Prognostic value of the advanced lung cancer inflammation index in intrahepatic cholangiocarcinoma

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2024-10-18 DOI:10.1016/j.ejso.2024.108773

Giovanni Catalano , Laura Alaimo , Odysseas P. Chatzipanagiotou , Andrea Ruzzenente , Federico Aucejo , Hugo P. Marques , Vincent Lam , Tom Hugh , Nazim Bhimani , Shishir K. Maithel , Minoru Kitago , Itaru Endo , Guillaume Martel , Carlo Pulitano , Feng Shen , Irinel Popescu , Bas Groot Koerkamp , Todd W. Bauer , François Cauchy , George A. Poultsides , Timothy M. Pawlik

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引用次数: 0

Abstract

Introduction

The advanced lung cancer inflammation index (ALI), which combines inflammation and nutrition data, was recently proposed as a prognostic biomarker. We assessed the impact of ALI on overall survival (OS) among patients undergoing surgery for intrahepatic cholangiocarcinoma (ICC).

Methods

Patients who underwent surgery for ICC were identified from an international cohort. ALI was calculated as body-mass index (BMI)∗albumin/neutrophil-to-lymphocyte ratio; patients were categorized into “low-” and “high-ALI” using log-rank statistics. The impact of ALI on OS was compared against other inflammatory markers (i.e., neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], systemic immune inflammation index [SII = platelets∗NLR]) using Harrell's Concordance index (C-index) and the Akaike Information Criterion (AIC). To minimize intergroup differences, propensity score matching was employed.

Results

Among 1045 patients, more than one-half of individuals underwent major hepatectomy (n = 582, 55.7 %), median tumor size was 5.5 cm (IQR, 3.8–7.8), and median ALI was 38.9 (IQR 26.5–57.2). On multivariate analysis, low ALI was an independent risk factor for worse OS (HR 1.21, 95 % CI 1.01–1.46; p = 0.04). Patients with low ALI had worse 5-year OS (36.9 % vs. 49.9 %; p < 0.001), which remained significant after PSM (36.9 % vs. 41.3 %; p = 0.039). ALI had a comparable discriminatory ability compared with NLR, PLR, and SII (C-index: 0.646 vs. 0.644 vs. 0.640 vs. 0.641, respectively), yet had a lower AIC (5475.31 vs. 5546.80 vs. 5550.45 vs. 5548.62, respectively) suggesting slightly better model fit and accuracy.

Conclusions

ALI was an independent predictor of OS among patients undergoing surgery for ICC. Nutritional and inflammatory markers should be incorporated into predictive models to improve prognostic stratification.

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肝内胆管癌晚期肺癌炎症指数的预后价值

简介晚期肺癌炎症指数（ALI）结合了炎症和营养数据，最近被提出作为预后生物标志物。我们评估了ALI对肝内胆管癌（ICC）手术患者总生存期（OS）的影响：方法：从国际队列中筛选出接受 ICC 手术的患者。ALI以体重指数（BMI）∗白蛋白/中性粒细胞与淋巴细胞比值计算；使用对数秩统计将患者分为 "低ALI "和 "高ALI"。使用哈雷尔一致性指数（C-index）和阿凯克信息标准（AIC）比较了ALI与其他炎症指标（即中性粒细胞与淋巴细胞比值[NLR]、血小板与淋巴细胞比值[PLR]、全身免疫炎症指数[SII=血小板∗NLR]）对OS的影响。为尽量减少组间差异，采用了倾向得分匹配法：在 1045 名患者中，超过二分之一的患者接受了大肝切除术（n = 582，55.7%），肿瘤大小中位数为 5.5 厘米（IQR，3.8-7.8），ALI 中位数为 38.9（IQR 26.5-57.2）。多变量分析显示，低ALI是OS恶化的独立风险因素（HR 1.21，95 % CI 1.01-1.46；P = 0.04）。低ALI患者的5年OS较差（36.9%对49.9%；P 结论：低ALI患者的5年OS较差：ALI是ICC手术患者OS的独立预测因子。营养和炎症标记物应纳入预测模型，以改善预后分层。

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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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.