Cargando…

Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study

BACKGROUND: Preoperative nutritional status is an important host-related prognostic factor for non-small cell lung carcinoma (NSCLC); however, the significance of postoperative changes in nutritional status remains unclear. This study aimed to elucidate the significance of postoperative decreases in...

Descripción completa

Detalles Bibliográficos
Autores principales: Kinoshita, Fumihiko, Tagawa, Tetsuzo, Yamashita, Takanori, Takenaka, Tomoyoshi, Matsubara, Taichi, Toyokawa, Gouji, Takada, Kazuki, Oba, Taro, Osoegawa, Atsushi, Yamazaki, Koji, Takenoyama, Mitsuhiro, Shimokawa, Mototsugu, Nakashima, Naoki, Mori, Masaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8412276/
https://www.ncbi.nlm.nih.gov/pubmed/34473762
http://dx.doi.org/10.1371/journal.pone.0256894
_version_ 1783747418193395712
author Kinoshita, Fumihiko
Tagawa, Tetsuzo
Yamashita, Takanori
Takenaka, Tomoyoshi
Matsubara, Taichi
Toyokawa, Gouji
Takada, Kazuki
Oba, Taro
Osoegawa, Atsushi
Yamazaki, Koji
Takenoyama, Mitsuhiro
Shimokawa, Mototsugu
Nakashima, Naoki
Mori, Masaki
author_facet Kinoshita, Fumihiko
Tagawa, Tetsuzo
Yamashita, Takanori
Takenaka, Tomoyoshi
Matsubara, Taichi
Toyokawa, Gouji
Takada, Kazuki
Oba, Taro
Osoegawa, Atsushi
Yamazaki, Koji
Takenoyama, Mitsuhiro
Shimokawa, Mototsugu
Nakashima, Naoki
Mori, Masaki
author_sort Kinoshita, Fumihiko
collection PubMed
description BACKGROUND: Preoperative nutritional status is an important host-related prognostic factor for non-small cell lung carcinoma (NSCLC); however, the significance of postoperative changes in nutritional status remains unclear. This study aimed to elucidate the significance of postoperative decreases in serum albumin (ΔAlb) on the outcomes of early-stage NSCLC. METHODS: We analyzed 443 training cohort (TC) and 642 validation cohort (VC) patients with pStage IA NSCLC who underwent surgery and did not recur within 1 year. We measured preoperative serum albumin levels (preAlb) and postoperative levels 1 year after surgery (postAlb), and calculated ΔAlb as (preAlb − postAlb)/preAlb × 100%. A cutoff value of 11% for ΔAlb was defined on the basis of the receiver operating characteristic curve for the TC. RESULTS: Patients were divided into ΔAlb-Decreased and ΔAlb-Stable groups, including 100 (22.6%) and 343 (77.4%) in the TC, and 58 (9.0%) and 584 (90.1%) in the VC. ΔAlb-Decreased was associated with male sex (p = 0.0490), smoking (p = 0.0156), and non-adenocarcinoma (p<0.0001) in the TC, and pT1b (p = 0.0169) and non-adenocarcinoma (p = 0.0251) in the VC. Multivariable analysis identified ΔAlb as an independent prognostic factor for disease-free survival (DFS) and overall survival (OS) in both cohorts (VC: DFS, HR = 1.9, 95%CI: 1.10–3.15, p = 0.0197; OS, HR = 2.0, 95%CI: 1.13–3.45, p = 0.0173). Moreover, subgroup analysis demonstrated that the prognostic value of ΔAlb was consistent for age, sex, smoking history, surgical procedure, and histological type. CONCLUSION: We demonstrated a negative impact of postoperative decrease of the serum albumin on the prognosis of patients with early-stage NSCLC. Postoperative changes in nutritional status might be important in NSCLC outcomes.
format Online
Article
Text
id pubmed-8412276
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-84122762021-09-03 Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study Kinoshita, Fumihiko Tagawa, Tetsuzo Yamashita, Takanori Takenaka, Tomoyoshi Matsubara, Taichi Toyokawa, Gouji Takada, Kazuki Oba, Taro Osoegawa, Atsushi Yamazaki, Koji Takenoyama, Mitsuhiro Shimokawa, Mototsugu Nakashima, Naoki Mori, Masaki PLoS One Research Article BACKGROUND: Preoperative nutritional status is an important host-related prognostic factor for non-small cell lung carcinoma (NSCLC); however, the significance of postoperative changes in