin AT, Sertdemir AL, İcli A, Akilli H. Does the Naples Prognostic Score Predict Long-Term Mortality in Patients with Advanced-Stage Heart Failure? ACTA CARDIOLOGICA SINICA 2025; 41:210-218. [PMID: 40123607 PMCID: PMC11923788 DOI: 10.6515/acs.202503_41(2).20241023a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 10/23/2024] [Indexed: 03/25/2025]
Abstract
Background Inflammation and malnutrition have negative effects on heart failure. The Naples Prognostic Score (NPS) is a new scoring system that incorporates these two parameters. Objectives Our aim was to investigate the relationship between the NPS and long-term mortality in patients with advanced-stage heart failure. Methods The study included 148 patients with advanced-stage heart failure. The patients were divided into two groups: those who died, and those who survived. Demographic, clinical, and laboratory characteristics of the groups were compared. The impact of NPS on mortality was examined. Results The patients were further classified into three groups according to NPS. The patients with NPS 3 had a higher mortality rate compared to those with NPS 1 and NPS 2 (died vs. survived respectively, NPS 3: 75% vs. 25%, NPS 1: 31.1% vs. 68.9%, NPS 2: 48.9% vs. 51.1%, p < 0.001). In multivariate regression analysis, NPS 3 was found to be an independent predictor [odds ratio: 0.13, 95% confidence interval (CI): 0.051-0.333; p = 0.0001]. Receiver operating characteristic analysis revealed that NPS had a sensitivity of 82% and specificity of 53% for mortality, with an area under curve of 0.699 (95% CI: 0.614-0.784, p = 0.0001). Kaplan-Meier survival analysis demonstrated a higher mortality rate in those with a high NPS (long-rank: 5.29, p = 0.021). In patients with advanced-stage heart failure, NPS may be considered a determinant of long-term mortality. Conclusions This study demonstrated an association between NPS and long-term mortality in patients with advanced-stage heart failure. NPS, indicating inflammation and nutritional status, can be utilized as a long-term prognostic indicator in patients with advanced-stage heart failure.
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Affiliation(s)
- Sefa Tatar
- Department of Cardiology, Necmettin Erbakan University, Meram Faculty of Medicine, Meram, Konya, Turkey
| | - Hasan Kan
- Department of Cardiology, Necmettin Erbakan University, Meram Faculty of Medicine, Meram, Konya, Turkey
| | - Ahmet Taha Sahin
- Department of Cardiology, Necmettin Erbakan University, Meram Faculty of Medicine, Meram, Konya, Turkey
| | - Ahmet Lutfu Sertdemir
- Department of Cardiology, Necmettin Erbakan University, Meram Faculty of Medicine, Meram, Konya, Turkey
| | - Abdullah İcli
- Department of Cardiology, Necmettin Erbakan University, Meram Faculty of Medicine, Meram, Konya, Turkey
| | - Hakan Akilli
- Department of Cardiology, Necmettin Erbakan University, Meram Faculty of Medicine, Meram, Konya, Turkey
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Hosoda K, Shimizu A, Kubota K, Notake T, Kitagawa N, Yoshizawa T, Sakai H, Hayashi H, Yasukawa K, Soejima Y. Clinical significance of the Naples prognostic score in predicting short- and long-term postoperative outcomes of patients with hepatocellular carcinoma. World J Surg 2025; 49:502-511. [PMID: 39631788 PMCID: PMC11798678 DOI: 10.1002/wjs.12448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 11/24/2024] [Indexed: 12/07/2024]
Abstract
BACKGROUND The Naples prognostic score (NPS) is a remarkable marker of short- and long-term outcomes in various types of cancer. However, its impact on the postoperative outcomes of hepatocellular carcinoma remains controversial. This study aimed to clarify the impact of the NPS on the prognosis and incidence of postoperative complications in hepatocellular carcinoma. METHODS Patients with hepatocellular carcinoma (n = 374) were categorized into high- and low-Naples prognostic score groups; their postoperative outcomes were compared. Prognostic and risk factors for severe postoperative complications were identified using multivariate analyses. RESULTS The low-Naples prognostic score group had significantly longer overall and recurrence-free survivals than the high-Naples prognostic score group (p = 0.03 and 0.04, respectively). Subgroup analysis revealed a superior predictive value of the NPS in the group with a single tumor (p = 0.03), tumor diameter ≤5 cm (p = 0.04), and tumor stage I or II (p = 0.04). A high NPS was an independent prognostic factor for overall survival (hazard ratio, 1.45; 95% confidence interval (CI), 1.01-2.05; and p = 0.04). The NPS 2-4 group had a higher incidence of the Clavien-Dindo grade ≥ IIIa postoperative complications than the 0-1 group (p = 0.03) and a score of 2-4 was identified as an independent risk factor for the Clavien-Dindo grade ≥ IIIa postoperative complications (odds ratio, 2.06; 95% CI, 1.01-4.20; and p = 0.05). CONCLUSIONS The NPS effectively predicts postoperative outcomes in patients with hepatocellular carcinoma.
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Affiliation(s)
- Kiyotaka Hosoda
- Division of Gastroenterological, Hepato‐Biliary‐Pancreatic, Transplantation, and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Akira Shimizu
- Division of Gastroenterological, Hepato‐Biliary‐Pancreatic, Transplantation, and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Koji Kubota
- Division of Gastroenterological, Hepato‐Biliary‐Pancreatic, Transplantation, and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Tsuyoshi Notake
- Division of Gastroenterological, Hepato‐Biliary‐Pancreatic, Transplantation, and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Noriyuki Kitagawa
- Division of Gastroenterological, Hepato‐Biliary‐Pancreatic, Transplantation, and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Takahiro Yoshizawa
- Division of Gastroenterological, Hepato‐Biliary‐Pancreatic, Transplantation, and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Hiroki Sakai
- Division of Gastroenterological, Hepato‐Biliary‐Pancreatic, Transplantation, and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Hikaru Hayashi
- Division of Gastroenterological, Hepato‐Biliary‐Pancreatic, Transplantation, and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Koya Yasukawa
- Division of Gastroenterological, Hepato‐Biliary‐Pancreatic, Transplantation, and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Yuji Soejima
- Division of Gastroenterological, Hepato‐Biliary‐Pancreatic, Transplantation, and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumotoJapan
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Xu XL, Cheng H. Development of a Prognostic Nomogram Incorporating the Naples Prognostic Score for Postoperative Oral Squamous Cell Carcinoma Patients. J Inflamm Res 2025; 18:325-345. [PMID: 39802503 PMCID: PMC11724622 DOI: 10.2147/jir.s500518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Accepted: 12/31/2024] [Indexed: 01/16/2025] Open
Abstract
Background The Naples prognostic score (NPS) and its relation to the prognosis of oral squamous cell carcinoma (OSCC) have been inconclusive. This study aimed to investigate the correlation between NPS and the prognosis of postoperative OSCC patients. Additionally, the study sought to develop a new nomogram for predicting disease-free survival (DFS) and overall survival (OS). Methods The study included 576 OSCC patients who underwent surgical treatment at two hospitals between August 2008 and June 2018. Univariate and multivariate Cox regression analyses were conducted to identify independent prognostic factors. Subsequently, two nomograms were developed to predict DFS and OS based on these factors and underwent rigorous validation. Results The median DFS and OS were 31.5 months and 36.5 months, respectively. Significant differences in DFS and OS were observed among patients with different NPS scores. Adjuvant radiotherapy, age-adjusted Charlson comorbidity index (ACCI), extranodal extension (ENE), NPS, American Joint Committee on Cancer (AJCC) stage, surgical safety margin, eastern cooperative oncology group performance status (ECOG PS), and systemic inflammation score (SIS) were identified as independent predictors of DFS and OS. In the training cohort, the nomogram's concordance index (C-index) for predicting DFS and OS was 0.701 and 0.693, respectively. In the validation group, the corresponding values were 0.642 and 0.635, respectively. Calibration plots confirmed a high level of agreement between the model's predictions and actual outcomes. Decision curve analysis (DCA) demonstrated the nomogram's good clinical utility. Additionally, patients in the low-risk group did not benefit from adjuvant radiotherapy, while those in the medium-risk and high-risk group could benefit from adjuvant radiotherapy. Conclusion NPS significantly influences the prognosis of OSCC patients following surgery. The nomogram developed in this study holds significant clinical application potential. The low-risk subgroup of patients was not required to undergo postoperative radiotherapy.
