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Background: The clinical value of the controlling nutritional status (CONUT) score has been widely reported in multiple malignancies. The aim of this study is to investigate the association between the CONUT score and clinical outcomes in patients with gastric cancer. Methods: A comprehensive literature search of electronic databases including PubMed, Embase, and Web of Science was performed up to December 2022. The primary endpoints were survival outcomes and postoperative complications. Subgroup analysis and sensitivity analysis were performed during the pooled analysis. Results: Nineteen studies including 9,764 patients were included. The pooled results indicated that patients in the high CONUT group had a worse overall survival (HR = 1.70 95%CI: 1.54-1.87; P < 0.0001; I 2 = 33%) and recurrence-free survival (HR = 1.57; 95%CI: 1.36-1.82; P < 0.0001; I 2 = 30%), and a higher risk of complications (OR = 1.96; 95%CI: 1.50-2.57; P < 0.0001; I 2 = 69%). In addition, a high CONUT score was significantly associated with larger tumor size, higher percentage of microvascular invasion, later TNM stage and fewer patients receiving adjuvant chemotherapy, but not with tumor differentiation. Conclusion: Based on existing evidence, the CONUT score could act as a valuable biomarker to predict clinical outcomes in patients with gastric cancer. Clinicians could use this useful indicator to stratify patients and formulate individual treatment plans.
RESUMO
Background: The pan-immune-inflammation value (PIV) has been reported as a novel prognostic biomarker in multiple malignancies. The aim of this study is to investigate the prognostic value of the PIV in patients with colorectal cancer. Methods: We comprehensively searched electronic databases including PubMed, Embase and Web of Science up to August 2022. The endpoints were survival outcomes. Hazard ratios (HRs) with 95% confidence intervals (CIs) for survival data were collected for analysis. Results: Six studies including 1879 participants were included. A significant heterogeneity in the PIV cut-off value among studies was observed. The combined results indicated that patients in the high baseline PIV group had a worse overall survival (HR=2.09; 95%CI: 1.67-2.61; P<0.0001; I2 = 7%) and progression-free survival (HR=1.82; 95%CI: 1.49-2.22; P<0.0001; I2 = 15%). In addition, early PIV increase after treatment initiation was significantly associated with decreased overall survival (HR=1.79; 95%CI: 1.13-2.93; P=0.01; I2 = 26%), and a trend toward poor progression-free survival (HR=2.00; 95%CI: 0.90-4.41; P=0.09; I2 = 70%). Conclusion: Based on existing evidence, the PIV could act as a valuable prognostic index in patients with colorectal cancer. However, the heterogeneity in the PIV cut-off value among studies should be considered when interpreting these findings.
RESUMO
OBJECTIVE: To evaluate the value of dual time point 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in differentiating malignant and benign superficial lymph nodes. METHODS: Sixty-eight patients with ninety superficial lymph nodes were examined. Whole body 18F-FDG PET imaging was performed one hour (early) after FDG injection and repeated one hour (delayed) later but only for the interesting areas. The maximum standardized uptake value (SUVmax) was determined for each of the node on both early and delayed images (SUV early and SUV delayed, respectively). Retention index (RI) was then calculated. The cutoff values of SUV early, SUV delayed and RI were determined by receiver operating characteristic (ROC) analyses. The efficacy of each parameter was also analyzed by ROC analyses. RESULTS: The histopathology examinations confirmed 51 malignant nodes and 39 benign nodes. The SUV early (x +/- s) for benign nodes and malignant nodes were 3.26 +/- 1.62 and 8.04 +/- 5.56, respectively (P=0.000). The SUV delayed for benign nodes and malignant nodes were 3.93 +/- 2.11 and 9.82 +/- 6.29, respectively (P=0.000). The RI for benign nodes and malignant nodes were 19.1 +/- 22.5 and 24.8 +/- 18.8, respectively (P=0.191). The cutoff values of SUV early, SUV delayed and RI were 4.3, 4.8 and 18, respectively. The cutoff values of SUV early, SUV delayed and RI produced a sensitivity of 71%, 78% and 63%, a specificity of 87%, 85% and 46%, and an accuracy of 78%, 80% and 57%, respectively. The ROC analyses illustrated that the diagnostic efficacy of SUV early, SUV delayed was higher than RI (P<0.001). However, there was no difference in diagnostic efficacy between SUV early, and SUV delayed (P=0.409). CONCLUSION: Dual-time point 18F-FDG PET does differentiate benign and malignant superficial lymph nodes effectively.