scholarly journals Multicenter Study of Controlling Nutritional Status (CONUT) Score as a Prognostic Factor in Patients With HIV-Related Renal Cell Carcinoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Wenrui Xue ◽  
Yu Zhang ◽  
Hua Wang ◽  
Yu Zhang ◽  
Xiaopeng Hu
Keyword(s):  
Renal Cell Carcinoma ◽  
Nutritional Status ◽  
T Lymphocyte ◽  
Independent Predictor ◽  
Tumor Grade ◽  
Optimal Cutoff ◽  
Fuhrman Grade ◽  
Cutoff Value ◽  
Urological Neoplasms ◽  
Conut Score

ObjectiveIn recent years, the controlled nutritional status (CONUT) score has been widely recognized as a new indicator for assessing survival in patients with urological neoplasms, including renal, ureteral, and bladder cancer. However, the CONUT score has not been analyzed in patients with HIV-related urological neoplasms. Therefore, we aimed to evaluate the prognostic significance of the CONUT score in patients with HIV-related renal cell carcinoma (RCC).MethodsA total of 106 patients with HIV-related RCC were recruited from four hospitals between 2012 and 2021, and all included patients received radical nephrectomy or partial nephrectomy. The CONUT score was calculated by serum albumin, total lymphocyte counts, and total cholesterol concentrations. Patients with RCC were divided into two groups according to the optimal cutoff value of the CONUT score. Survival analysis of different CONUT groups was performed by the Kaplan–Meier method and a log rank test. A Cox proportional risk model was used to test for correlations between clinical variables and cancer-specific survival (CSS), overall survival (OS), and disease-free survival (DFS). Clinical variables included age, sex, hypertension, diabetes, tumor grade, Fuhrman grade, histology, surgery, and CD4+ T lymphocyte count.ResultThe median age was 51 years, with 93 males and 13 females. At a median follow-up of 41 months, 25 patients (23.6%) had died or had tumor recurrence and metastasis. The optimal cutoff value for the CONUT score was 3, and a lower CONUT score was associated with the Fuhrman grade (P=0.024). Patients with lower CONUT scores had better CSS (HR 0.197, 95% CI 0.077-0.502, P=0.001), OS (HR 0.177, 95% CI 0.070-0.446, P<0.001) and DFS (HR 0.176, 95% CI 0.070-0.444, P<0.001). Multivariate Cox regression analysis indicated that a low CONUT score was an independent predictor of CSS, OS and DFS (CSS: HR=0.225, 95% CI 0.067-0.749, P=0.015; OS: HR=0.201, 95% CI 0.061-0.661, P=0.008; DFS: HR=0.227, 95% CI 0.078-0.664, P=0.007). In addition, a low Fuhrman grade was an independent predictor of CSS (HR 0.192, 95% CI 0.045-0.810, P=0.025), OS (HR 0.203, 95% CI 0.049-0.842, P=0.028), and DFS (HR 0.180, 95% CI 0.048-0.669, P=0.010), while other factors, such as age, sex, hypertension, diabetes, tumor grade, histology, surgery, and CD4+ T lymphocyte count, were not associated with survival outcome.ConclusionThe CONUT score, an easily measurable immune-nutritional biomarker, may provide useful prognostic information in HIV-related RCC.

scholarly journals Preoperative Controlling Nutritional Status (CONUT) Score Predicts Short-Term Surgical Prognosis in Patients with Gastric Cancer After Laparoscopy-Assisted Radical Gastrectomy

2020 ◽  
Author(s):  
Yun Qian ◽  
Huaying Liu ◽  
Junhai Pan ◽  
Weihua Yu ◽  
Jiemin Lv ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Assessment Tool ◽  
Predictive Ability ◽  
Short Term ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Conut Score

