控制营养状态评分作为一种新的预后预测因子在接受放疗的宫颈癌患者中的应用：倾向评分匹配分析。
The controlling nutritional status score as a new prognostic predictor in patients with cervical cancer receiving radiotherapy: a propensity score matching analysis.
机构信息
Department of Clinical Nutrition, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China.
Department of Pharmacy, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
出版信息
BMC Cancer. 2024 Sep 3;24(1):1093. doi: 10.1186/s12885-024-12872-9.
BACKGROUND
As assessment tools of nutritional status, the controlling nutritional status (CONUT) and modified controlling nutritional status (mCONUT) score are associated with survival in various cancers. We aimed to investigate the association between the CONUT/mCONUT score's prognostic value and survival time in patients with FIGO stage IIB-IIIB cervical cancer treated with radiotherapy.
METHODS
In this retrospective study, 165 patients between September 2013 and September 2015 were analyzed, and the optimal CONUT/mCONUT score cut-off values were determined using receiver operating characteristic curves. Propensity score matching (PSM) was used to minimize selection bias. The Kaplan-Meier method and a Cox proportional hazard model were used to assess the CONUT/mCONUT score's predictive value linked to survival time. Two nomograms were created to predict the overall survival (OS) and progression-free survival (PFS).
RESULTS
The cut-off values for CONUT and mCONUT score were both 2. Five-year OS and PFS rates were higher in a low CONUT score group than in a high CONUT score group (OS: 81.1% vs. 53.8%, respectively, P < 0.001; PFS: 76.4% vs. 48.2%, respectively; P < 0.001). A high CONUT score was associated with decreased OS (hazard ratio (HR) 2.93, 95% CI 1.54-5.56; P = 0.001) and PFS (HR 2.77, 95% CI 1.52-5.04; P < 0.001). High CONUT scores influenced OS in the PSM cohort. A high mCONUT score was not associated with decreased OS and PFS in Cox regression analysis.
CONCLUSION
The CONUT score is a promising indicator for predicting survival in patients with cervical cancer receiving radiotherapy.
背景
作为营养状况评估工具，控制营养状况（CONUT）和改良控制营养状况（mCONUT）评分与各种癌症的生存率相关。我们旨在研究 CONUT/mCONUT 评分的预后价值与接受放疗的 FIGO 分期 IIB-IIIB 宫颈癌患者生存时间之间的关系。
方法
在这项回顾性研究中，分析了 2013 年 9 月至 2015 年 9 月期间的 165 名患者，并使用接收者操作特征曲线确定了最佳 CONUT/mCONUT 评分截断值。采用倾向评分匹配（PSM）以最小化选择偏倚。使用 Kaplan-Meier 方法和 Cox 比例风险模型评估与生存时间相关的 CONUT/mCONUT 评分的预测价值。创建了两个列线图来预测总生存期（OS）和无进展生存期（PFS）。
结果
CONUT 和 mCONUT 评分的截断值均为 2。低 CONUT 评分组的 5 年 OS 和 PFS 率均高于高 CONUT 评分组（OS：分别为 81.1%和 53.8%，P<0.001；PFS：分别为 76.4%和 48.2%，P<0.001）。高 CONUT 评分与 OS 降低相关（风险比（HR）2.93，95%置信区间（CI）1.54-5.56；P=0.001）和 PFS（HR 2.77，95%CI 1.52-5.04；P<0.001）。高 CONUT 评分在 PSM 队列中影响 OS。在 Cox 回归分析中，高 mCONUT 评分与 OS 和 PFS 降低无关。
结论
CONUT 评分是预测接受放疗的宫颈癌患者生存的有前途的指标。
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