Erkan Topkan, Ahmet Kucuk, Duriye Ozturk, Emine Elif Ozkan, Ali Ayberk Besen, Berrin Pehlivan, Ugur Selek
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Patients were additionally divided into two groups based on their status of significant WL according to the well-recognized Delphi criteria. Then, the CARWL score was created by combining all feasible combinations of the CAR and significant WL groupings. The potential links between pretreatment CARWL groups and the post-CCRT OS and PFS outcomes were determined as the primary and secondary endpoints.</p><p><strong>Results: </strong>This retrospective cohort study comprised a total of 651 stage IIIC NSCLC patients. ROC curve analysis indicated that rounded 3.0 was the ideal CAR cutoff (area under the curve (AUC): 70.1%; sensitivity: 67.8%; specificity: 65.9%), which categorized the patients into CAR < 3.0 (<i>N</i> = 324) and CAR ≥ 3.0 (<i>N</i> = 327) groups. There were 308 (47.3%) and 343 (52.7%) patients without and with significant WL, respectively. The created CARWL groups were CARWL-0: CAR < 3.0 and WL ≤ 5.0%; CARWL-1: CAR < 3.0 and WL > 5.0%, or CAR ≥ 3.0 and WL ≤ 5.0%; and CARWL-2: CAR > 3.0 and WL > 5.0%. The Kaplan-Meier curves showed that the PFS (14.2 vs. 11.4 vs. 7.5 months; <i>P</i> < 0.001) and OS (37.3 vs. 23.6 vs. 12.8 months; <i>P</i> < 0.001) durations were gradually and significantly lowered from the CARWL-0 to CARWL-2 groups. The CARWL score's significant impacts on PFS and OS outcomes were found to be independent of the other variables in the multivariate analysis (<i>P</i> < 0.001, for each).</p><p><strong>Conclusions: </strong>Our findings indicate that the novel CARWL score, which accounts for pretreatment CAR and significant WL during the preceding 6 months, can reliably stratify newly diagnosed stage IIIC NSCLC patients into three groups with significantly different PFS and OS after definitive CCRT.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11226337/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prognostic Value of Novel CARWL Score in Stage IIIC Non-Small-Cell Lung Cancer Patients Undergoing Concurrent Chemoradiotherapy.\",\"authors\":\"Erkan Topkan, Ahmet Kucuk, Duriye Ozturk, Emine Elif Ozkan, Ali Ayberk Besen, Berrin Pehlivan, Ugur Selek\",\"doi\":\"10.1155/2024/2803044\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>We explored the prognostic utility of the unique combination of C-reactive-protein-to-albumin ratio (CAR) and significant weight loss (WL > 5%) over the preceding 6 months, namely, the CARWL score, in stage IIIC non-small-cell lung cancer (NSCLC) patients who underwent concurrent chemoradiotherapy (CCRT).</p><p><strong>Methods: </strong>For each patient, the CAR was calculated using C-reactive protein and albumin measurements obtained on the first day of CCRT: CAR = C-reactive protein ÷ albumin. The availability of an ideal CAR cutoff that may categorize patients into two distinct progression-free (PFS) and overall survival (OS) outcomes was explored by employing receiver operating characteristic (ROC) curve analysis. Patients were additionally divided into two groups based on their status of significant WL according to the well-recognized Delphi criteria. Then, the CARWL score was created by combining all feasible combinations of the CAR and significant WL groupings. The potential links between pretreatment CARWL groups and the post-CCRT OS and PFS outcomes were determined as the primary and secondary endpoints.</p><p><strong>Results: </strong>This retrospective cohort study comprised a total of 651 stage IIIC NSCLC patients. ROC curve analysis indicated that rounded 3.0 was the ideal CAR cutoff (area under the curve (AUC): 70.1%; sensitivity: 67.8%; specificity: 65.9%), which categorized the patients into CAR < 3.0 (<i>N</i> = 324) and CAR ≥ 3.0 (<i>N</i> = 327) groups. There were 308 (47.3%) and 343 (52.7%) patients without and with significant WL, respectively. The created CARWL groups were CARWL-0: CAR < 3.0 and WL ≤ 5.0%; CARWL-1: CAR < 3.0 and WL > 5.0%, or CAR ≥ 3.0 and WL ≤ 5.0%; and CARWL-2: CAR > 3.0 and WL > 5.0%. The Kaplan-Meier curves showed that the PFS (14.2 vs. 11.4 vs. 7.5 months; <i>P</i> < 0.001) and OS (37.3 vs. 23.6 vs. 12.8 months; <i>P</i> < 0.001) durations were gradually and significantly lowered from the CARWL-0 to CARWL-2 groups. 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引用次数: 0
