Prognostic Importance of Combined Use of MELD Scores and SII in Hepatic Visceral Crisis in Patients with Solid Tumours.

IF 0.7 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Jcpsp-Journal of the College of Physicians and Surgeons Pakistan Pub Date : 2023-08-01 DOI:10.29271/jcpsp.2023.08.879

Fatih Tay, Mustafa Buyukkor, Ayse Ocak Duran

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引用次数: 2

Abstract

Objective: To determine the sensitivity of combining the model for end-stage liver disease (MELD) scoring with new inflammatory indexes in determining the priority for liver transplantation and demonstrating its potential usability in solid tumour visceral crisis.

Study design: Descriptive study. Place and Duration of the Study: Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkiye, from June 2017 to June 2022.

Methodology: Patients hospitalised in the medical oncology clinic for hepatic dysfunction were included. The MELD scores of these patients were calculated, and the predictive contribution of the systemic immune-inflammatory index (SII) to prognosis and mortality was evaluated.

Results: A total of 295 patients (158 (53.6%) men and 137 (46.4%) women) were included. When compared for primary tumour types, colorectal cancers were the most common with 55 (18.6%) cases, followed by breast cancers at 52 (17.6%), pancreatic carcinoma at 50 (16.9%), and stomach cancers at 40 (13.6%) cases. In the survival analyses of all three MELD scores (MELD-Original, MELD-Na, and MELD 3.0) between <20 groups and ≥20 groups, the median Overall Survival (OS) for MELD-Original was 1.44 vs. 0.88 months (p<0.001), for MELD- Na it was 1.64 vs. 0.85 months (p<0.001), and for MELD 3.0 it was 2.16 vs. 1.28 months (p=0.039). In the ROC analysis, the SII parameter cut-off was ≥626.28 for the estimation of mortality, SII sensitivity was 78.7%, and specificity was 100% (p=0.013).

Conclusion: Combined use of MELD and SII scores in patients with solid tumours with hepatic visceral crises will be practical, cost-effective, and easy to access, eliminate gender-based disparities, and contribute to clinical follow-ups with objective data.

Key words: Malignant neoplasm, MELD score, MELD-Na, MELD 3.0, SII.

查看原文本刊更多论文

MELD评分和SII联合应用在实体肿瘤患者肝脏器危象中的预后重要性。

目的:探讨终末期肝病(MELD)评分模型与新的炎症指标相结合在确定肝移植优先级中的敏感性，并证明其在实体瘤脏器危像中的潜在可用性。研究设计:描述性研究。研究地点和时间:Abdurrahman Yurtaslan肿瘤培训和研究医院，土耳其安卡拉，2017年6月至2022年6月。方法:纳入因肝功能障碍住院的肿瘤内科门诊患者。计算这些患者的MELD评分，并评估全身免疫炎症指数(SII)对预后和死亡率的预测作用。结果:共纳入295例患者，其中男性158例(53.6%)，女性137例(46.4%)。当比较原发性肿瘤类型时，结直肠癌最常见，有55例(18.6%)，其次是乳腺癌52例(17.6%)，胰腺癌50例(16.9%)，胃癌40例(13.6%)。在MELD- original, MELD- na和MELD 3.0之间的所有三个MELD评分的生存分析中，结论:MELD和SII评分在合并肝脏器危像的实体瘤患者中联合使用将是实用的，具有成本效益，易于获取，消除了基于性别的差异，并有助于客观数据的临床随访。关键词:恶性肿瘤，MELD评分，MELD- na, MELD 3.0, SII

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来源期刊

Jcpsp-Journal of the College of Physicians and Surgeons Pakistan MEDICINE, GENERAL & INTERNAL-

CiteScore

1.40

自引率

0.00%

发文量

453

审稿时长

3-6 weeks

期刊介绍： Journal of College of Physicians and Surgeons Pakistan (JCPSP), is the prestigious, peer reviewed monthly biomedical journal of the country published regularly since 1991. Established with the primary aim of promotion and dissemination of medical research and contributed by scholars of biomedical sciences from Pakistan and abroad, it carries original research papers, , case reports, review articles, articles on medical education, commentaries, short communication, new technology, editorials and letters to the editor. It covers the core biomedical health science subjects, basic medical sciences and emerging community problems, prepared in accordance with the “Uniform requirements for submission to bio-medical journals” laid down by International Committee of Medical Journals Editors (ICMJE). All publications of JCPSP are peer reviewed by subject specialists from Pakistan and locally and abroad.