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
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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