Cargando…
Combination of Albumin-Globulin Score and Sarcopenia to Predict Prognosis in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy
We conducted a multicenter clinical study to construct a novel index based on a combination of albumin-globulin score and sarcopenia (CAS) that can comprehensively reflect patients' nutritional and inflammatory status and assess the prognostic value of CAS in renal cell carcinoma (RCC) patients...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8495413/ https://www.ncbi.nlm.nih.gov/pubmed/34631767 http://dx.doi.org/10.3389/fnut.2021.731466 |
_version_ | 1784579546187563008 |
---|---|
author | Mao, Weipu Zhang, Nieke Wang, Keyi Hu, Qiang Sun, Si Xu, Zhipeng Yu, Junjie Wang, Can Chen, Saisai Xu, Bin Wu, Jianping Zhang, Hua Chen, Ming |
author_facet | Mao, Weipu Zhang, Nieke Wang, Keyi Hu, Qiang Sun, Si Xu, Zhipeng Yu, Junjie Wang, Can Chen, Saisai Xu, Bin Wu, Jianping Zhang, Hua Chen, Ming |
author_sort | Mao, Weipu |
collection | PubMed |
description | We conducted a multicenter clinical study to construct a novel index based on a combination of albumin-globulin score and sarcopenia (CAS) that can comprehensively reflect patients' nutritional and inflammatory status and assess the prognostic value of CAS in renal cell carcinoma (RCC) patients. Between 2014 and 2019, 443 patients from 3 centers who underwent nephrectomy were collected (343 in the training set and 100 in the test set). Kaplan-Meier curves were employed to analyze the impact of albumin-globulin ratio (AGR), albumin-globulin score (AGS), sarcopenia, and CAS on overall survival (OS) and cancer-specific survival (CSS) in RCC patients. Receiver operating characteristic (ROC) curves were used to assess the predictive ability of AGR, AGS, sarcopenia, and CAS on prognosis. High AGR, low AGS, and nonsarcopenia were associated with higher OS and CSS. According to CAS, the training set included 60 (17.5%) patients in grade 1, 176 (51.3%) patients in grade 2, and 107 (31.2%) patients in grade 3. Lower CAS was linked to longer OS and CSS. Multivariate Cox regression analysis revealed that CAS was an independent risk factor for OS (grade 1 vs. grade 3: aHR = 0.08; 95% CI: 0.01–0.58, p = 0.012; grade 2 vs. grade 3: aHR = 0.47; 95% CI: 0.25–0.88, p = 0.018) and CSS (grade 1 vs. grade 3: aHR = 0.12; 95% CI: 0.02–0.94, p = 0.043; grade 2 vs. grade 3: aHR = 0.31; 95% CI: 0.13–0.71, p = 0.006) in RCC patients undergoing nephrectomy. Additionally, CAS had higher accuracy in predicting OS (AUC = 0.687) and CSS (AUC = 0.710) than AGR, AGS, and sarcopenia. In addition, similar results were obtained in the test set. The novel index CAS developed in this study, which reflects patients' nutritional and inflammatory status, can better predict the prognosis of RCC patients. |
format | Online Article Text |
id | pubmed-8495413 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84954132021-10-08 Combination of Albumin-Globulin Score and Sarcopenia to Predict Prognosis in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy Mao, Weipu Zhang, Nieke Wang, Keyi Hu, Qiang Sun, Si Xu, Zhipeng Yu, Junjie Wang, Can Chen, Saisai Xu, Bin Wu, Jianping Zhang, Hua Chen, Ming Front Nutr Nutrition We conducted a multicenter clinical study to construct a novel index based on a combination of albumin-globulin score and sarcopenia (CAS) that can comprehensively reflect patients' nutritional and inflammatory status and assess the prognostic value of CAS in renal cell carcinoma (RCC) patients. Between 2014 and 2019, 443 patients from 3 centers who underwent nephrectomy were collected (343 in the training set and 100 in the test set). Kaplan-Meier curves were employed to analyze the impact of albumin-globulin ratio (AGR), albumin-globulin score (AGS), sarcopenia, and CAS on overall survival (OS) and cancer-specific survival (CSS) in RCC patients. Receiver operating characteristic (ROC) curves were used to assess the predictive ability of AGR, AGS, sarcopenia, and CAS on prognosis. High AGR, low AGS, and nonsarcopenia were associated with higher OS and CSS. According to CAS, the training set included 60 (17.5%) patients in grade 1, 176 (51.3%) patients in grade 2, and 107 (31.2%) patients in grade 3. Lower CAS was linked to longer OS and CSS. Multivariate Cox regression analysis revealed that CAS was an independent risk factor for OS (grade 1 vs. grade 3: aHR = 0.08; 95% CI: 0.01–0.58, p = 0.012; grade 2 vs. grade 3: aHR = 0.47; 95% CI: 0.25–0.88, p = 0.018) and CSS (grade 1 vs. grade 3: aHR = 0.12; 95% CI: 0.02–0.94, p = 0.043; grade 2 vs. grade 3: aHR = 0.31; 95% CI: 0.13–0.71, p = 0.006) in RCC patients undergoing nephrectomy. Additionally, CAS had higher accuracy in predicting OS (AUC = 0.687) and CSS (AUC = 0.710) than AGR, AGS, and sarcopenia. In addition, similar results were obtained in the test set. The novel index CAS developed in this study, which reflects patients' nutritional and inflammatory status, can better predict the prognosis of RCC patients. Frontiers Media S.A. 2021-09-23 /pmc/articles/PMC8495413/ /pubmed/34631767 http://dx.doi.org/10.3389/fnut.2021.731466 Text en Copyright © 2021 Mao, Zhang, Wang, Hu, Sun, Xu, Yu, Wang, Chen, Xu, Wu, Zhang and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Nutrition Mao, Weipu Zhang, Nieke Wang, Keyi Hu, Qiang Sun, Si Xu, Zhipeng Yu, Junjie Wang, Can Chen, Saisai Xu, Bin Wu, Jianping Zhang, Hua Chen, Ming Combination of Albumin-Globulin Score and Sarcopenia to Predict Prognosis in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy |
title | Combination of Albumin-Globulin Score and Sarcopenia to Predict Prognosis in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy |
title_full | Combination of Albumin-Globulin Score and Sarcopenia to Predict Prognosis in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy |
title_fullStr | Combination of Albumin-Globulin Score and Sarcopenia to Predict Prognosis in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy |
title_full_unstemmed | Combination of Albumin-Globulin Score and Sarcopenia to Predict Prognosis in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy |
title_short | Combination of Albumin-Globulin Score and Sarcopenia to Predict Prognosis in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy |
title_sort | combination of albumin-globulin score and sarcopenia to predict prognosis in patients with renal cell carcinoma undergoing laparoscopic nephrectomy |
topic | Nutrition |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8495413/ https://www.ncbi.nlm.nih.gov/pubmed/34631767 http://dx.doi.org/10.3389/fnut.2021.731466 |
work_keys_str_mv | AT maoweipu combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT zhangnieke combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT wangkeyi combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT huqiang combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT sunsi combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT xuzhipeng combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT yujunjie combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT wangcan combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT chensaisai combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT xubin combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT wujianping combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT zhanghua combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy AT chenming combinationofalbuminglobulinscoreandsarcopeniatopredictprognosisinpatientswithrenalcellcarcinomaundergoinglaparoscopicnephrectomy |