Abstract Background: The Controlling Nutritional Status (CONUT) score is an emerging nutrition assessment tool that is very useful in patients with gastric cancer who usually experience weight loss and malnutrition. The aim of our study was to assess the predictive ability of the preoperative CONUT score for short-term prognosis in patients with gastric cancer undergoing laparoscopy-assisted gastrectomy.Methods: We retrospectively reviewed medical records of 309 patients who underwent curative laparoscopy-assisted gastrectomy. The patients were divided into two groups according to the optimal cutoff value of the CONUT score. The clinical association for the CONUT score, characteristics, and postoperative complications were evaluated and analyzed. The risk factors for complications were identified by univariate and multivariate analysis.Results: The preoperative CONUT score showed a good predictive ability for postoperative complications (AUC=0.718，Youden index=0.343)，with an optimal cutoff value of 2.5. The patients with high CONUT scores had a higher incidence of overall complications (P<0.001) and mild complications (P<0.001). Univariate and multivariate analysis revealed that the CONUT score was independently associated with postoperative complications (P=0.012；OR=2.433；95%CI：1.218-4.862).Conclusions：The preoperative CONUT score was identified as a reliable nutritional assessment tool for predicting short-term prognosis in patients with gastric cancer after laparoscopy-assisted gastrectomy.

scholarly journals THE PREDICTIVE UTILITY OF GRACE SCORE FOR OBSTRUCTIVE CORONARY ARTERY DISEASE IN PATIENTS WITH NON ST ELEVATION MYOCARDIAL INFARCTION

2021 ◽  
Vol 54 (3) ◽  
pp. 239-243
Author(s):  
Haroon Ishaq ◽  
Bilal Akhtar ◽  
Mukesh Kumar ◽  
Ghulam Shabbir Shar ◽  
Abdul Hakeem ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Predictive Value ◽  
Independent Predictor ◽  
Obstructive Coronary Artery Disease ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Artery Disease ◽  
Grace Score

Objectives: The objective of this study was to determine the predictive value of GRACE score for predicting obstructive coronary artery disease in patients with non ST-segment elevation myocardial infarction (NSTEMI). Methodology: This cross-sectional study was conducted at the largest public sector cardiac care center of the Pakistan between January 2020 and June 2020. In this study, we included adult patients diagnosed with NSTEMI and correlation of GRACE score was assessed with angiographic finding of obstructive CAD defined as ≥50% stenosis in the left main or ≥70% stenosis in other coronary arteries. Results: A total of 227 patients were included in this study, out of whom 72.2% (164) were male patients and mean age was 55.77 ± 9.15 years. Mean GRACE score was found to be 95.89 ± 21.15. On coronary angiography obstructive CAD was present in 84.6% (192) of the patients. Area under the cure for predicting obstructive CAD was 0.669 [0.552 to 0.785]. The optimal cutoff value of GRACE score was ≥ 84 with sensitivity of 79.7% [73.3% to 85.1%] and specificity of 57.1% [39.3% to 73.7%]. GRACE score of ≥ 84 was found to be an independent predictor of obstructive CAD with odds ratio of 4.33 [1.61 - 11.64; p=0.004] adjusted for gender, age, hypertension, diabetes, family history of CAD, and smoking. Conclusion: GRACE score has a moderate predictive value in predicting obstructive CAD in patients with NSTEMI. The optimal cutoff value of 84 is an independent predictor with good sensitivity but moderate specificity in predicting obstructive CAD.

Ratio of maximum to minimum tumor diameter can predict the pathology type of renal cell carcinoma before surgery

2020 ◽  
pp. 030089162093599
Author(s):  
Weixing Jiang ◽  
Dong Wang ◽  
Hongzhe Shi ◽  
Bingqing Shang ◽  
Li Wen ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Roc Curve ◽  
Renal Cell ◽  
Tumor Necrosis ◽  
Tumor Diameter ◽  
Independent Predictive Factor ◽  
Fuhrman Grade ◽  
Cutoff Value ◽  
Papillary Rcc

Introduction: Previous reports have described several methods and markers used to distinguish pathologic subtypes of renal cell carcinoma (RCC). This study aimed to evaluate the utility of the ratio of maximum to minimum tumor diameter (ROD) in predicting pathologic subtypes of RCC. Methods: Data from patients with RCC who underwent surgery between January 2015 and December 2019 were reviewed retrospectively. The cutoff value for ROD was calculated using receiver operating characteristic (ROC) curve analysis. Results: In the clear cell RCC (ccRCC) and non-ccRCC groups, the optimal ROD cutoff value to predict ccRCC was determined to be 1.201 (sensitivity, 90.7%; specificity, 76.1%; area under the ROC curve [AUC], 0.827; p < 0.001). In the non-ccRCC group, the cutoff value for ROD in predicting papillary RCC was 1.092 (sensitivity, 87.9%; specificity, 40.5%; AUC, 0.637; p = 0.003). Compared with patients with ROD <1.201, more patients in the ccRCC group exhibited tumors with an ROD ⩾1.201 (14.2% versus 85.8%, respectively; p < 0.001). Multivariate analysis of preoperative features revealed that ROD ⩾1.201 was an independent predictive factor for ccRCC. In addition, patients with ROD ⩾1.201 had higher percentages of Fuhrman grade III/IV (91.2% versus 8.8%; p = 0.014), tumor necrosis (86.7% versus 13.3%; p = 0.012) and sarcomatoid differentiation (90.6% versus 9.4%; p < 0.001). Conclusions: ROD was a novel indicator for preoperatively predicting histologic type in patients with RCC. ROD cutoff values of 1.201 and 1.092 were the most discriminative for ccRCC and papillary RCC, respectively. Moreover, ROD ⩾1.201 was associated with high Fuhrman grade, sarcomatoid features, and tumor necrosis.

