Preoperative Immune-Nutritional Abnormality Predicts Poor Outcome in Elderly Non-Small-Cell Lung Cancer Patients with Comorbidities
Autor: | Naoko Miura, Sadanori Takeo, Fumihiro Shoji, Koji Yamazaki, Yuka Kozuma, Gouji Toyokawa |
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Rok vydání: | 2020 |
Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Multivariate analysis surgical outcome Nutritional Status Comorbidity 030204 cardiovascular system & hematology elderly patients Risk Assessment 03 medical and health sciences preoperative immune-nutritional status 0302 clinical medicine Predictive Value of Tests Risk Factors Carcinoma Non-Small-Cell Lung Internal medicine medicine Humans preoperative comorbidities Stage (cooking) Pneumonectomy Lung cancer Geriatric Assessment Pathological Aged Retrospective Studies Aged 80 and over Univariate analysis business.industry Malnutrition Age Factors Gastroenterology General Medicine controlling nutritional status score medicine.disease Confidence interval Nutrition Assessment Treatment Outcome non-small-cell lung cancer 030228 respiratory system Cardiothoracic surgery Relative risk Female Original Article Surgery Cardiology and Cardiovascular Medicine business |
Zdroj: | Annals of Thoracic and Cardiovascular Surgery |
ISSN: | 2186-1005 1341-1098 |
Popis: | Background Elderly non-small-cell lung cancer (NSCLC) patients are increasing. In general, elderly patients often have more comorbidities and worse immune-nutritional condition. Patients and methods In total, 122 NSCLC patients aged 75 years or older, underwent thoracic surgery between January 2007 and December 2010. In all, 99 of 122 patients (81.1%) who had preoperative comorbidities were retrospectively analyzed. We evaluated the preoperative immune-nutritional condition using the controlling nutritional status (CONUT) score. Results We decided the best cutoff value for CONUT score was 1; as a result, 42 of 99 patients (42.4%) had abnormal preoperative CONUT score. Univariate analyses showed sex (P = 0.0099), smoking status (P = 0.0176), pathological stage (P = 0.0095), and preoperative CONUT score (P = 0.0175) significantly affected overall survival (OS). In multivariate analysis, pathological stage (relative risk (RR): 2.12; 95% confidence interval (CI): 1.10-3.90; P = 0.0268) and preoperative CONUT score (RR: 2.10; 95% CI: 1.20-3.67; P = 0.0094) were shown to be independent prognostic factors. In Kaplan-Meier analysis of OS, the preoperative abnormal CONUT score group had significantly shorter OS than did the preoperative normal CONUT score group (P = 0.0152, log-rank test); however, there were no statistical differences both in disease-free survival (DFS) and cancer-specific survival (CSS; P = 0.9238 and P = 0.8661, log-rank test, respectively). In total, 22 patients (46.8%) were dead caused by other diseases such as pneumonia or other organs malignancies. Conclusion Preoperative abnormal CONUT score is a poor prognostic factor for the elderly NSCLC patients with preoperative comorbidities and might predict poor postoperative outcome caused by not primary lung cancer but other diseases. |
Databáze: | OpenAIRE |
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