medigraphic.com
ISSN 1561-3011 (Electronic)

2022, Number 1

<< Back Next >>

Rev Cubana Invest Bioméd 2022; 41 (1)

Nutritional prognostic index in patients with advanced pancreatic cancer treated with nimotuzumab combined with chemotherapy

Lima-Pérez M, Soriano-García JL, Soriano-Lorenzo JL, González-Meisozo M, Fleites-Calvo V, Morales-Morgado D, Rodríguez-Barrios R, Domínguez-Álvarez C, Ramón-Concepción I, Batista-Albuerne N

Language: Spanish
References: 32
Page: 1-22
PDF size: 340.04 Kb.


ABSTRACT

Background: The nutritional prognostic index is an immuno-nutritional marker that can be useful as a prognostic factor in gastrointestinal tumors.
Aim: To evaluate the survival of patients with advanced pancreatic adenocarcinoma treated with chemoimmunotherapy according to the nutritional prognostic index, according to clinical-pathological parameters and treatment.
Methods: A retrospective and observational study was carried out in patients who received gemcitabine-oxaliplatin chemotherapy combined with nimotuzumab (n=118), at the Ameijeiras Hospital, between 2014 and 2019. Survival was evaluated by the Kaplan-Meier method, and Cox regression, for determine independent prognostic factors for survival.
Results: The selected cut-off point was 40 (52.9% sensitivity and 85.7% specificity) (p=0,019), with an area under the curve of 0,693. For patients with an index less than 40, survival was lower compared to patients with index ≥ 40 (11, 4 months vs. 16, 0 months; p=0,001), with a HR of 1, 7 (1, 13-2, 60; p=0,011). The variables mostly associated with nutritional prognostic index patients with 60 years or less, ECOG 0, body mass index ≥ 25 kg/m² and serum albumin >3,5g/dL (x² < 0, 05). Patients with index ≥ 40 have higher median survival than patients with index < 40 in the selected variables with p < 0, 05, except body mass index.
Conclusions: This work constitutes the first national report on the use of the nutritional prognostic index as a prognosis of survival in patients with advanced pancreatic cancer.


REFERENCES

  1. Galán Y, Iglesias Y, Kindelan G, Planas S, Fernandez LM. Incidencia de cánceren Cuba en el 2016. Rev Cub Oncol. 2020 [acceso 30/12/2021]; 18 (3): e_46.Disponible en: http://revoncologia.sld.cu/index.php/onc/article/view/46/36

  2. Galán Y, Iglesias Y, Kindelan G, Planas S, Fernandez LM. Incidencia de cánceren Cuba en el 2017. Rev Cuban Oncol. 2021 [acceso 30/12/2021]; 19 (3): e_155.Disponible en: http://revoncologia.sld.cu/index.php/onc/article/view/155

  3. Lima-Pérez M, Galán-Alvarez YH, Soriano-García JL, Iglesias-Ventura Y, Medina-Pérez VM. Incidencia y mortalidad por cáncer del sistema digestivo en Cuba. 2015-2017. Rev Cuban Oncol. 2021[acceso 30/12/2021]; 19 (2): e_142. Disponible en:http://revoncologia.sld.cu/index.php/onc/article/view/142

  4. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al.Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortalityworldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; 71 (3): 209-49.DOI:10.3322/caac.21660.

  5. World Health Organization (WHO). Global Health Estimates 2020: Deaths byCause, Age, Sex, by Country and by Region, 2000-2019. WHO. 2020 [acceso30/05/2021]. Disponible en: who.int/data/gho/data/themes/mortality-andglobalhealth-estimates/ghe-leadingcauses-of- death

  6. Arnold M, Abnet CC, Neale RE, Vignat J, Giovannucci EL, McGlynn KA, et al.Global burden of 5 major types of gastrointestinal cancer. Gastroenterology.2020; 159 (1): 335-49. DOI: 10.1053/j.gastro.2020.02.068.