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Affiliation(s)
- Xue-Lian Xu
- Department of Radiotherapy Oncology, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453100, People’s Republic of China
| | - Hao Cheng
- Department of Radiotherapy Oncology, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453100, People’s Republic of China
- Department of Radiotherapy Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China
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Liu H, Zhu D, Jiang D, Pang H, Yang X. Prognostic value of the pretreatment Naples prognostic score in patients with colorectal cancer: a systematic review and meta-analysis. Front Oncol 2025; 14:1498854. [PMID: 39839774 PMCID: PMC11746047 DOI: 10.3389/fonc.2024.1498854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Accepted: 12/16/2024] [Indexed: 01/23/2025] Open
Abstract
Background The prognostic significance of the Naples prognostic score (NPS) in colorectal cancer remains uncertain. This study aims to investigate the correlation between the pretreatment NPS and long-term oncological outcomes in patients with colorectal cancer. Methods A comprehensive literature search of electronic databases, including PubMed, Embase, and Web of Science, was conducted up to July 1st, 2024. The primary outcomes assessed were survival outcomes. Subgroup analysis and sensitivity analysis were performed during the pooled analysis. Results Eight studies including 2571 patients were included. The pooled results indicated that patients in the high NPS group exhibited significantly worse overall survival (HR= 2.08 95%CI: 1.74-2.48; P<0.01; I2 = 0%) and disease-free survival (HR=2.03; 95%CI: 1.49-2.77; P<0.01; I2 = 30%). Notably, the prognostic significance of NPS on both overall survival and disease-free survival was consistent across different geographical regions, tumor stages, and primary treatments examined in this study. Furthermore, sensitivity analyses confirmed the robustness of these combined results. Conclusion The pretreatment NPS could serve as a valuable biomarker for predicting long-term oncological outcomes in patients diagnosed with colorectal cancer.
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Affiliation(s)
- Hui Liu
- Department of Gastrointestinal Surgery, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Dailiang Zhu
- Department of Anorectal Surgery, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Dequan Jiang
- Department of Gastrointestinal Surgery, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Huayang Pang
- Department of Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, China
| | - Xiaolian Yang
- Department of Anorectal Surgery, Chongqing University Jiangjin Hospital, Chongqing, China
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Li X, Cheng C, Huo X, Zhao C, Yuan H, Chen G, Yu J, Mu M, Sun X. Clinical significance of the modified Naples prognostic score in patients with stage II-III colon cancer undergoing curative resection: a retrospective study from the real world. Front Oncol 2024; 14:1403666. [PMID: 39351349 PMCID: PMC11439623 DOI: 10.3389/fonc.2024.1403666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 08/27/2024] [Indexed: 10/04/2024] Open
Abstract
Background The Naples prognostic score (NPS) determined by the nutritional and inflammatory condition of an individual is attracting growing attention for predicting postoperative outcomes in a variety of malignancies. The study aimed to assess the clinical significance of a modified NPS (M-NPS) and establish and validate nomograms incorporating M-NPS in curative stage II-III colon cancer patients. Methods We retrospectively analyzed 328 stage II-III colon cancer patients receiving radical surgical resection at our hospital from January 2011 to December 2016. Kaplan-Meier (KM) survival analysis and Cox regression analysis were executed for overall survival (OS) and cancer-specific survival (CSS). Independent predictive indicators were applied to develop nomograms. The model's performance was evaluated using many different methods. Results Of a total of 328 cases, 153 cases were in group 0, 145 in group 1, and 30 in group 2. In terms of OS or CSS, there were obvious differences between groups 0 and 1, and between groups 0 and 2. Age, obstruction, N stage, gross tumor type, and M-NPS group were independent prognostic indicators for OS, while obstruction, gross tumor type, M-NPS group, and N stage were independent predictive parameters for CSS. Furthermore, the training and validation sets were randomly allocated among a cohort of 328 patients. OS and CSS prediction nomograms were developed. In the training and validation cohort, the C-index and ROC analysis showed good discrimination, calibration curves exhibited an excellent level of consistency between model-predicted survival and actual survival outcomes, and DCA curves demonstrated good clinical performance. Conclusion M-NPS is a reliable survival predictor in patients with curative stage II-III colon cancer. Nomograms incorporating M-NPS for OS and CSS have good predictive performance and clinical utility.
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Affiliation(s)
- Xiaopeng Li
- Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Chen Cheng
- Department of Gynecologic Oncology, the Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - Xiongwei Huo
- Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Chenye Zhao
- Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hang Yuan
- Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Gang Chen
- Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Junhui Yu
- Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mingchao Mu
- Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xuejun Sun
- Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Qiu Y, Chen Y, Shen H, Yan S, Li J, Wu W. Naples Prognostic Score: A Novel Predictor of Survival in Patients with Triple-Negative Breast Cancer. J Inflamm Res 2024; 17:5253-5269. [PMID: 39135978 PMCID: PMC11318610 DOI: 10.2147/jir.s472917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 08/02/2024] [Indexed: 08/15/2024] Open
Abstract
Purpose This study investigated the correlation between the Naples prognostic score (NPS), clinicopathological traits, and the postoperative prognoses of patients with triple-negative breast cancer (TNBC). Based on NPS, a predictive nomogram was developed to estimate the long-term survival probabilities of patients with TNBC post-surgery. Patients and Methods We retrospectively examined the clinical records of 223 women with TNBC treated at Ningbo Medical Center, Lihuili Hospital between January 1, 2016 and December 31, 2020. Blood tests and biochemical analyses were conducted before surgery. The prognostic nutritional index (PNI), controlling nutritional status (CONUT), neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and NPS were determined based on blood-related markers. A Kaplan-Meier survival analysis assessed the association between NPS, PNI, CONUT score, overall survival (OS), and breast cancer-specific survival (BCSS). Predictive accuracy was evaluated using the area under the receiver operating characteristic curve (AUC) and C index. The patients were randomly divided into the training and the validation group (6:4 ratio). A nomogram prediction model was developed and evaluated using the R Software for Statistical Computing (RMS) package. Results NPS outperformed other scores in predicting inflammation outcomes. Patients with an elevated NPS had a poorer prognosis (P<0.001). Lymph node ratio (LNR), surgical method, postoperative chemotherapy, and NPS independently predicted OS, whereas M stage, LNR, and NPS independently predicted BCSS outcome. The OS and BCSS predicted by the nomogram model aligned well with the actual OS and BCSS. The decision curve analysis showed significant clinical utility for the nomogram model. Conclusion In this study, NPS was an important prognostic indicator for patients with TNBC. The nomogram prognostic model based on NPS outperformed other prognostic scores for predicting patient prognosis. The model demonstrated a clear stratification ability for patient prognosis, which emphasized the potential benefits of early intervention for high-risk patients.
