探索短期周诊断体重动态的最佳指标,以预测癌症存活率:一个多中心队列研究
Liangyu Yin1,2, Ling Zhang1, Long Li1
1Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Journal of cachexia, sarcopenia and muscle
|April 22, 2024
概括
癌症诊断周围的体重变化显著影响生存率. 围绕诊断的相对体重变化 (RWC) 是预测癌症患者整体存活率 (OS) 的最佳指标,其表现优于其他指标. 这凸显了在癌症治疗期间需要持续监测体重的必要性.
科学领域:
- 在瘤学瘤学.
- 临床研究 临床研究
- 生物统计学 生物统计学
背景情况:
- 体重波动与癌症结局有关,但诊断周围的短期体重变化缺乏明确的预后价值.
- 现有研究尚未确定预测癌症存活率的短期体重动态的最佳指标.
研究的目的:
- 确定和评估最有效的短期体重动态指标,以预测癌症患者的整体存活率 (OS).
- 在临床相关的时间框架内评估各种体重相关指标的预后表现.
主要方法:
- 一项前性多中心队列研究,涉及7460名在2013年至2019年期间被诊断为癌症的癌症患者.
- 在诊断前1个月,诊断时和诊断后1个月收集的体重数据.
- 创建并比较12个与体重相关的指标,包括周期诊断相对体重变化 (RWC),使用Harrell的C指数,歧视改进和重新分类指标.
主要成果:
- 与其他指标 (如BMI和诊断前/后RWC) 相比,周诊断RWC显示出更好的预后表现 (C指数=0.601).
- 在周周诊断RWC和OS之间观察到一个N形的非线性关联,体重增加与更好的生存率和体重减轻与更差的生存率有关.
- 显著的体重增加 (>10%) 与47%的死亡风险降低有关 (HR=0.530),而显著的体重减轻 (>10%) 增加了28%的死亡风险 (HR=1.280).
结论:
- 周周诊断 (RWC) 是癌症患者整体存活期的优越预后指标,与其他与体重相关的指标相比.
- 强调从诊断前到诊断后在操作时间框架内监测身体体重变化的重要性.
- 表明,识别和干预患有体重变化相关死亡风险的患者对于改善癌症护理结果至关重要.
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