  7. DaVee T, Coronel E, Papafragkakis C, Thaiudom S, Lanke G, Chakinala RC, etal. Pancreatic cancer screening in high-risk individuals with germline geneticmutations. Gastrointest Endosc. 2018; 87 (6): 1443-50.DOI:10.1016/j.gie.2017.12.019.

  8. Ghosn M, Ibrahim T, Assi T, El Rassy E, Kourie HR, Kattan J. Dilemma of firstline regimens in metastatic pancreatic adenocarcinoma. World J Gastroenterol.2016; 22 (46): 10124-30. DOI: 10.3748/wjg.v22.i46.10124.

  9. Jin SF, Fan ZK, Pan L, Jin LM. Gemcitabine-based combination therapycompared with gemcitabine alone for advanced pancreatic cancer: a metaanalysisof nine randomized controlled trials. Hepatobiliary Pancreat Dis Int.2017; 6(3): 236-44. DOI: 10.1016/s1499-3872(17)60022-5.

  10. Blomstrand H, Batra A, Cheung WY, Elander NO. Real-world evidence on firstandsecond-line palliative chemotherapy in advanced pancreatic cancer. World JClin Oncol. 2021; 12 (9): 787-99. DOI: 10.5306/wjco.v12.i9.787.

  11. Hu J, Zhao G, Wang HX, Tang L, Xu YC, Ma Y, et al. A meta-analysis ofgemcitabine containing chemotherapy for locally advanced and metastaticpancreatic adenocarcinoma. J Hematol Oncol. 2011;4:11. DOI: 10.1186/1756-8722-4-11.

  12. Lima-Pérez M, Soriano-García JL, González-Meisozo M, Rodríguez-Barrios R,Vals-Machado Y, Domínguez-Alvarez C, et al. Nimotuzumab combinado a esquemade quimioterapia GEMOX en pacientes con cáncer pancreático avanzado.Vaccimonitor. 2021 [acceso 30/12/2021]; 30 (3): 133-144. Disponible en:http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-028X2021000300133&lng=es&nrm=iso&tlng=es

  13. Liu J, Jiang S, Yang X, Li X, Wang N. The significant value of preoperativeprognostic nutritional index for survival in pancreatic cancer: a meta-analysis.Pancreas. 2018; 47(8):793-799. DOI: 10.1097/MPA.0000000000001089.

  14. Tashiro M, Yamada S, Sonohara F, Takami H, Suenaga M, Hayashi M, et al.Clinical impact of neoadjuvant therapy on nutritional status in pancreatic cancer.Ann Surg Oncol. 2018; 25: 3365-3371. DOI: 10.1245/s10434-018-6699-8.

  15. Sun K, Chen S, Xu J, Li G, He Y. The prognostic significance of the prognosticnutritional index in cancer: a systematic review and meta-analysis. J Cancer ResClin Oncol. 2014; 140 (9):1537-49. DOI: 10.1007/s00432-014-1714-3.

  16. Schwartz LH, Litière S, de Vries E, Ford R, Gwyther S, Mandrekar S, et al.RECIST 1.1-Update and clarification: From the RECIST committee. Eur J Cancer.2016; 62: 132-7. DOI: 10.1016/j.ejca.2016.03.081.

  17. Singh N, Baby D, Rajguru JP, Patil PB, Thakkannavar SS, Pujari VB.Inflammation and cancer. Ann Afr Med. 2019; 18 (3): 121-6. DOI:10.4103/aam.aam_56_18.

  18. Shadhu K, Xi C. Inflammation and pancreatic cancer: An updated review.Saudi J Gastroenterol. 2019; 25 (1): 3-13. DOI: 10.4103/sjg.SJG_390_18.

  19. Stone ML, Beatty GL. Cellular determinants and therapeutic implications ofinflammation in pancreatic cancer. Pharmacol Ther. 2019; 201: 202-13. DOI:10.1016/j.pharmthera.2019.05.012.

  20. Szkandera J, Stotz M, Absenger G, Stojakovic T, Samonigg H, Kornprat P, etal. Validation of C-reactive protein levels as a prognostic indicator for survival ina large cohort of pancreatic cancer patients. Br J Cancer. 2014; 110 (1): 183-8.DOI: 10.1038/bjc.2013.701.