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Affiliation(s)
- Yu Qiu
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315000, People’s Republic of China
- Health Science Center, Ningbo University, Ningbo, Zhejiang, 315000, People’s Republic of China
| | - Yan Chen
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315000, People’s Republic of China
- Health Science Center, Ningbo University, Ningbo, Zhejiang, 315000, People’s Republic of China
| | - Haoyang Shen
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315000, People’s Republic of China
- Health Science Center, Ningbo University, Ningbo, Zhejiang, 315000, People’s Republic of China
| | - Shuixin Yan
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315000, People’s Republic of China
- Health Science Center, Ningbo University, Ningbo, Zhejiang, 315000, People’s Republic of China
| | - Jiadi Li
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315000, People’s Republic of China
- Health Science Center, Ningbo University, Ningbo, Zhejiang, 315000, People’s Republic of China
| | - Weizhu Wu
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315000, People’s Republic of China
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Du CF, Gao ZY, Xu ZD, Fang ZK, Yu ZC, Shi ZJ, Wang KD, Lu WF, Huang XK, Jin L, Fu TW, Shen GL, Liu JW, Zhang CW, Huang DS, Liang L. Prognostic value of the Naples prognostic score in patients with intrahepatic cholangiocarcinoma after hepatectomy. BMC Cancer 2024; 24:727. [PMID: 38877445 PMCID: PMC11177390 DOI: 10.1186/s12885-024-12502-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/11/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND The Naples Prognostic Score (NPS), integrating inflammatory and nutritional biomarkers, has been reported to be associated with the prognosis of various malignancies, but there is no report on intrahepatic cholangiocarcinoma (ICC). This study aimed to explore the prognostic value of NPS in patients with ICC. METHODS Patients with ICC after hepatectomy were collected, and divided into three groups. The prognosis factors were determined by Cox regression analysis. Predictive efficacy was evaluated by the time-dependent receiver operating characteristic (ROC) curves. RESULTS A total of 174 patients were included (Group 1: 33 (19.0%) patients; Group 2: 83 (47.7%) patients; and Group 3: 58 (33.3%) patients). The baseline characteristics showed the higher the NPS, the higher the proportion of patients with cirrhosis and Child-Pugh B, and more advanced tumors. The Kaplan-Meier curves reflect higher NPS were associated with poor survival. Multivariable analysis showed NPS was an independent risk factor of overall survival (NPS group 2 vs. 1: HR = 1.671, 95% CI: 1.022-3.027, p = 0.009; NPS group 3 vs. 1: HR = 2.208, 95% CI: 1.259-4.780, p = 0.007) and recurrence-free survival (NPS group 2 vs. 1: HR = 1.506, 95% CI: 1.184-3.498, p = 0.010; NPS group 3 vs. 1: HR = 2.141, 95% CI: 2.519-4.087, P = 0.001). The time ROC indicated NPS was superior to other models in predicting prognosis. CONCLUSIONS NPS is a simple and effective tool for predicting the long-term survival of patients with ICC after hepatectomy. Patients with high NPS require close follow-up, and improving NPS may prolong the survival time.
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Affiliation(s)
- Cheng-Fei Du
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
- Department of the Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhen-Yu Gao
- Department of the Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhu-Ding Xu
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China
| | - Zheng-Kang Fang
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Zi-Chen Yu
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Zhe-Jin Shi
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Kai-Di Wang
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Wen-Feng Lu
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China
| | - Xiao-Kun Huang
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Lei Jin
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Tian-Wei Fu
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Guo-Liang Shen
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Jun-Wei Liu
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Cheng-Wu Zhang
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Dong-Sheng Huang
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.
| | - Lei Liang
- Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.
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Guo H, Wang T. Predictive role of Naples prognostic score for survival in esophageal cancer: A meta-analysis. Medicine (Baltimore) 2024; 103:e38160. [PMID: 38787991 PMCID: PMC11124694 DOI: 10.1097/md.0000000000038160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/17/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND To further clarify the predictive value of pretreatment Naples prognostic score (NPS), calculating based on the serum albumin concentration, total cholesterol level, neutrophil to lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR), among esophageal cancer patients based on available evidence. METHODS The PubMed, EMBASE, Web of Science and CNKI databases were searched up to December 1, 2023 for relevant studies. Overall survival (OS), progression-free survival (PFS) and cancer-specific survival (CSS) were endpoints and the hazard ratio (HR) with 95% confidence interval (CI) was combined to evaluate the predictive role of NPS for survival. Subgroup analysis based on pathological type and treatment were further conducted. RESULTS Ten retrospective studies with 2250 cases were included in our analysis. Pooled results demonstrated that higher pretreatment NPS predicted poorer OS (HR = 2.24, 95% CI: 1.57-3.20, P < .001), PFS (HR = 3.03, 95% CI: 1.84-4.98, P < .001) and CSS (HR = 2.90, 95% CI: 1.80-4.68, P < .001). Then subgroup analysis for the OS and PFS stratified by the pathological type (squamous cell carcinoma vs esophageal cancer) and treatment (surgery vs non-surgery) were further conducted, which showed similar results. CONCLUSION Pretreatment NPS is significantly associated with prognosis in esophageal cancer and higher NPS predicts worse survival among patients with esophageal cancer.
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Affiliation(s)
- Hongmei Guo
- Department of Critical Care Medicine/West China School of Nursing, Sichuan University, Chengdu, P.R. China
| | - Ting Wang
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, P.R. China
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, P.R. China
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11
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Guo XW, Ji L, Xi XX, Zhao WW, Liu YC, Zhou SB, Ji SJ. Predictive potential of preoperative Naples prognostic score-based nomogram model for the prognosis in surgical resected thoracic esophageal squamous cell carcinoma patients: A retrospective cohort study. Medicine (Baltimore) 2024; 103:e38038. [PMID: 38701277 PMCID: PMC11062709 DOI: 10.1097/md.0000000000038038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/05/2024] [Indexed: 05/05/2024] Open
Abstract
The present study aimed to establish an effective prognostic nomogram model based on the Naples prognostic score (NPS) for resectable thoracic esophageal squamous cell carcinoma (ESCC). A total of 277 patients with ESCC, who underwent standard curative esophagectomy and designated as study cohort, were retrospectively analyzed. The patients were divided into different groups, including NPS 0, NPS 1, NPS 2, and NPS 3 or 4 groups, for further analysis, and the results were validated in an external cohort of 122 ESCC patients, who underwent surgery at another cancer center. In our multivariate analysis of the study cohort showed that the tumor-node-metastasis (TNM) stage, systemic inflammation score, and NPS were the independent prognostic factors for the overall survival (OS) and progression-free survival (PFS) durations. In addition, the differential grade was also an independent prognostic factor for the OS in the patients with ESCC after surgery (all P < .05). The area under the curve of receiver operator characteristics for the PFS and OS prediction with systemic inflammation score and NPS were 0.735 (95% confidence interval [CI] 0.676-0.795, P < .001) and 0.835 (95% CI 0.786-0.884, P < .001), and 0.734 (95% CI 0.675-0.793, P < .001) and 0.851 (95% CI 0.805-0.896, P < .001), respectively. The above independent predictors for OS or PFS were all selected in the nomogram model. The concordance indices (C-indices) of the nomogram models for predicting OS and PFS were 0.718 (95% CI 0.681-0.755) and 0.669 (95% CI 0.633-0.705), respectively, which were higher than that of the 7th edition of American Joint Committee on Cancer TNM staging system [C-index 0.598 (95% CI 0.558-0.638) for OS and 0.586 (95% CI 0.546-0.626) for PFS]. The calibration curves for predicting the 5-year OS or PFS showed a good agreement between the prediction by nomogram and actual observation. In the external validation cohort, the nomogram discrimination for OS was better than that of the 7th edition of TNM staging systems [C-index: 0.697 (95% CI 0.639-0.755) vs 0.644 (95% CI 0.589-0.699)]. The calibration curves showed good consistency in predicting the 5-year survival between the actual observation and nomogram predictions. The decision curve also showed a higher potential of the clinical application of predicting the 5-years OS of the proposed nomogram model as compared to that of the 7th edition of TNM staging systems. The preoperative NPS-based nomogram model had a certain potential role for predicting the prognosis of ESCC patients.
