A Novel Systemic Inflammation Prognostic Score to Stratify Survival in Elderly Patients With Cancer

Frontiers in Nutrition

Meng-Yan Wang¹  Ming-Hua Cong²  Lei Pan⁶  Kun-Hua Wang⁷  Yi-Zhen Gong⁸  He-Yang Zhang⁹  Yi-Zhong Ge⁹  Guo-Tian Ruan⁹  Ming Yang⁹  Xi Zhang⁹  Zi-Wen Wang⁹  Han-Ping Shi⁹  Qi Zhang⁹  Hai-Lun Xie⁹  Meng Tang⁹  Li Deng⁹  Meng-Meng Song⁹  Xiao-Wei Zhang⁹ 

[1] 0Department of General Surgery, The 906th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Ningbo, China;Comprehensive Oncology Department, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China;Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China;Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, China;Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China;General Surgery Clinical Medical Center of Yunnan Province, Kunming, China;Guangxi Clinical Research Center for Colorectal Cancer, Nanning, China;Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China;Yunnan University, Kunming, China;

关键词: SIPS;    systemic inflammation;    malnutrition;    elderly patients with cancer;    overall survival;   

DOI  :  10.3389/fnut.2022.893753

来源: DOAJ

【 摘 要 】

BackgroundElderly patients with cancer face the challenge of systemic inflammation, which can lead to a poor prognosis. Existing inflammatory indices cannot fully reflect the immune-inflammatory status of patients. This study aimed to develop a new scoring system to predict the survival of elderly patients with cancer using inflammatory indices, namely, the systemic inflammation prognostic score (SIPS).Materials and MethodsThis prospective multicenter study included a total of 1,767 patients with cancer, with a mean age of 70.97 ± 5.49 years, of whom 1,170 (66.2%) were men. We performed the least absolute shrinkage and selection operator (LASSO) regression to screen inflammatory indicators to include in constructing SIPS. Prognostic analysis of SIPS was performed using univariate and multivariate survival analyzes. The prognostic value of SIPS and its components were compared using the prognostic receiver operating characteristic curve and concordance index. The population was divided into the training cohort and the validation cohort in a 7:3 ratio and a SIPS prognostic analysis was performed.ResultsThe LASSO regression selected C-reactive protein (CRP) (≤ 9.81, “0”; > 9.81, “1”), geriatric nutritional risk index (GNRI) (≤ 93.85, “1”; 93.85, “0”), advanced lung cancer inflammation index (ALI) (≤ 23.49, “1”; > 23.49, “0”), and lymphocyte to C-reactive protein ratio (LCR) (≤ 2523.81, “1”; > 2523.81, “0”) to develop SIPS. Patients were divided into the three groups based on the total SIPS: low-risk (0), moderate-risk (1–2), and high-risk (3–4). On the multivariate survival analysis, patients in the moderate-risk [P < 0.001, hazard ratio (HR) = 1.79, 95% CI: 1.47–2.17] and high-risk groups (P < 0.001, HR = 2.40, 95% CI: 1.98–2.92) showed a worse prognosis than those in the low-risk group. The total cohort, training cohort, and validation cohort all showed that SIPS had better survival prediction than CRP, GNRI, ALI, and LCR. The HRs were 2.81 times higher in patients in the high-risk group with malnutrition than in patients in the low-risk group without malnutrition.ConclusionSIPS was an independent prognostic indicator in elderly patients with cancer. Malnutrition in the high-risk group increased the mortality risk.

【 授权许可】

Unknown