  21. Onodera T, Goseki N, Kosaki G. [Prognostic nutritional index ingastrointestinal surgery of malnourished cancer patients]. Nihon Geka GakkaiZasshi. 1984; 85 (9): 1001-5. Japanese. PMID: 6438478.

  22. Xu SS, Li S, Xu HX, Li H, Wu CT, Wang WQ, et al. Haemoglobin, albumin,lymphocyte and platelet predicts postoperative survival in pancreatic cancer.World J Gastroenterol. 2020; 26 (8): 828-38. DOI: 10.3748/wjg.v26.i8.828.

  23. Lee SH, Chung MJ, Kim B, Lee HS, Lee HJ, Heo JY, et al. The significance ofthe prognostic nutritional index for all stages of pancreatic cancer. Nutr Cancer.2017; 69 (3): 512-519. DOI: 10.1080/01635581.2016.1250921.

  24. Fogar P, Sperti C, Basso D, Sanzari MC, Greco E, Davoli C, et al. Decreasedtotal lymphocyte counts in pancreatic cancer: an index of adverse outcome.Pancreas. 2006; 32 (1): 22-8. DOI: 10.1097/01.mpa.0000188305.90290.50.

  25. Shimizu T, Taniguchi K, Asakuma M, Tomioka A, Inoue Y, Komeda K, et al.Lymphocyte-to-Monocyte ratio and prognostic nutritional index predict poorprognosis in patients on chemotherapy for unresectable pancreatic cancer.Anticancer Res. 2019; 39 (4): 2169-76. DOI: 10.21873/anticanres.13331.

  26. Vashi P, Popiel B, Lammersfeld C, Gupta D. Outcomes of systematicnutritional assessment and medical nutrition therapy in pancreatic cancer.Pancreas. 2015; 44 (5): 750-5. DOI: 10.1097/MPA.0000000000000336.

  27. Soriano-Lorenzo JL, Lima-Pérez M, Soriano-García JL, González-Meisozo M,Domínguez-Alvarez C, Rodríguez-Barrios R, et al. Índice neutrófilo/linfocito comofactor pronóstico en pacientes con adenocarcinoma pancreático avanzadotratados con quimioinmunoterapia. Rev Cubana Oncol. 2021 [acceso 30/09/2021];19 (2): e_131. Disponible en:http://revoncologia.sld.cu/index.php/onc/article/view/131

  28. Xiang ZJ, Hu T, Wang Y, Wang H, Xu L, Cui N. Neutrophil-lymphocyte ratio(NLR) was associated with prognosis and immunomodulatory in patients withpancreatic ductal adenocarcinoma (PDAC). Biosci Rep. 2020; 40 (6): BSR20201190.DOI: 10.1042/BSR20201190.

  29. Geng Y, Qi Q, Sun M, Chen H, Wang P, Chen Z. Prognostic nutritional indexpredicts survival and correlates with systemic inflammatory response in advancedpancreatic cancer. Eur J Surg Oncol. 2015; 41 (11): 1508-14. DOI:10.1016/j.ejso.2015.07.022.

  30. Wang DS, Luo HY, Qiu MZ, Wang ZQ, Zhang DS, et al. Comparison of theprognostic values of various inflammation based factors in patients withpancreatic cancer. Med Oncol. 2012; 29: 3092-3100. DOI: 10.1007/s12032-012-0226-8.

  31. Yu SL, Xu LT, Qi Q, Geng YW, Chen H, Meng ZQ, et al. Serum lactatedehydrogenase predicts prognosis and correlates with systemic inflammatoryresponse in patients with advanced pancreatic cancer after gemcitabine-basedchemotherapy. Sci Rep. 2017; 7: 45194. DOI: 10.1038/srep45194.

  32. Li S, Tian G, Chen Z, Zhuang Y, Li G. Prognostic role of the prognosticnutritional index in pancreatic cancer: A meta-analysis. Nutr Cancer.2019;71(2):207-13. DOI: 10.1080/01635581.2018.1559930.




2020     |     www.medigraphic.com