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Affiliation(s)
- Xin-Wei Guo
- Department of Radiation Oncology, Affiliated Taixing People’s Hospital of Nanjing Medical University, Kangda College, Taixing, People’s Republic of China
| | - Lei Ji
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
| | - Xiao-Xiang Xi
- Department of Thoracic Surgery, Affiliated Taixing People’s Hospital of Nanjing Medical University, Kangda College, Taixing, People’s Republic of China
| | - Wei-Wei Zhao
- Department of Radiation Oncology, Affiliated Taixing People’s Hospital of Nanjing Medical University, Kangda College, Taixing, People’s Republic of China
| | - Yang-Chen Liu
- Department of Radiation Oncology, Affiliated Taixing People’s Hospital of Nanjing Medical University, Kangda College, Taixing, People’s Republic of China
| | - Shao-Bing Zhou
- Department of Radiation Oncology, Affiliated Taixing People’s Hospital of Nanjing Medical University, Kangda College, Taixing, People’s Republic of China
| | - Sheng-Jun Ji
- Department of Radiotherapy and Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, People’s Republic of China
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12
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Qian D, Shen P, Zhu J, Ji S, Kong Y. Association of preoperative muscle-adipose index measured by computed tomography with survival in patients with esophageal squamous cell carcinoma. World J Surg Oncol 2024; 22:61. [PMID: 38383431 PMCID: PMC10882774 DOI: 10.1186/s12957-024-03338-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/14/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Conventional nutritional metrics are closely associated with the prognosis of patients with radically resected esophageal squamous cell carcinoma (ESCC). Nevertheless, the prognostic implications of muscle and adipose tissue composite indexes in ESCC remain unknown. METHODS We retrospectively analyzed clinicopathological data of 304 patients who underwent resected ESCC. To obtain measurements of the muscle and adipose indexes, preoperative computed tomography (CT) images were used to quantify skeletal-muscle adipose tissue. The diagnostic threshold for muscle-adipose imbalance was determined using X-tile software and used to analyze the association between the muscle-adipose index (MAI) and survival. Instantaneous risk of recurrence was assessed using a hazard function. We constructed a nomogram based on the MAI and other clinical characteristics and established a novel predictive model with independent prognostic factors. The prognostic capabilities of these nomograms were evaluated using calibration curves, receiver operating characteristic (ROC) curves, and decision-curve analysis (DCA). RESULTS The overall survival (OS) and disease-free survival (DFS) rates in the muscle-adipose-balanced group were significantly better than those in the muscle-adipose-imbalanced group. Multivariate analyses revealed that the MAI, prognostic nutritional index (PNI), tumor stage, and tumor differentiation were independent prognostic factors for OS and DFS in patients with resected ESCC (P < 0.05). The nuclear density curve indicated a lower risk of recurrence for patients in the muscle-adipose-balanced group than that for their imbalanced counterparts. Conversely, the nuclear density curve for PNI was confounded. Postoperative radiotherapy- (RT) benefit analysis demonstrated that patients with ESCC in the muscle-adipose-balanced group could benefit from adjuvant RT. CONCLUSION This study confirmed that preoperative MAI could serve as a useful independent prognostic factor in patients with resected ESCC. A nomogram based on the MAI and other clinical characteristics could provide individualized survival prediction for patients receiving radical resection. Timely and appropriate nutritional supplements may improve treatment efficacy.
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Affiliation(s)
- Danqi Qian
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, 214000, People's Republic of China
| | - Peipei Shen
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, 214000, People's Republic of China
| | - Jiahao Zhu
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, 214000, People's Republic of China
| | - Shengjun Ji
- Department of Radiotherapy and Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, 215000, People's Republic of China.
| | - Yan Kong
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, 214000, People's Republic of China.
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13
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Xu B, Zhu J, Wang R, Pang X, Wang X, Lian J, Lu H. Clinical Implications of Naples Prognostic Score for Patients with Resected Cholangiocarcinoma: A Real-World Experience. J Inflamm Res 2024; 17:655-667. [PMID: 38328562 PMCID: PMC10849881 DOI: 10.2147/jir.s446735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024] Open
Abstract
Purpose The Nutritional Prognostic Score (NPS) is a composite indicator that effectively reflects the preoperative nutritional and inflammation status of patients. Its prognostic value has been extensively confirmed in various types of tumors. Our study aims to investigate the clinical implications of the NPS in the postoperative patients with cholangiocarcinoma (CCA). Patients and Methods Data on clinicopathological characteristics were collected from CCA patients who underwent radical surgery between 2014 and 2019 at Harbin Medical University Cancer Hospital. NPS was calculated using relevant indicators to categorize the patients, and association of NPS with clinicopathological characteristics and survival outcomes were analyzed. To assess differences in survival rates between different groups, we utilized the Kaplan-Meier method. Independent prognostic risk factors were identified by Cox regression analysis. A CONomogram was created, and its accuracy in survival prediction was evaluated using receiver operating characteristic (ROC) curves. Independent verification was conducted in the validation group. Results For this study, a cohort of 232 patients was enlisted and subsequently divided into training group (N=162) and validation group (N=70). An evident correlation was detected between NPS and preoperative malnutrition. Patients with higher NPS exhibited a worse overall survival (OS), with 5-year OS rates of 79.1%, 33.1%, and 10.6%. Multivariate analysis revealed that NPS was an independent risk factor for OS in resected CCA patients (P<0.001). The NPS-based Nomogram was developed to accurately assess the risk of patients. Conclusion The NPS was identified as a significant risk factor that impacts the prognosis of patients with resected CCA. In order to improve prognosis management, the NPS-based Nomogram has been demonstrated to be a precise and efficient tool.
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Affiliation(s)
- Benjie Xu
- Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of China
| | - Jiahao Zhu
- Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of China
| | - Ren Wang
- Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of China
| | - Xiangyi Pang
- Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of China
| | - Xin Wang
- Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of China
| | - Jie Lian
- Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of China
| | - Haibo Lu
- Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of China
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14
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Saygi M, Tanalp AC, Tezen O, Pay L, Dogan R, Uzman O, Karabay CY, Tanboga IH, Kacar FO, Karagoz A. The prognostic importance of the Naples prognostic score for in-hospital mortality in patients with ST-segment elevation myocardial infarction. Coron Artery Dis 2024; 35:31-37. [PMID: 37990558 DOI: 10.1097/mca.0000000000001285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
BACKGROUND The Naples prognostic score (NPS) is an effective inflammatory and nutritional scoring system widely applied as a prognostic factor in various cancers. However, the prognostic significance of NPS is unknown in ST-segment elevation myocardial infarction (STEMI). We aimed to analyze the prognostic value of the NPS in-hospital mortality in patients with STEMI. METHODS The study consisted of 3828 patients diagnosed with STEMI who underwent primer percutaneous coronary intervention. As the primary outcome, in-hospital mortality was defined as all-cause deaths during hospitalization. The included patients were categorized into three groups based on NPS (group 1:NPS = 0,1,2; group 2:NPS = 3; group 3:NPS = 4). RESULTS Increased NPS was associated with higher in-hospital mortality rates( P < 0.001). In the multivariable logistic regression analysis, the relationship between NPS and in-hospital mortality continued after adjustment for age, male sex, diabetes, hypertension, Killip score, SBP, heart rate, left ventricular ejection fraction, myocardial infarction type and postprocedural no-reflow. A strong positive association was found between in-hospital mortality and NPS by multivariable logistic regression analysis [NPS 0-1-2 as a reference, OR = 1.73 (95% CI, 1.04-2.90) for NPS 3, OR = 2.83 (95% CI, 1.76-4.54) for NPS 4]. CONCLUSION The present study demonstrates that the NPS could independently predict in-hospital mortality in STEMI. Prospective studies will be necessary to confirm the performance, clinical applicability and practicality of the NPS for in-hospital mortality in STEMI.
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Affiliation(s)
- Mehmet Saygi
- Department of Cardiology, Hisar Intercontinental Hospital, Istanbul
| | | | - Ozan Tezen
- Department of Cardiology, Dr. Siyami Ersek Thoracic And Cardiovascular Surgery Education Research Hospital, Istanbul
| | - Levent Pay
- Department of Cardiology, Ardahan Public Hospital, Ardahan
| | - Remziye Dogan
- Department of Cardiology, Hisar Intercontinental Hospital, Istanbul
| | - Osman Uzman
- Department of Cardiology, Dr. Siyami Ersek Thoracic And Cardiovascular Surgery Education Research Hospital, Istanbul
| | - Can Yucel Karabay
- Department of Cardiology, Dr. Siyami Ersek Thoracic And Cardiovascular Surgery Education Research Hospital, Istanbul
| | - Ibrahim Halil Tanboga
- Department of Biostatistics and Cardiology, Nisantasi University Medical School, Istanbul
| | - Flora Ozkalayci Kacar
- Department of Biostatistics and Cardiology, Nisantasi University Medical School, Istanbul
| | - Ali Karagoz
- Department of Cardiology, Kosuyolu Education Research Hospital, Istanbul, Turkey
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15
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Elia S, Patirelis A, Hardavella G, Santone A, Carlea F, Pompeo E. The Naples Prognostic Score Is a Useful Tool to Assess Surgical Treatment in Non-Small Cell Lung Cancer. Diagnostics (Basel) 2023; 13:3641. [PMID: 38132225 PMCID: PMC10742842 DOI: 10.3390/diagnostics13243641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Different prognostic scores have been applied to identify patients with non-small cell lung cancer who have a higher probability of poor outcomes. In this study, we evaluated whether the Naples Prognostic Score, a novel index that considers both inflammatory and nutritional values, was associated with long-term survival. This study presents a retrospective propensity score matching analysis of patients who underwent curative surgery for non-small cell lung cancer from January 2016 to December 2021. The score considered the following four pre-operative parameters: the neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, serum albumin, and total cholesterol. The Kaplan-Meier method and Cox regression analysis were performed to evaluate the relationship between the score and disease-free survival, overall survival, and cancer-related survival. A total of 260 patients were selected for the study, though this was reduced to 154 after propensity score matching. Post-propensity Kaplan-Meier analysis showed a significant correlation between the Naples Prognostic Score, overall survival (p = 0.018), and cancer-related survival (p = 0.007). Multivariate Cox regression analysis further validated the score as an independent prognostic indicator for both types of survival (p = 0.007 and p = 0.010, respectively). The Naples Prognostic Score proved to be an easily achievable prognostic factor of long-term survival in patients with non-small cell lung cancer after surgical treatment.