摘要
研究目的我们探讨了在接受同期化疗(CCRT)的IIIC期非小细胞肺癌(NSCLC)患者中,C反应蛋白与白蛋白比值(CAR)和前6个月体重显著下降(WL > 5%)的独特组合,即CARWL评分的预后效用:方法:每位患者的 CAR 分值均根据 CCRT 第一天获得的 C 反应蛋白和白蛋白测量值计算得出:CAR = C 反应蛋白 ÷ 白蛋白。通过接收器操作特征曲线(ROC)分析,探讨了是否有一个理想的CAR分界线,可将患者分为两种不同的无进展(PFS)和总生存(OS)结果。此外,根据公认的德尔菲(Delphi)标准,根据患者的显著 WL 状态将其分为两组。然后,结合 CAR 和显著 WL 分组的所有可行组合,得出 CARWL 评分。将治疗前CARWL分组与CCRT后OS和PFS结果之间的潜在联系作为主要和次要终点:这项回顾性队列研究共纳入了 651 例 IIIC 期 NSCLC 患者。ROC曲线分析表明,圆形 3.0 是理想的 CAR 临界值(曲线下面积 (AUC):70.1%;灵敏度:67.0%):70.1%;灵敏度:67.8%;特异性:65.9%),将患者分为 CAR N = 324 组和 CAR ≥ 3.0 组(N = 327)。无明显 WL 和有明显 WL 的患者分别为 308 人(47.3%)和 343 人(52.7%)。创建的 CARWL 组为 CARWL-0:CAR 5.0%,或 CAR ≥ 3.0 且 WL ≤ 5.0%;CARWL-2:CAR > 3.0 且 WL > 5.0%。Kaplan-Meier曲线显示,从CARWL-0组到CARWL-2组,PFS(14.2个月 vs. 11.4个月 vs. 7.5个月;P < 0.001)和OS(37.3个月 vs. 23.6个月 vs. 12.8个月;P < 0.001)持续时间逐渐显著缩短。在多变量分析中发现,CARWL评分对PFS和OS结果的显著影响与其他变量无关(P<0.001):我们的研究结果表明,新的CARWL评分考虑了治疗前的CAR和前6个月的显著WL,可以可靠地将新诊断的IIIC期NSCLC患者分为三组,三组患者在接受明确的CCRT治疗后的PFS和OS显著不同。
Prognostic Value of Novel CARWL Score in Stage IIIC Non-Small-Cell Lung Cancer Patients Undergoing Concurrent Chemoradiotherapy.
Objectives: We explored the prognostic utility of the unique combination of C-reactive-protein-to-albumin ratio (CAR) and significant weight loss (WL > 5%) over the preceding 6 months, namely, the CARWL score, in stage IIIC non-small-cell lung cancer (NSCLC) patients who underwent concurrent chemoradiotherapy (CCRT).
Methods: For each patient, the CAR was calculated using C-reactive protein and albumin measurements obtained on the first day of CCRT: CAR = C-reactive protein ÷ albumin. The availability of an ideal CAR cutoff that may categorize patients into two distinct progression-free (PFS) and overall survival (OS) outcomes was explored by employing receiver operating characteristic (ROC) curve analysis. Patients were additionally divided into two groups based on their status of significant WL according to the well-recognized Delphi criteria. Then, the CARWL score was created by combining all feasible combinations of the CAR and significant WL groupings. The potential links between pretreatment CARWL groups and the post-CCRT OS and PFS outcomes were determined as the primary and secondary endpoints.
Results: This retrospective cohort study comprised a total of 651 stage IIIC NSCLC patients. ROC curve analysis indicated that rounded 3.0 was the ideal CAR cutoff (area under the curve (AUC): 70.1%; sensitivity: 67.8%; specificity: 65.9%), which categorized the patients into CAR < 3.0 (N = 324) and CAR ≥ 3.0 (N = 327) groups. There were 308 (47.3%) and 343 (52.7%) patients without and with significant WL, respectively. The created CARWL groups were CARWL-0: CAR < 3.0 and WL ≤ 5.0%; CARWL-1: CAR < 3.0 and WL > 5.0%, or CAR ≥ 3.0 and WL ≤ 5.0%; and CARWL-2: CAR > 3.0 and WL > 5.0%. The Kaplan-Meier curves showed that the PFS (14.2 vs. 11.4 vs. 7.5 months; P < 0.001) and OS (37.3 vs. 23.6 vs. 12.8 months; P < 0.001) durations were gradually and significantly lowered from the CARWL-0 to CARWL-2 groups. The CARWL score's significant impacts on PFS and OS outcomes were found to be independent of the other variables in the multivariate analysis (P < 0.001, for each).
Conclusions: Our findings indicate that the novel CARWL score, which accounts for pretreatment CAR and significant WL during the preceding 6 months, can reliably stratify newly diagnosed stage IIIC NSCLC patients into three groups with significantly different PFS and OS after definitive CCRT.
期刊介绍:
Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.