Prognostic significance of body mass index and serum albumin as the indicators of nutritional status in small cell lung cancer.

Postgraduate medicine Pub Date : 2024-03-01 Epub Date: 2024-03-12 DOI:10.1080/00325481.2024.2328512

Faruk Tas, Akın Ozturk, Kayhan Erturk

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Abstract

Background: Body mass index (BMI) and serum albumin (ALB) level are long-established markers that reflect the nutritional status and eventually the prognosis of cancer patients. The objective of the study was to determine the clinical significance of these factors and specify their roles in outcomes compared with performance status (PS) and weight loss (WL), which are considered the most significant patient-related prognostic factors in small cell lung cancer (SCLC) treated with platinum-etoposide-based chemotherapy.

Methods: A total of 378 patients with SCLC were enrolled in the study and analyzed retrospectively.

Results: BMI values were similar by clinical stage, whereas the percentages of the patients with WL, low serum ALB, and particularly poor (≥2) PS were significantly higher in patients with extended disease SCLC (ED-SCLC) compared to those with limited disease SCLC (LD-SCLC). In LD-SCLC, patients with poor PS lived for a significantly shorter time than patients with good PS (HR: 7.791, p = 0.0001); however, BMI (HR: 1.035, p = 0.8), WL (HR: 0.857, p = 0.5), and ALB (HR: 0.743, p = 0.3) had no significant effect on the outcome. In ED-SCLC, PS (HR: 4.257, p = 0.0001), WL (HR: 1.677, p = 0.001), and ALB (HR: 0.680, p = 0.007) had an impact on survival, but BMI did not (HR: 0.791, p = 0.08). In LD-SCLC, the univariate analysis showed that only poor PS was correlated with increased mortality (HR: 7.791, p = 0.0001); yet it lost significance in multivariate analysis. In ED-SCLC, poor PS (HR: 4.257, p = 0.0001), WL (HR: 1.667, p = 0.001), and a low ALB level (HR: 0.680, p = 0.007) were shown to be factors for poor prognosis in the univariate analysis; yet only PS remained significant in multivariate analysis (HR: 2.286, p = 0.001).

Conclusion: Even though BMI and serum albumin showed no prognostic value in SCLC patients treated with chemotherapy, PS was found to be the most significant prognostic factor in both LD- and ED-SCLC stages.

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体重指数和血清白蛋白作为小细胞肺癌营养状况指标的预后意义。

背景：体重指数（BMI）和血清白蛋白（ALB）水平是反映癌症患者营养状况和预后的公认指标。本研究的目的是确定这些因素的临床意义，并明确它们与表现状态（PS）和体重减轻（WL）相比在预后中的作用，后者被认为是接受以铂-依托泊苷为基础的化疗的小细胞肺癌（SCLC）患者最重要的预后因素：研究共纳入了 378 名 SCLC 患者，并对其进行了回顾性分析：不同临床分期的BMI值相似，而与局限性疾病SCLC（LD-SCLC）患者相比，扩展性疾病SCLC（ED-SCLC）患者中WL、低血清ALB和PS特别差（≥2）的患者比例明显更高。在LD-SCLC中，PS差的患者的存活时间明显短于PS好的患者（HR：7.791，p = 0.0001）；然而，BMI（HR：1.035，p = 0.8）、WL（HR：0.857，p = 0.5）和ALB（HR：0.743，p = 0.3）对预后无明显影响。在 ED-SCLC 中，PS（HR：4.257，p = 0.0001）、WL（HR：1.677，p = 0.001）和 ALB（HR：0.680，p = 0.007）对生存率有影响，但 BMI 没有影响（HR：0.791，p = 0.08）。在 LD-SCLC 中，单变量分析显示，只有 PS 差与死亡率增加相关（HR：7.791，p = 0.0001）；但在多变量分析中，PS 差失去了意义。在 ED-SCLC 中，单变量分析显示，不良 PS（HR：4.257，p = 0.0001）、WL（HR：1.667，p = 0.001）和低 ALB 水平（HR：0.680，p = 0.007）是预后不良的因素；但在多变量分析中，只有 PS 仍具有显著性（HR：2.286，p = 0.001）：结论：尽管BMI和血清白蛋白对接受化疗的SCLC患者没有预后价值，但在LD-和ED-SCLC分期中，PS是最重要的预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Postgraduate medicine

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