nutritional status remains unclear. This study aimed to elucidate the significance of postoperative decreases in serum albumin (ΔAlb) on the outcomes of early-stage NSCLC. METHODS: We analyzed 443 training cohort (TC) and 642 validation cohort (VC) patients with pStage IA NSCLC who underwent surgery and did not recur within 1 year. We measured preoperative serum albumin levels (preAlb) and postoperative levels 1 year after surgery (postAlb), and calculated ΔAlb as (preAlb − postAlb)/preAlb × 100%. A cutoff value of 11% for ΔAlb was defined on the basis of the receiver operating characteristic curve for the TC. RESULTS: Patients were divided into ΔAlb-Decreased and ΔAlb-Stable groups, including 100 (22.6%) and 343 (77.4%) in the TC, and 58 (9.0%) and 584 (90.1%) in the VC. ΔAlb-Decreased was associated with male sex (p = 0.0490), smoking (p = 0.0156), and non-adenocarcinoma (p<0.0001) in the TC, and pT1b (p = 0.0169) and non-adenocarcinoma (p = 0.0251) in the VC. Multivariable analysis identified ΔAlb as an independent prognostic factor for disease-free survival (DFS) and overall survival (OS) in both cohorts (VC: DFS, HR = 1.9, 95%CI: 1.10–3.15, p = 0.0197; OS, HR = 2.0, 95%CI: 1.13–3.45, p = 0.0173). Moreover, subgroup analysis demonstrated that the prognostic value of ΔAlb was consistent for age, sex, smoking history, surgical procedure, and histological type. CONCLUSION: We demonstrated a negative impact of postoperative decrease of the serum albumin on the prognosis of patients with early-stage NSCLC. Postoperative changes in nutritional status might be important in NSCLC outcomes. Public Library of Science 2021-09-02 /pmc/articles/PMC8412276/ /pubmed/34473762 http://dx.doi.org/10.1371/journal.pone.0256894 Text en © 2021 Kinoshita et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kinoshita, Fumihiko
Tagawa, Tetsuzo
Yamashita, Takanori
Takenaka, Tomoyoshi
Matsubara, Taichi
Toyokawa, Gouji
Takada, Kazuki
Oba, Taro
Osoegawa, Atsushi
Yamazaki, Koji
Takenoyama, Mitsuhiro
Shimokawa, Mototsugu
Nakashima, Naoki
Mori, Masaki
Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study
title Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study
title_full Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study
title_fullStr Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study
title_full_unstemmed Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study
title_short Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: A multicenter retrospective study
title_sort prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: a multicenter retrospective study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8412276/
https://www.ncbi.nlm.nih.gov/pubmed/34473762
http://dx.doi.org/10.1371/journal.pone.0256894
work_keys_str_mv AT kinoshitafumihiko prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT tagawatetsuzo prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT yamashitatakanori prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT takenakatomoyoshi prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT matsubarataichi prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT toyokawagouji prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT takadakazuki prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT obataro prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT osoegawaatsushi prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT yamazakikoji prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT takenoyamamitsuhiro prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT shimokawamototsugu prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT nakashimanaoki prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy
AT morimasaki prognosticvalueofpostoperativedecreaseinserumalbuminonsurgicallyresectedearlystagenonsmallcelllungcarcinomaamulticenterretrospectivestudy