Serial ammonia measurement in patients poisoned with glufosinate ammonium herbicide

2015 ◽  
Vol 35 (5) ◽  
pp. 554-561 ◽  
Author(s):  
JM Moon ◽  
BJ Chun
Keyword(s):  
Odds Ratio ◽  
Independent Predictor ◽  
Ammonia Concentration ◽  
Ammonia Level ◽  
P Value ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Glufosinate Ammonium ◽  
Time Latency

This study investigated whether ammonia concentrations can predict delayed neurotoxicity development and neurotoxicity latency in glufosinate ammonium (GLA) herbicide-poisoned patients presenting with an alert mental state and stable hemodynamics. This retrospective observational case study included 26 patients divided into 2 groups: neurotoxicity during hospitalization (complicated group) and without neurotoxicity (noncomplicated group). Thirteen patients (50.0%) experienced neurotoxicity at 16 h post-ingestion. Although ammonia concentrations at presentation did not differ significantly between the two groups, the ammonia level in the complicated group increased significantly at the next measurement and remained significantly higher than that in the noncomplicated group until 48 h after ingestion. The peak ammonia concentration before neurotoxicity development was an independent predictor of neurotoxicity (odds ratio: 1.047, 95% confidence interval: 1.010–1.087, p value = 0.014), and the optimal cutoff value of peak ammonia concentration for predicting neurotoxicity was 101.5 μg/dL. The rate of ammonia increase was not associated with the time latency from ingestion to neurotoxicity development. This study showed that serial ammonia measurements in GLA-poisoned patients may identify those who are at high risk of developing neurotoxicity. However, as this study enrolled few patients, further qualified trials are required to confirm our results and to reveal the etiology of hyperammonemia and its causality in neurotoxicity.

The prognostic value of the controlling nutritional status (CONUT) score on patients undergoing nephrectomy for upper tract urothelial carcinoma or renal cell carcinoma: a systematic review and meta-analysis

2021 ◽  
pp. 1-20
Author(s):  
Junhao Chen ◽  
Dehong Cao ◽  
Zhufeng Peng ◽  
Pan Song ◽  
Zhenghuan Liu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Nutritional Status ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Subgroup Analysis ◽  
Renal Cell ◽  
Prognostic Value ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
Conut Score

Abstract Background & aims: In recent years, the controlling nutritional status (CONUT) score has increasingly became an effective indicator associated with tumor prognosis. This study was conducted to synthesise data on the prognostic value of CONUT score on patients with upper tract urothelial carcinoma (UTUC) or renal cell carcinoma (RCC) undergoing nephrectomy. Methods: We designed and performed a systematic analysis of studies that verified the correlation between preoperative CONUT score and prognosis for UTUC and RCC using PubMed, Web of Science and Embase. The conclusion was clarified by pooled hazard ratios (HR) and 95% confidence intervals (95% CI). Subgroup analysis were further conducted in accordance with different primary tumor. Results: Six studies involving 3529 patients were included in this evidence synthesis, which revealed that the CONUT score had a potential role to predict the survival of UTUC and RCC patients accepting surgery. Pooled analysis showed that the overall survival (OS, HR 2.32, p<0.0001), cancer-special survival (CSS, HR 2.68, p<0.0001) and disease-free survival (DFS, HR 1.62, p<0.00001) were inferior in the high CONUT score group when compared with low score group. Subgroup analysis revealed that this result was in line with UTUC (OS: HR 1.86, P=0.02; CSS: HR 2.24, P=0.01; DFS: HR 1.54, P<0.00001) and RCC (OS: HR 3.05, P<0.00001; CSS: HR 3.47, P<0.00001; DFS: HR 2.21, P=0.0005) patients respectively. Conclusion: The CONUT score is a valuable preoperative index to predict the survival of patients with UTUC or RCC undergoing nephrectomy.