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Affiliation(s)
- Stefano Elia
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy;
- Thoracic Surgery Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.P.); (E.P.)
| | - Alexandro Patirelis
- Thoracic Surgery Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.P.); (E.P.)
| | - Georgia Hardavella
- 9th Department of Respiratory Medicine, Athens Chest Diseases Hospital Sotiria, 11527 Athens, Greece;
| | - Antonella Santone
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy;
| | - Federica Carlea
- Thoracic Surgery Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.P.); (E.P.)
| | - Eugenio Pompeo
- Thoracic Surgery Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.P.); (E.P.)
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16
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Xiu Y, Jiang C, Huang Q, Yu X, Qiao K, Wu D, Yang X, Zhang S, Lu X, Huang Y. Naples score: a novel prognostic biomarker for breast cancer patients undergoing neoadjuvant chemotherapy. J Cancer Res Clin Oncol 2023; 149:16097-16110. [PMID: 37698677 DOI: 10.1007/s00432-023-05366-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/28/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND AND PURPOSE The Naples Score (NPS) is a novel prognostic indicator that has been used in various cancers, but its potential in breast malignant tumor patients receiving neoadjuvant chemotherapy (NAC) has not been discovered. This study aimed to investigate the relationship between NPS and overall survival (OS) and disease-free survival (DFS) in breast cancer patients. METHODS A total of 217 breast cancer patients undergoing NAC were incorporated into this retrospectively research. K-M survival curves and log-rank tests are used to determine OS and DFS. Cox regression model was used to evaluate the relationship between NPS and OS and DFS. Nomogram was developed based on the results of multivariate Cox regression analysis. Prognostic models were internally validated using bootstrapping and the consistency index (C-index). RESULTS Age group was correlated with NPS (p < 0.05). Low and moderate Naples risk patients had higher 5-year OS and DFS rates than high risk Naples patients (93.8% vs. 75.4% vs. 60.0%; X2 = 9.2, P = 0.01; 82.4% vs 64.5% vs 43.7%; X2 = 7.4, P = 0.024; respectively). The nomogram based on demonstrated good performance in predicting OS and DFS (AUC = 0.728, 0.630; respectively). CONCLUSIONS In breast cancer patients who have undergone NAC, NPS is a novel prognostic indicator. NPS combined with clinicopathological features showed good predictive ability, and its performance was better than that of traditional pathological TNM staging.
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Affiliation(s)
- Yuting Xiu
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, 150086, China
| | - Cong Jiang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, 150086, China
| | - Qinghua Huang
- Department of Breast Surgery, Wuzhou Red Cross Hospital, Wuzhou, 543000, China
| | - Xiao Yu
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, 150086, China
| | - Kun Qiao
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, 150086, China
| | - Danping Wu
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, 150086, China
| | - Xiaotian Yang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, 150086, China
| | - Shiyuan Zhang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, 150086, China
| | - Xiangshi Lu
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, 150086, China.
| | - Yuanxi Huang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, 150086, China.
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17
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Erdogan A, Genc O, Ozkan E, Goksu MM, Ibisoglu E, Bilen MN, Guler A, Karagoz A. Impact of Naples Prognostic Score at Admission on In-Hospital and Follow-Up Outcomes Among Patients with ST-Segment Elevation Myocardial Infarction. Angiology 2023; 74:970-980. [PMID: 36625023 DOI: 10.1177/00033197231151559] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The Naples prognostic score (NPS) consists of cholesterol level, albumin concentration, lymphocyte-to-monocyte and neutrophil-to-lymphocyte ratios and reflects systemic inflammation, malnutrition, and survival for various conditions. We investigated the relationship of NPS at admission with in-hospital and follow-up outcomes among ST-segment elevation myocardial infarction (STEMI) patients. This retrospective study included 1887 consecutive patients diagnosed with STEMI and who underwent primary percutaneous coronary intervention between March 2020 and May 2022. The study population was divided by NPS into 2; low (0-1-2) and high (3-4). In-hospital adverse events and all-cause mortality rates during follow-up were extracted from the registry. The Median follow-up time was 15 months. The overall mortality rate was 14.6%. The proportions of in-hospital events that included acute respiratory failure, acute kidney injury, malignant arrhythmia, and mortality were significantly higher in the high NPS group than in the low NPS group. Compared with the baseline model, in the full model of Cox regression analysis; NPS was an independent predictor of all-cause mortality (adjusted hazard ratio (aHR): 2.49, 95%CI, 1.75-3.50, P < .001), with a significant improvement in model performance (likelihood ratio χ2, P < .001) and better calibration. In conclusion, we found an association between NPS and in-hospital and follow-up outcomes in STEMI patients.
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Affiliation(s)
- Aslan Erdogan
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Omer Genc
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Eyüp Ozkan
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Muhammed M Goksu
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Ersin Ibisoglu
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Mehmet N Bilen
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Ahmet Guler
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Clinic of Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
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18
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Demir M, Demircan NC. The Naples prognostic score in esophagus cancer: Prognostic and beyond. Bull Cancer 2023; 110:1027-1040. [PMID: 37516650 DOI: 10.1016/j.bulcan.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/20/2023] [Accepted: 06/07/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVES The role of inflammation in tumor biology has been better understood over time. The utility of the Naples prognostic score (NPS), which is a novel inflammation-based marker, was shown in esophageal carcinoma (EC) patients treated with surgery. We herein presented the prognostic and predictive value of NPS in EC patients treated with upfront chemoradiotherapy (CRT). METHODS Adult EC patients with squamous cell carcinoma or adenocarcinoma were included. Median survival was compared by log-rank test. Cox regression analyses were performed to establish the independent prognostic effect of NPS. RESULTS Of 153 patients, 97 (63.4%) and 56 (36.6%) patients were treated with CRT alone and CRT followed by surgery, respectively. The median overall survival (OS) was significantly different among the Naples prognostic groups (NPG) (60+ months [CI 95%: NA], 27 months [CI 95%: 16.8-37.5], and 18.5 months [CI 95%: 15.3-30.7] for NPG 0,1, and 2, respectively; P=0.007). Surgery following CRT provided survival benefit in NPG 1 (65+ months with surgery vs. 17.3 months without surgery, P<0.001) and in NPG 2 (33 months with surgery vs. 15 months without surgery, P=0.009). Multivariate Cox regression analysis showed that the NPS is an independent prognostic marker for OS (HR is 1.28 for OS [CI 95%: 1.03-1.59], P=0.02). CONCLUSION NPS might be useful as a prognostic marker in also EC patients treated with upfront CRT. Patients with high NPS may have a high risk of recurrence. Surgery might be planned in EC at the diagnosis in NPG 1 and 2.
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Affiliation(s)
- Metin Demir
- Erzurum Regional Training and Research Hospital, Department of Medical Oncology, 25100 Erzurum, Turkey.
| | - Nazım Can Demircan
- Erzurum Regional Training and Research Hospital, Department of Medical Oncology, 25100 Erzurum, Turkey.
