Clinical significance of preoperative serum albumin level for prognosis in surgically resected patients with non-small cell lung cancer

Miura, Kentaro; Hamanaka, Kazutoshi; Koizumi, Tomonobu; Kitaguchi, Yoshiaki; Terada, Yukihiro; Nakamura, Daisuke; Kumeda, Hirotaka; Agatsuma, Hiroyuki; Hyogotani, Akira; Kawakami, Satoshi; Yoshizawa, Akihiko; Asaka, Shiho; Ito, Kenichi

doi:10.1016/j.lungcan.2017.07.003

Cited by 85 publications

(71 citation statements)

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“…In addition, malnutrition is closely related to the decrease of immune function, which weakens the body's anti-tumor immunity. Based on the above theory, a series of studies have confirmed that CRP and ALB are significantly associated with the prognosis of various tumors [35][36][37], including GC [33,38]. CRP/ALB, the combination of CRP and ALB, is closely related to the prognosis of many tumors [6,28,39,40] and is superior to other traditional inflammatory indices.…”

Section: Discussionmentioning

confidence: 93%

“…A retrospective study conducted by Mohammad found that SII is an independent risk factor for postoperative recurrence in patients with pancreatic cancer [46]. Kentaro reported that preoperative ALB is closely associated with postoperative recurrence of NSCLC [37]. In GC, Powell and mohri respectively confirmed that mGPS and GPS were related to recurrence [47,48].…”

Section: Discussionmentioning

confidence: 99%

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CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized phase III trial

Lü

Zheng

et al. 2018

Gastric Cancer

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Background Serum prealbumin (PALB) can predict the prognosis of patients with gastric cancer (GC). However, the prognostic value of combination of C-reactive protein and PALB (CRP/PALB) remains unclear. Methods A total of 419 gastric cancer patients included in a clinical trial (NCT02327481) were analyzed. The present study is a substudy of the trial. Receiver operating characteristic (ROC) curves were generated, and by calculating the areas under the curve (AUC) and the C-index, the discriminative ability of each inflammatory index was compared, including CRP/ PALB, C-reactive protein/albumin, Glasgow prognostic score (GPS), modified GPS, systemic immune-inflammation index, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio. Results Ultimately, 401 patients were included in this study. The optimal cutoff value of CRP/PALB was 17.7. According to this cutoff point, the entire sample was divided into a CRP/PALB < 17.7 (LCP) group and a CRP/PALB ≥ 17.7 (HCP) group, comprising 245 and 156 patients, respectively. There were 54 and 22 patients experienced recurrence in the HCP and LCP group, respectively, p < 0.001. Compared with traditional inflammatory indices, CRP/PALB had the highest AUC (0.707) and C-index (0.716), all p < 0.05. The post-recurrence survival (PRS) of patients in the HCP group was significantly shorter than that in the LCP group (p = 0.010), especially for pathological stage III patients (p = 0.015) or patients with distant (p = 0.018) or local (p = 0.023) recurrences. Conclusions The predictive value of preoperative CRP/PALB for the recurrence of GC is significantly better than traditional inflammatory indices. HCP significantly reduces the PRS, especially for pathological stage III patients or patients with distant or local recurrences.Keywords Gastric cancer · Inflammatory index · CRP/prealbumin · Recurrence · Post-recurrence survival Jun Lu and Bin-bin Xu contributed equally to this work and should be considered co-first authors. Electronic supplementary materialThe online version of this article (https ://doi.org/10.1007/s1012 0-018-0892-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized phase III trial

Lü

Zheng

et al. 2018

Gastric Cancer

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“…Higher number of metastatic sites increases disease burden and can result in mixed responses where one or more lesions may be responding while others are progressing which ultimately results a progressive disease. The other clinical covariate, serum albumin, has shown to be associated with survival in NSCLC patients 38,39 and used. As lower serum albumin is an indicator of malnutrition, inflammation, and hepatic dysfunction it may lead patients to a worse outcome.…”