scholarly journals Fibrinogen/albumin ratio index is an independent predictor of recurrence-free survival in patients with intrahepatic cholangiocarcinoma following surgical resection

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Hu Liu ◽  
Guoteng Qiu ◽  
Fengjuan Hu ◽  
Hong Wu
Keyword(s):  
Multivariate Analysis ◽  
Intrahepatic Cholangiocarcinoma ◽  
Independent Predictor ◽  
Recurrence Free Survival ◽  
Optimal Cutoff ◽  
Free Survival ◽  
Albumin Ratio ◽  
Cutoff Value ◽  
Node Metastasis ◽  
Tumor Node Metastasis Stage

Abstract Background Systemic inflammation and nutritional status are associated with tumor development and progression. This study investigated the prognostic value of fibrinogen/albumin ratio index (FARI) in predicting recurrence-free survival (RFS) in patients with intrahepatic cholangiocarcinoma (ICC) undergoing hepatectomy. Methods A retrospective cohort was conducted including patients who received curative hepatectomy for ICC at our hospital between May 2010 and December 2016. We collected the preoperative hematologic parameters and clinical data of all patients. Time-dependent receiver operating characteristic curve was used to identify the optimal cutoff value of FARI. The association between FARI-high and FARI-low group was investigated by using the Kaplan–Meier method. A nomogram based on the results of univariate and multivariate analysis was established. Results A total of 394 patients with ICC who underwent hepatectomy at our hospital were enrolled. K-M analysis revealed that increased FARI was related to reduced RFS (P < 0.001). The multivariate analysis indicated that tumor number, tumor–node–metastasis stage, lymph node metastasis, cirrhosis, serum carbohydrate antigen 19-9, and FARI were independent predictors of RFS, and the ROC curve analysis showed that the optimal cutoff value for FARI was 0.084 based on the Youden index. The nomogram for FARI showed satisfactory accuracy in predicting RFS for ICC patients undergoing hepatectomy (C index = 0.663; AIC = 3081.07). Conclusion Preoperative FARI is an independent predictor of RFS in patients undergoing hepatectomy for ICC, and the nomogram can be useful for clinical decision-making in the postoperative management of these patients.

scholarly journals Preoperative Controlling Nutritional Status plus Tumor Burden (CONUT-TB) Score for the Assessment of Prognosis after Curative Liver Resection for Hepatocellular Carcinoma

2020 ◽  
Author(s):  
Yasuyuki Fukami ◽  
Takuya Saito ◽  
Takaaki Osawa ◽  
Takashi Arikawa ◽  
Tatsuki Matsumura ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Nutritional Status ◽  
Medical Records ◽  
Metastatic Lesion ◽  
Tumor Burden ◽  
P Value ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Valuable Predictor

Objective: There is no prior study analyzing the prognostic predictive value of adding the tumor factor (i.e., tumor burden score) to the Controlling Nutritional Status (CONUT) score for patients with hepatocellular carcinoma (HCC). This study aimed to investigate the value of the CONUT plus Tumor Burden (CONUT-TB) score as a prognostic predictor in patients with HCC undergoing liver resection. Methods: Between 2015 and 2018, 96 consecutive patients with HCC underwent liver resection at our institution. Patients undergoing repeated liver resection and combined resection of a metastatic lesion were excluded. Patients were divided into two groups according to their CONUT-TB scores according to a cutoff value. Clinicopathological prognostic factors for survival were analyzed using a database containing the medical records. Results: The optimal cutoff value of the CONUT-TB score determined by using a minimum p value approach was 13 points. Among the 81 patients included in the analytic cohort, 71 patients had low (<13) and 10 patients had high (>13) CONUT-TB scores. The overall 3-year survival rate of patients following liver resection for HCC in the high CONUT-TB group was significantly worse than that of patients in the low CONUT-TB group (62.5% vs. 89.3%, p=0.003). Multivariate analysis indicated that a high CONUT-TB score was independently associated with overall survival after liver resection (p=0.010). Conclusions: The CONUT-TB score is a valuable predictor of survival in patients with HCC after liver resection.

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