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Gradel KO. Interpretations of the Role of Plasma Albumin in Prognostic Indices: A Literature Review. J Clin Med 2023; 12:6132. [PMID: 37834777 PMCID: PMC10573484 DOI: 10.3390/jcm12196132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
This review assesses how publications interpret factors that influence the serum or plasma albumin (PA) level in prognostic indices, focusing on inflammation and nutrition. On PubMed, a search for "albumin AND prognosis" yielded 23,919 results. From these records, prognostic indices were retrieved, and their names were used as search strings on PubMed. Indices found in 10 or more original research articles were included. The same search strings, restricted to "Review" or "Systematic review", retrieved yielded on the indices. The data comprised the 10 latest original research articles and up to 10 of the latest reviews. Thirty indices had 294 original research articles (6 covering two indices) and 131 reviews, most of which were from recent years. A total of 106 articles related the PA level to inflammation, and 136 related the PA level to nutrition. For the reviews, the equivalent numbers were 54 and 65. In conclusion, more publications mention the PA level as a marker of nutrition rather than inflammation. This is in contrast to several general reviews on albumin and nutritional guidelines, which state that the PA level is a marker of inflammation but not nutrition. Hypoalbuminemia should prompt clinicians to focus on the inflammatory aspects in their patients.
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Affiliation(s)
- Kim Oren Gradel
- Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense, Denmark; ; Tel.: +45-21-15-80-85
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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Xie YM, Lu W, Cheng J, Dai M, Liu SY, Wang DD, Fu TW, Ye TW, Liu JW, Zhang CW, Huang DS, Liang L. Naples Prognostic Score is an Independent Prognostic Factor in Patients Undergoing Hepatectomy for Hepatocellular Carcinoma. J Hepatocell Carcinoma 2023; 10:1423-1433. [PMID: 37691971 PMCID: PMC10488664 DOI: 10.2147/jhc.s414789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023] Open
Abstract
Background Nutritional and inflammatory status has been reported to be associated with the prognosis of hepatocellular carcinoma (HCC), but many studies did not include all biomarkers simultaneously. The present study aimed to determine the impact of Naples prognostic score (NPS) on the long-term survival in patients undergoing hepatectomy for HCC. Methods Patients with HCC after curative resection were eligible. Then, all patients were stratified into three groups according to the NPS. Clinical features and survival outcomes were compared among the three groups. Independent prognostic factors were determined by COX analysis. The time dependent receiver operating characteristic (ROC) curves were used to compare prognostic performance with other immunonutrition scoring systems. Results A total of 476 patients were enrolled eventually. Baseline characteristics showed that patients with higher NPS had a higher proportion of poor liver function and advanced tumor features. Accordingly, Kaplan-Meier survival curves showed that patients with higher NPS had a lower rate of overall survival (OS) and recurrence-free survival (RFS). Multivariable COX analysis demonstrated that NPS was an independent risk factor of OS (NPS group 2 vs 1: HR=1.958, 95% CI: 1.038-3.369, p = 0.038; NPS group 3 vs 1: HR=2.608, 95% CI: 1.358-5.008, p=0.004, respectively) and RFS (NPS group 2 vs 1: HR=2.014, 95% CI: 1.299-2-3.124, p=0.002; NPS group 3 vs 1: HR=2.002, 95% CI: 1.262-3.175, p=0.003, respectively). The time-dependent ROC curve showed that NPS was superior to other models in prognostic performance and discriminatory power for long-term survival (median AUC 0.675, 95% CI: 0.586-0.712, P < 0.05). Conclusion The NPS is a simple tool strongly associated with long-term survival in patients undergoing curative hepatectomy for HCC.
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Affiliation(s)
- Ya-Ming Xie
- Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China
| | - Wenfeng Lu
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, People’s Republic of China
| | - Jian Cheng
- Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China
| | - Mugen Dai
- Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, People’s Republic of China
| | - Si-Yu Liu
- Department of Laboratory Medicine, The Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang Province, Zhejiang University Lishui Hospital, Lishui, Zhejiang, People’s Republic of China
| | - Dong-Dong Wang
- Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China
| | - Tian-Wei Fu
- Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China
| | - Tai-Wei Ye
- Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China
| | - Jun-Wei Liu
- Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China
| | - Cheng-Wu Zhang
- Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China
| | - Dong-Sheng Huang
- Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China
| | - Lei Liang
- Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China
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Chen F, Xie C, Ren K, Xu X. Prognostic Value of the Naples Prognostic Score in Patients with Gastrointestinal Cancers: A Meta-Analysis. Nutr Cancer 2023:1-11. [PMID: 37177915 DOI: 10.1080/01635581.2023.2212426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This meta-analysis was conducted to systematically evaluate the prognostic role of the Naples prognostic score (NPS) in patients with gastrointestinal (GI) cancers. A comprehensive literature search of several major databases was performed for studies published until October 16, 2022. Hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted and pooled by fixed-effects or random-effects models to analyze the associations between the NPS and overall survival (OS), cancer-specific survival (CSS), and recurrence-free/disease-free survival (RFS/DFS) in GI cancers. Thirteen studies were included in the meta-analysis. Pooled results indicated that a high NPS predicted poor OS (HR = 2.28, 95% CI: 1.90-2.74, p < 0.001), CSS (HR = 2.77, 95% CI: 2.10-3.66, p < 0.001), and RFS/DFS (HR = 2.77, 95% CI: 2.26-3.40, p < 0.001). For OS-related and RFS/DFS-related studies, subgroup analyses showed that a high NPS was significantly associated with poor OS and RFS/DFS irrespective of NPS group, calculation of the NPS, and tumor type. In the study that focused on CSS, subgroup analyses by NPS group and calculation of the NPS revealed similar results. The NPS may represent an effective prognostic indicator in patients with GI cancers.
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Affiliation(s)
- Fengmei Chen
- Department of Clinical Medicine, Suzhou Vocational Health College, Suzhou, Jiangsu, China
| | - Chen Xie
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Kai Ren
- Department of Nursing, Suzhou Vocational Health College, Suzhou, Jiangsu, China
| | - Xiaomin Xu
- Department of Clinical Medicine, Suzhou Vocational Health College, Suzhou, Jiangsu, China
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Zhang Y, Wang LJ, Li QY, Yuan Z, Zhang DC, Xu H, Yang L, Gu XH, Xu ZK. Prognostic value of preoperative immune-nutritional scoring systems in remnant gastric cancer patients undergoing surgery. World J Gastrointest Surg 2023; 15:211-221. [PMID: 36896300 PMCID: PMC9988643 DOI: 10.4240/wjgs.v15.i2.211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 12/14/2022] [Accepted: 01/01/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Remnant gastric cancer (GC) is defined as GC that occurs five years or more after gastrectomy. Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic impact on postoperative remnant gastric cancer (RGC) patients are crucial. A simple scoring system that combines multiple immune or nutritional indicators to identify nutritional or immune status before surgery is necessary.
AIM To evaluate the value of preoperative immune-nutritional scoring systems in predicting the prognosis of patients with RGC.
METHODS The clinical data of 54 patients with RGC were collected and analyzed retrospectively. Prognostic nutritional index (PNI), controlled nutritional status (CONUT), and Naples prognostic score (NPS) were calculated by preoperative blood indicators, including absolute lymphocyte count, lymphocyte to monocyte ratio, neutrophil to lymphocyte ratio, serum albumin, and serum total cholesterol. Patients with RGC were divided into groups according to the immune-nutritional risk. The relationship between the three preoperative immune-nutritional scores and clinical characteristics was analyzed. Cox regression and Kaplan–Meier analysis was performed to analyze the difference in overall survival (OS) rate between various immune-nutritional score groups.
RESULTS The median age of this cohort was 70.5 years (ranging from 39 to 87 years). No significant correlation was found between most pathological features and immune-nutritional status (P > 0.05). Patients with a PNI score < 45, CONUT score or NPS score ≥ 3 were considered to be at high immune-nutritional risk. The areas under the receiver operating characteristic curves of PNI, CONUT, and NPS systems for predicting postoperative survival were 0.611 [95% confidence interval (CI): 0.460–0.763; P = 0.161], 0.635 (95%CI: 0.485–0.784; P = 0.090), and 0.707 (95%CI: 0.566–0.848; P = 0.009), respectively. Cox regression analysis showed that the three immune-nutritional scoring systems were significantly correlated with OS (PNI: P = 0.002; CONUT: P = 0.039; NPS: P < 0.001). Survival analysis revealed a significant difference in OS between different immune-nutritional groups (PNI: 75 mo vs 42 mo, P = 0.001; CONUT: 69 mo vs 48 mo, P = 0.033; NPS: 77 mo vs 40 mo, P < 0.001).
CONCLUSION These preoperative immune-nutritional scores are reliable multidimensional prognostic scoring systems for predicting the prognosis of patients with RGC, in which the NPS system has relatively effective predictive performance.
