Predictive ability of prognostic nutritional index in surgically resected gastrointestinal stromal tumors: a propensity score matching analysis

2019 ◽  
Vol 49 (9) ◽  
pp. 823-831 ◽  
Author(s):  
Wei-Kun Shi ◽  
Xin-Hua Zhang ◽  
Jian Zhang ◽  
Miao Yu ◽  
Yu-Jie Yuan ◽  
...  

Prognostic nutritional index was found to be correlated with prognosis in GISTs before and after propensity score matching and its incorporation improved the prognostic stratification of NIH risk criteria.

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Zhi Yang ◽  
...  

Abstract Background Immunoinflammatory and nutritional markers, such as the peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and Onodera’s prognostic nutritional index (OPNI), have gained considerable attention and have been preliminarily revealed as prognostic markers of gastrointestinal stromal tumors (GISTs). Methods In this study, we first investigated the prognostic value of OPNI in GISTs treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, and data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan–Meier method and compared by the log-rank test. Results The patients were divided into groups treated and not treated with TKIs, and we used the propensity score matching method to homogenize their baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen, and 280 of them were included for analysis under the inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI as an independent prognostic marker that was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 42.6; HR 0.409; P < 0.001) was associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated and not treated with TKIs. Higher NLR and PLR have negative effects on RFS.


2019 ◽  
Vol 10 (12) ◽  
pp. 2679-2686 ◽  
Author(s):  
Jianyi Sun ◽  
Ying Mei ◽  
Qiutao Zhu ◽  
Chunhui Shou ◽  
Welda E.H. Tjhoi ◽  
...  

2020 ◽  
Author(s):  
Jian fang Rong ◽  
Si hai Chen ◽  
Cong hua Song ◽  
Huan Wang ◽  
Qiao yun Zhao ◽  
...  

Abstract Background Gastrointestinal stromal tumors (GISTs) of the stomach are the most common GISTs. The risk, incidence and outcome of cancer are different between the sexes. Whether gender is related to the prognosis of gastric stromal tumors is unclear. Therefore, this study aims to explore the relationship between gender and gastric GIST prognosis. Methods Data from gastric GIST patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database. After propensity score matching (PSM) was performed to reduce confounding factors, the clinicopathological features and prognosis of GIST patients were comprehensively evaluated. Results There were 512 male patients and 538 female patients with gastric GIST. The gender of gastric GIST patients was associated with marital status, surgical treatment, tumor size, and mitotic index (P < 0.05). The Kaplan-Meier analysis and log-rank test revealed that male patients had a higher mortality rate than female patients (P = 0.0024). After matching all the potential confounding factors, the survival of the female gastric GIST patients was better than that of the male gastric GIST patients (P = 0.042). Cox regression analysis revealed that gender was an independent risk factor for overall survival. The risk of death was higher for males than for females (HR: 1.539, 95% CI: 1.066–2.222, P = 0.021). Conclusion Gender could be a prognostic factor for gastric GIST survival, and male patients had a higher risk of death.


2020 ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Xuefeng Xia ◽  
...  

Abstract Background Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST). Methods In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, The data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. Results These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables.A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 44.05; HR 0.433; 95% CI 0.236–0.794; P = 0.007) were associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs.


2021 ◽  
Vol 11 ◽  
Author(s):  
Feng Zhang ◽  
Shuang Gao ◽  
Yiqiao Zhao ◽  
Bin Wu ◽  
Xiaonan Chen

Objective: To compare the functional outcome, safety and efficacy of sutureless and conventional laparoscopic partial nephrectomy.Methods: After the inclusion and exclusion criteria were applied, our study reviewed 379 patients with T1 stage renal tumors. We applied propensity score matching (PSM) to limit potential baseline confusion. Perioperative and functional outcomes between sutureless laparoscopic partial nephrectomy (sLPN) and conventional laparoscopic partial nephrectomy (cLPN) groups were compared and analyzed before and after PSM.Results: Of our 379 patients with T1 stage renal tumors, 199 and 180 were identified in the cLPN and sLPN groups, respectively. After applying PSM with preoperative features, 116 patients in the cLNP group were paired to 116 patients in the sLNP group. We found that all differences in preoperative baseline characteristics disappeared. All the preoperative characteristics (age, gender, tumor diameter, RENAL nephrometry score, side, preoperative eGFR, hypertension, diabetes mellitus, ASA score) were not statistically different between the two groups. The operative time (OT) (p &lt; 0.001) and warm ischemia time (WIT) (p &lt; 0.001) of the sLPN group were of shorter duration than that of the cLPN group. The eGFR baseline was almost equal, but there was a statistically smaller decrease in eGFR in the sLPN than in the cLPN group 1 week after surgery (14.3 vs. 7.4, p &lt; 0.001) and after 6 months (11.9 vs. 5.0, p &lt; 0.001). After both preoperative features and WIT were included in PSM, fifty-one pairs of patients were identified between the groups, the WIT difference between them disappeared, while the decrease in eGFR between the groups remained as it was previously at 1 week (15.4 vs. 8.6, p &lt; 0.001) and at 6 months (13.0 vs. 6.2, p &lt; 0.001).Conclusion: Sutureless laparoscopic partial nephrectomy is as safe and effective as conventional laparoscopic partial nephrectomy, and compared to cLPN, sLPN can effectively reduce the WIT, retain more renal parenchyma and protect renal function.


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