Section: Discussionmentioning

confidence: 99%

Hypoxia-related radiomics predict immunotherapy response: A multi-cohort study of NSCLC

Tunali

Tan

Gray

et al. 2020

Preprint

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word count: 398 Word count: 4245 Abstract Checkpoint blockade immunotherapy provides improved long-term survival in a subset of advanced stage nonsmall cell lung cancer (NSCLC) patients. However, highly predictive biomarkers of immunotherapy response are unmet clinical need. In this study, we utilized pre-treatment clinical factors and quantitative image-based biomarkers (radiomics) to identify a parsimonious model that predicts survival outcomes among NSCLC patients treated with immunotherapy. The NSCLC patients treated with single or double agent immunotherapy were included in three different cohorts: Training (N = 180), test (N = 90) and validation (N = 62) cohorts. The models were created based on overall survival (OS) and were additionally assessed for progression-free survival (PFS). Including most predictive radiomic features and clinical covariates, Classification and Regression Tree analysis was applied to stratify patients into survival risk-groups in the training cohort. The risk groups were later generated in the test and validation cohorts. Four independent NSCLC cohorts (total N = 446) were utilized for further validation of the radiomic signature. The biological underpinnings of the most informative radiomics were assessed using gene expression data from a radiogenomics dataset and validated by immunohistochemistry data (IHC). A parsimonious clinical-radiomics model was found to be significantly associated with OS and PFS after stratifying patients into groups of low-, moderate-, high-, and very-high risk of death and progression. This trained model was further tested and validated in two independent cohorts. When the extreme phenotypes were compared, the very-high risk group was found to be associated with extremely poor OS in both the test (hazard ratio [HR] = 5.35, 95% confidence interval [CI]: 2.14 -13.36; 1-year OS = 11.1%) and validation (HR = 13.81, 95% CI: 2.58 -73.93; 1year OS = %47.6) cohorts when compared to the low risk group (HRs = 1.00; 1-year OS = 85.0% & 80.2%).Similar findings were observed for PFS. The final radiomic feature (GLCM inverse difference) was associated with OS in four independent NSCLC cohorts and was found to be positively associated with the hypoxia-related carbonic anhydrase, CAIX, by gene expression profiling and immunohistochemistry. We validated a novel clinical-radiomics model that is associated with OS and PFS among NSCLC patients treated with immunotherapy and identified a highly vulnerable subset of patients that are unlikely to respond to immunotherapy. The most informative radiomic feature was associated with CAIX, a marker of tumor hypoxia, tumor acidosis, and treatment resistance.

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“…Several parameters, including PNI [3], serum albumin level [19], or NLR [20], are used to evaluate nutritional status. Increasing evidence suggests that high preoperative PNI is a predictor of better postoperative complications and patients outcomes in various types of malignancy [4][5][6][7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…Increasing evidence suggests that high preoperative PNI is a predictor of better postoperative complications and patients outcomes in various types of malignancy [4][5][6][7][8][9][10]. Meanwhile, both high serum albumin level and low preoperative NLR also have been reported to be associated with better postoperative outcomes in several cancers [19][20][21][22][23][24][25][26][27]. BMI is also a well-known prognostic factor in breast cancers [28][29][30], and body weight is also associated with the patients' nutritional condition [31].…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant chemotherapy-induced decrease of prognostic nutrition index predicts poor prognosis in patients with breast cancer

Oba

Maeno²,

Takekoshi

et al. 2019

Preprint

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Clinical significance of preoperative serum albumin level for prognosis in surgically resected patients with non-small cell lung cancer

Cited by 85 publications

References 22 publications

CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized phase III trial

CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized phase III trial

Hypoxia-related radiomics predict immunotherapy response: A multi-cohort study of NSCLC

Neoadjuvant chemotherapy-induced decrease of prognostic nutrition index predicts poor prognosis in patients with breast cancer

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