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Affiliation(s)
- Yan Zhang
- Department of Gastrointestinal Surgery, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, Suzhou 215000, Jiangsu Province, China
| | - Lin-Jun Wang
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
| | - Qin-Ya Li
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
| | - Zhen Yuan
- Department of Gastrointestinal Surgery, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, Suzhou 215000, Jiangsu Province, China
| | - Dian-Cai Zhang
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
| | - Hao Xu
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
| | - Li Yang
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
| | - Xin-Hua Gu
- Department of Gastrointestinal Surgery, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, Suzhou 215000, Jiangsu Province, China
| | - Ze-Kuan Xu
- Department of General Surgery, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu Province, China
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Zou Z, Li J, Ji X, Wang T, Chen Q, Liu Z, Ji S. Naples Prognostic Score as an Independent Predictor of Survival Outcomes for Resected Locally Advanced Non-Small Cell Lung Cancer Patients After Neoadjuvant Treatment. J Inflamm Res 2023; 16:793-807. [PMID: 36860794 PMCID: PMC9969868 DOI: 10.2147/jir.s401446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Background The Naples Prognostic Score (NPS) can reflect patient's nutritional and inflammatory status, which is identified as a prognostic indicator for various malignant tumors. However, its significance in patients with resected locally advanced non-small cell lung cancer (LA-NSCLC) patients who receive neoadjuvant treatment remains unclear so far. Methods A total of 165 LA-NSCLC patients surgically treated from May 2012 to November 2017 were retrospectively investigated. The LA-NSCLC patients were divided into three groups according to NPS scores. The receiver operating curve (ROC) analysis was performed to reveal the discriminatory ability of NPS and other indicators for predicting the survival. The NPS and clinicopathological variables were further evaluated the prognostic value by univariate and multivariate Cox analysis. Results The NPS was related to age (P = 0.046), smoking history (P = 0.004), Eastern Cooperative Oncology Group (ECOG) score (P = 0.005), and adjuvant treatment (P = 0.017). Patients with high NPS scores had worse overall survival (OS) (group 1 vs 0, P = 0.006; group 2 vs 0, P < 0.001) and disease-free survival (DFS) (group 1 vs 0, P < 0.001; group 2 vs 0, P < 0.001). The ROC analysis demonstrated that NPS had better predictive ability than other prognostic indicators. Multivariate analysis revealed that NPS was independent prognostic indicator of OS (group 1 vs 0, hazard ratio [HR] =2.591, P = 0.023; group 2 vs 0, HR = 8.744, P = 0.001) and DFS (group 1 vs 0, HR =3.754, P < 0.001; group 2 vs 0, HR = 9.673, P < 0.001). Conclusion The NPS could be an independent prognostic indicator in patients with resected LA-NSCLC receiving neoadjuvant treatment and more reliable than the other nutritional and inflammatory indicators.
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Affiliation(s)
- Zhonghua Zou
- Department of Radiotherapy & Oncology, the Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, People’s Republic of China
| | - Jinping Li
- Department of Gastroenterology, Fangzi People’s Hospital, Weifang, People’s Republic of China
| | - Xiang Ji
- Department of Gastroenterology, Fangzi People’s Hospital, Weifang, People’s Republic of China
| | - Tingxing Wang
- Department of Radiotherapy & Oncology, the Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, People’s Republic of China
| | - Qingqing Chen
- Department of Radiotherapy & Oncology, the Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, People’s Republic of China
| | - Zhengcao Liu
- Department of Radiotherapy & Oncology, the Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, People’s Republic of China
| | - Shengjun Ji
- Department of Radiotherapy & Oncology, the Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, People’s Republic of China,Correspondence: Shengjun Ji, Department of Radiotherapy & Oncology, the affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, No. 16 Baita Road, Suzhou, 215001, People’s Republic of China, Email
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Teke K, Erkut Avci I, Burak Cinar N, Abdullah Baynal E, Bosnali E, Polat S, Yilmaz H, Kara O, Dillioglugil O. El estado inmunológico-inflamatorio-nutricional predice los resultados oncológicos tras la cistectomía radical por carcinoma urotelial de vejiga. Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Hu H, Zhang J, Yan H, Qin C, Guo H, Liu T, Tang S, Zhou H. Development and validation of a novel prognostic model for patients with surgically resected esophageal squamous cell carcinoma. Front Oncol 2022; 12:955353. [PMID: 36059713 PMCID: PMC9435602 DOI: 10.3389/fonc.2022.955353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/18/2022] [Indexed: 01/17/2023] Open
Abstract
Background and objectives Esophageal squamous cell carcinoma (ESCC) is the most common pathological type of esophageal malignancy in most regions of the world. The study aimed to identify risk factors and develop a predictive model for ESCC following surgical resection. Patients and methods A total of 533 ESCC patients who underwent surgical resection from Suining Central Hospital were enrolled in the study. Cox proportional hazards regression and Least Absolute Shrinkage and Selection Operator (LASSO) regression were performed to identify significant prognostic factors. A prognostic model was constructed, and the receiver operating characteristic (ROC) curve, concordance index (C-index), and decision cure analysis (DCA) were used to evaluate the discrimination and calibration of the prognostic model. Subsequently, we built a nomogram for overall survival (OS) incorporating the prognostic factors, and a calibration plot was employed to assess the consistency between the predicted survival and the observed survival. Based on the model risk score, we split the patients into two subgroups, low-risk and high-risk, and we analyzed the survival time of these two groups using Kaplan–Meier (K-M) survival plots. Results Five independent prognosis factors were identified as independent risk factors for OS in ESCC patients who underwent surgical resection. The C-index, ROC curve, and DCA showed that the prognostic model had good predictive accuracy and discriminatory power in the training cohort and validation cohort than other clinical features. A nomogram consisting of prognosis factors showed some superior net benefit. K-M survival plots showed significant differences in OS between the low-risk and high-risk groups. Similar results were observed in the subgroup analysis based on age, grade, and stage. Univariate and multivariate Cox regression analyses revealed that both risk score and risk group are independent prognostic factors in the patient cohort. Conclusions This study put forward a novel prognostic model based on clinical features; biopsy data and blood biomarkers may represent a promising tool for estimating OS in ESCC patients.
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Affiliation(s)
- Haiyang Hu
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
| | - Jun Zhang
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
| | - Hang Yan
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
| | - Chao Qin
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
| | - Haiyang Guo
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Chengdu University of TCM, Chengdu, China
| | - Tao Liu
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
| | - Shengjie Tang
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
| | - Haining Zhou
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
- *Correspondence: Haining Zhou,
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Li J, Yang W, Yuan Y, Zuo M, Li T, Wang Z, Liu Y. Preoperative Naples prognostic score is a reliable prognostic indicator for newly diagnosed glioblastoma patients. Front Oncol 2022; 12:775430. [PMID: 36052263 PMCID: PMC9424989 DOI: 10.3389/fonc.2022.775430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Glioblastoma (GBM) accounts for approximately 80% of malignant gliomas and is characterized by considerable cellularity and mitotic activity, vascular proliferation, and necrosis. Naples prognostic score (NPS), based on inflammatory markers and nutritional status, has a prognostic ability in various cancers. In the current study, we aim to explore the prognostic value of operative NPS in GBM patients and compare the prognostic ability between NPS and controlling nutritional status (CONUT). Materials and methods The retrospective analysis was carried out on consecutive newly diagnosed GBM patients who had underwent tumor resection at West China Hospital from February 2016 to March 2019. All statistical analyses were conducted using SPSS software and R software. Results A total of 276 newly diagnosed GBM patients were enrolled in the current study. Overall survival (OS) (p < 0.001) and tumor location (p = 0.007) were significantly related to NPS. Serum albumin concentrate, cholesterol concentrate, neutrophil-to-lymphocyte ratio, lymphocyte ratio, and CONUT score were all significantly associated with NPS (p < 0.001). The Kaplan–Meier curve indicated that NPS (log-rank test, p < 0.001) and CONUT score (log-rank test, p = 0.023) were significantly associated with OS. Multivariate Cox regression revealed that both NPS and CONUT score served as independent prognostic indicators. The prognostic model with NPS had the strongest prognostic capability and best model-fitting. Conclusion In the current study, NPS is found as an independent prognostic indicator for patients with newly diagnosed GBM, and the prognostic ability of NPS is superior to CONUT score.
