Congyi Xie , Jinzhan Chen , Zhisheng Chen , Yijiao Xu , Jiaxin Liu , Huijun Zhang , Hongni Jiang , Feiyang Ye , Lin Tong
{"title":"应用广义加性模型评估晚期非小细胞肺癌患者接受安洛替尼治疗的白蛋白和总生存率:一项回顾性队列研究","authors":"Congyi Xie , Jinzhan Chen , Zhisheng Chen , Yijiao Xu , Jiaxin Liu , Huijun Zhang , Hongni Jiang , Feiyang Ye , Lin Tong","doi":"10.1016/j.ceh.2023.09.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Albumin is believed to be associated with the prediction of various cancers. This retrospective cohort study aimed to explore the non-linear relationship between albumin level and overall survival (OS) in advanced non-small cell lung cancer (NSCLC) patients with anlotinib therapy, utilizing the Generalized additive model (GAM) approach. Specifically, we investigated the potential non-linear associations that might not be captured by conventional linear analyses.</p></div><div><h3>Methods</h3><p>A retrospective cohort of 211 patients undergoing anlotinib treatment for advanced NSCLC was included in this study. A wide range of albumin levels was considered, and the GAM method was applied to account for potential confounding clinical variables and unveil the non-linear relationship between albumin and OS.</p></div><div><h3>Results</h3><p>A non-linear relationship with inflection points of 40 g/L and 48 g/L was detected between albumin level and OS after adjusting for potential confounders. The hazard ratio (HR) of the left, middle and right of the inflection points were 0.95 (95 % confidence interval [CI], 0.87 to 1.04, p = 0.2819, n = 71), 0.75 (95 % CI, 0.64 to 0.89, p = 0.0007, n = 133) and 2.79 (95 % CI, 1.39 to 5.61, p = 0.0039, n = 7), respectively. The findings indicate a negative correlation between albumin level and OS when albumin level was between 40 g/L and 48 g/L. For every unit increase in albumin, there was a 25 % reduction in the risk of death. Subgroup analysis revealed that the negative relationship was enhanced with blood urea nitrogen (BUN) level increase and diminished with D-dimer increase.</p></div><div><h3>Conclusions</h3><p>The relationship between albumin level and OS was non-linear. Albumin level is an independent prognostic factor for OS. In addition, BUN level and D-dimer level could modify the effect of albumin level on the risk of death in advanced NSCLC patients treated with anlotinib.</p></div>","PeriodicalId":100268,"journal":{"name":"Clinical eHealth","volume":"6 ","pages":"Pages 121-129"},"PeriodicalIF":0.0000,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessment of albumin and overall survival in advanced non-small cell lung cancer patients with anlotinib treatment using generalized additive model: A retrospective cohort study\",\"authors\":\"Congyi Xie , Jinzhan Chen , Zhisheng Chen , Yijiao Xu , Jiaxin Liu , Huijun Zhang , Hongni Jiang , Feiyang Ye , Lin Tong\",\"doi\":\"10.1016/j.ceh.2023.09.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Albumin is believed to be associated with the prediction of various cancers. This retrospective cohort study aimed to explore the non-linear relationship between albumin level and overall survival (OS) in advanced non-small cell lung cancer (NSCLC) patients with anlotinib therapy, utilizing the Generalized additive model (GAM) approach. Specifically, we investigated the potential non-linear associations that might not be captured by conventional linear analyses.</p></div><div><h3>Methods</h3><p>A retrospective cohort of 211 patients undergoing anlotinib treatment for advanced NSCLC was included in this study. A wide range of albumin levels was considered, and the GAM method was applied to account for potential confounding clinical variables and unveil the non-linear relationship between albumin and OS.</p></div><div><h3>Results</h3><p>A non-linear relationship with inflection points of 40 g/L and 48 g/L was detected between albumin level and OS after adjusting for potential confounders. The hazard ratio (HR) of the left, middle and right of the inflection points were 0.95 (95 % confidence interval [CI], 0.87 to 1.04, p = 0.2819, n = 71), 0.75 (95 % CI, 0.64 to 0.89, p = 0.0007, n = 133) and 2.79 (95 % CI, 1.39 to 5.61, p = 0.0039, n = 7), respectively. The findings indicate a negative correlation between albumin level and OS when albumin level was between 40 g/L and 48 g/L. For every unit increase in albumin, there was a 25 % reduction in the risk of death. Subgroup analysis revealed that the negative relationship was enhanced with blood urea nitrogen (BUN) level increase and diminished with D-dimer increase.</p></div><div><h3>Conclusions</h3><p>The relationship between albumin level and OS was non-linear. Albumin level is an independent prognostic factor for OS. In addition, BUN level and D-dimer level could modify the effect of albumin level on the risk of death in advanced NSCLC patients treated with anlotinib.</p></div>\",\"PeriodicalId\":100268,\"journal\":{\"name\":\"Clinical eHealth\",\"volume\":\"6 \",\"pages\":\"Pages 121-129\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-10-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical eHealth\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2588914123000242\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical eHealth","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2588914123000242","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Assessment of albumin and overall survival in advanced non-small cell lung cancer patients with anlotinib treatment using generalized additive model: A retrospective cohort study
Background
Albumin is believed to be associated with the prediction of various cancers. This retrospective cohort study aimed to explore the non-linear relationship between albumin level and overall survival (OS) in advanced non-small cell lung cancer (NSCLC) patients with anlotinib therapy, utilizing the Generalized additive model (GAM) approach. Specifically, we investigated the potential non-linear associations that might not be captured by conventional linear analyses.
Methods
A retrospective cohort of 211 patients undergoing anlotinib treatment for advanced NSCLC was included in this study. A wide range of albumin levels was considered, and the GAM method was applied to account for potential confounding clinical variables and unveil the non-linear relationship between albumin and OS.
Results
A non-linear relationship with inflection points of 40 g/L and 48 g/L was detected between albumin level and OS after adjusting for potential confounders. The hazard ratio (HR) of the left, middle and right of the inflection points were 0.95 (95 % confidence interval [CI], 0.87 to 1.04, p = 0.2819, n = 71), 0.75 (95 % CI, 0.64 to 0.89, p = 0.0007, n = 133) and 2.79 (95 % CI, 1.39 to 5.61, p = 0.0039, n = 7), respectively. The findings indicate a negative correlation between albumin level and OS when albumin level was between 40 g/L and 48 g/L. For every unit increase in albumin, there was a 25 % reduction in the risk of death. Subgroup analysis revealed that the negative relationship was enhanced with blood urea nitrogen (BUN) level increase and diminished with D-dimer increase.
Conclusions
The relationship between albumin level and OS was non-linear. Albumin level is an independent prognostic factor for OS. In addition, BUN level and D-dimer level could modify the effect of albumin level on the risk of death in advanced NSCLC patients treated with anlotinib.
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