ObjectiveTo evaluate whether three preoperative nutritional scoring indices, the Naples prognostic score (NPS), controlling nutritional status (CONUT), and prognostic nutritional index (PNI), are associated with the clinicopathological characteristics and prognosis of patients with esophageal squamous cell carcinoma (ESCC). MethodsA retrospective analysis was conducted on clinical data from ESCC patients who underwent surgical treatment in the Department of Thoracic Surgery at the First Hospital Affiliated to the University of Science and Technology of China between 2017 and 2019. Based on NPS, CONUT, and PNI scores, optimal cutoff values were determined using X-tile software to divide patients into a high-value group and a low-value group. Differences in clinicopathological characteristics between groups were compared. Survival analysis was performed using Kaplan-Meier method and log-rank test. Multivariate Cox proportional hazards model was used to analyze factors influencing overall survival (OS). The predictive performance of each nutritional index was evaluated by area under receiver operating characteristic curve (AUC). Differences in AUC values among ROC curves were compared using MedCalc software. ResultsA total of 606 ESCC patients were included, comprising 459 males and 147 females, with a mean age of (65.98±7.60) years. Univariate analysis showed that age, squamous cell carcinoma antigen level, NPS, CONUT, PNI, TNM stage, degree of differentiation, and tumor size were all risk factors affecting OS in ESCC patients (P<0.05). Multivariate analysis revealed that age, TNM stage, and NPS were independent risk factors for OS. Among the indices analyzed for prognostic efficacy via AUC values comparison, NPS demonstrated the highest AUC value (0.681) with statistically significant superiority over PNI and CONUT (P<0.05). Conclusion Age, TNM stage, and NPS are independent risk factors affecting the OS of ESCC patients after surgery. Moreover, prognostic evaluation efficacy of NPS surpasses that of PNI and CONUT, indicating its potential as a significant indicator for predicting outcomes in ESCC patients.
ObjectiveTo explore the factors of affecting the prognosis of pancreatic ductal adenocarcinoma (PDAC) after radical resection based on the preoperative systemic immune-inflammation index (SII) and the controlling nutritional status (CONUT) score and to establish a prognostic prediction model.MethodsThe clinicopathologic data of patients diagnosed with PDAC from January 2014 to December 2019 in the Second Hospital of Lanzhou University were retrospectively analyzed. The X-tile software was used to determine the optimal cut-off value of SII. The Kaplan-Meier method was used to analyze survival. The Cox proportional hazards regression model was used to conduct multivariate analysis of prognostic factors of PDAC after radical surgery. R4.0.5 software was used to draw a nomogram prediction model of 1-, 2-, and 3-year survival rates, then evaluate the effectiveness of the prediction model and establish a web page calculator.ResultsA total of 131 patients were included in the study. The median survival time was 18.6 months, and the cumulative survival rates at 1-, 2-, and 3-year were 73.86%, 36.44%, and 11.95%, respectively. The optimal cut-off value of preoperative SII was 313.1, and the prognosis of patients with SII>313.1 was worse than SII≤313.1 (χ2=8.917, P=0.003). The results of multivariate analysis suggested that the age>65 years old, clinical stage Ⅲ and Ⅳ, preoperative SII>313.1, and CONUT score >4 were the independent factors influencing the prognosis (overall survival) for PDAC after radical resection (P<0.05). The internal verification consistency index (C-index) of the nomogram prediction model including age, clinical stage, preoperative SII, CONUT score and postoperative chemotherapy was 0.669. The survival predicted by the nomogram correction curve fitted well with the observed survival. The decision curve analysis showed that the nomogram prediction model had a wider clinical net benefit (Threshold probability was 0.05–0.95), and the web calculator worked well.ConclusionsAge, clinical stage, preoperative SII, CONUT score are independent influencing factors for prognosis after radical PDAC surgery. Nomogram prediction model included these independent influencing factors is more accurate and web calculator will be more convenient for doctors and patients.