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Feng J, Wang L, Yang X, Chen Q, Cheng X. Pathologic Complete Response Prediction to Neoadjuvant Immunotherapy Combined with Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma: Real-World Evidence from Integrative Inflammatory and Nutritional Scores. J Inflamm Res 2022; 15:3783-3796. [PMID: 35832830 PMCID: PMC9271687 DOI: 10.2147/jir.s367964] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/21/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Neoadjuvant immunotherapy and chemotherapy (nICT) is an emerging hotspot that has been shown to be safe and feasible for locally advanced esophageal squamous cell carcinoma (LA-ESCC). This real-world study aimed to develop and validate a novel predictive model [integrative inflammatory and nutritional score (IINS)] in LA-ESCC patients receiving nICT to predict the pathologic complete response (pCR). Patients and Methods Patients with LA-ESCC who received nICT followed by surgery from Jun 2019 to Dec 2021 were enrolled and randomly divided into two sets (7:3). Using least absolute shrinkage and selection operator (LASSO) logistic regression analysis, the IINS was constructed in LA-ESCC patients received nICT to predict pCR. A nomogram based on IINS for pCR prediction was generated in the training cohort and verified in the validation cohort. Results Of the 285 enrolled LA-ESCC patients received nICT followed by radical resection, 84 (29.5%) patients achieved pCR. A predictive index of IINS based on 8 inflammatory and nutritional indicators was constructed using the LASSO model. According to the cutoff finder, patients were then stratified into two groups (high and low). The pCR rates were significantly higher in high-IINS group than in low-IINS group in both the training cohort (44.7% vs 17.4%, P < 0.001) and validation cohort (50.0% vs 13.3%, P < 0.001). The IINS [odds ratio (OR) = 0.237, 95% confidence interval (CI) = 0.117–0.480, P < 0.001] was an independent significant predictor for pCR in multivariate logistic analyses. The IINS-based nomogram showed an excellent discrimination for pCR prediction (C-indexes = 0.759 and 0.812 for training and validation cohorts, respectively). Conclusion Pretreatment IINS is an independent predictor for pCR in LA-ESCC patients who are treated with nICT. To our knowledge, the IINS-based nomogram is the first model for pCR prediction and may serve as a simple and potential risk stratification model in LA-ESCC who are treated with nICT.
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Affiliation(s)
- Jifeng Feng
- Department of Thoracic Oncological Surgery, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.,Zhejiang Provincial Research Center for Upper Gastrointestinal Tract Cancer, Key Laboratory of Prevention, Diagnosis and Therapy of Upper Gastrointestinal Cancer of Zhejiang Province, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.,The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Liang Wang
- Department of Thoracic Oncological Surgery, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Xun Yang
- Department of Thoracic Oncological Surgery, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Qixun Chen
- Department of Thoracic Oncological Surgery, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Xiangdong Cheng
- Zhejiang Provincial Research Center for Upper Gastrointestinal Tract Cancer, Key Laboratory of Prevention, Diagnosis and Therapy of Upper Gastrointestinal Cancer of Zhejiang Province, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
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Guo D, Liu J, Li Y, Li C, Liu Q, Ji S, Zhu S. Evaluation of Predictive Values of Naples Prognostic Score in Patients with Unresectable Stage III Non-Small Cell Lung Cancer. J Inflamm Res 2021; 14:6129-6141. [PMID: 34848991 PMCID: PMC8627309 DOI: 10.2147/jir.s341399] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/06/2021] [Indexed: 12/28/2022] Open
Abstract
Background Naples prognosis score (NPS) is a new prognostic score according to host inflammatory and nutritional state, and it could be useful for predicting tumor prognosis based on albumin level, total cholesterol level, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. This study aimed to evaluate the clinical significance of Naples prognostic score (NPS) in stage III non-small cell lung cancer patients (NSCLC). Patients and Methods In this study, 206 patients diagnosed with locally advanced NCCLC receiving chemoradiotherapy were retrospectively reviewed from January 2013 to January 2017. The included patients were divided into 3 groups according to NPS (group 0, group 1, and group 2), and the associations of the NPS with clinical characteristics and outcomes were evaluated among the groups. Survival curves for the NPS were analyzed using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the Cox proportional hazards regression model to evaluate the prognostic value of overall survival (OS) and progression-free survival (PFS). Results The median follow-up time of this study was 37.0 (range, 13-59) months. The median OS was 27 months in group 0, 23 months in group 1, and 21 months in group 2, and median PFS was 15, 12 and 13 in group 0, group 1 and group 2, respectively. Age was significantly different among the 3 groups. The NPS was superior to other host inflammatory and nutritional indexes for prognostic risk stratification. In the multivariate analysis, NPS was identified as an independent prognostic indicator for OS and PFS (all P<0.05). Conclusion The NPS system is considered to be a useful predictor of outcomes in patients with stage III NSCLC.
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Affiliation(s)
- Dong Guo
- Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Jiafeng Liu
- Department of Radiotherapy, Rizhao Center Hospital, Rizhao, People's Republic of China
| | - Yanping Li
- Sunshine Union Hospital, Weifang, People's Republic of China
| | - Chao Li
- Sunshine Union Hospital, Weifang, People's Republic of China
| | - Quan Liu
- Sunshine Union Hospital, Weifang, People's Republic of China
| | - Shengjun Ji
- Department of Radiotherapy & Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, People's Republic of China
| | - Shuchai Zhu
- Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
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Zhu X, Chen D, Li S, Zhang W, Li Y, Wang X, Zhou J, Wen Z. Albumin-To-Alkaline Phosphatase Ratio as a Novel and Promising Prognostic Biomarker in Patients Undergoing Esophagectomy for Carcinoma: A Propensity Score Matching Study. Front Oncol 2021; 11:764076. [PMID: 34746006 PMCID: PMC8563791 DOI: 10.3389/fonc.2021.764076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/04/2021] [Indexed: 01/06/2023] Open
Abstract
Background Albumin-to-alkaline phosphatase ratio (AAPR) has been reported as a novel prognostic predictor for numerous solid tumors. We aimed to assess the prognostic role of preoperative AAPR in surgically resectable esophageal squamous cell carcinoma (ESCC) by a propensity score matching (PSM) analysis with predictive nomograms. Methods Our study was conducted in a single-center prospective database between June 2009 and December 2012. Kaplan-Meier analysis was used to distinguish the difference in survival outcomes between patients stratified by an AAPR threshold. Multivariable Cox proportional hazards regression model was finally generated to specify independent prognostic markers for the entire and PSM cohorts. Results A total of 497 patients with ESCC were included in this study. An AAPR of 0.50 was determined as the optimal cutoff point for prognostic outcome stratification. Patients with AAPR<0.50 had significantly worse overall survival (OS), and progression-free survival (PFS) compared to those with AAPR≥0.50 (Log-rank P<0.001). This significant difference remained stable in the PSM analysis. Multivariable analyses based on the entire and PSM cohorts consistently showed that AAPR<0.50 might be one of the most predominant prognostic factors resulting in unfavorable OS and PFS of ESCC patients undergoing esophagectomy (P<0.001). The nomograms consisting of AAPR and other independent prognostic factors further demonstrated a plausible predictive accuracy of postoperative OS and PFS. Conclusion AAPR can be considered as a simple, convenient and noninvasive biomarker with a significant prognostic effect in surgically resected ESCC.
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Affiliation(s)
- Xianying Zhu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.,Intensive Care Unit, Sun Yat-Sen University Cancer Center, Sun Yat-Sen University, Guangzhou, China
| | - Dongni Chen
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shuangjiang Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.,Department of Endoscopy and Laser, Sun Yat-Sen University Cancer Center, Sun Yat-Sen University, Guangzhou, China
| | - Wenbiao Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.,Department of Medical Imaging, Sun Yat-Sen University Cancer Center, Sun Yat-Sen University, Guangzhou, China
| | - Yongjiang Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.,Department of Nuclear Medicine, Sun Yat-Sen University Cancer Center, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoyu Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Jian Zhou
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.,Department of Medical Imaging, Sun Yat-Sen University Cancer Center, Sun Yat-Sen University, Guangzhou, China
| | - Zhesheng Wen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Sun Yat-Sen University, Guangzhou, China
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