Prognostic nutritional index predicts initial response to treatment and prognosis in metastatic castration-resistant prostate cancer patients treated with abiraterone

被引：39

作者：

Fan, Liancheng ^{[1
]}

Wang, Xiao ^{[2
]}

Chi, Chenfei ^{[1
]}

Wang, Yanqing ^{[1
]}

Cai, Wen ^{[1
]}

Shao, Xiaoguang ^{[1
]}

Xu, Fan ^{[1
]}

Pan, Jiahua ^{[1
]}

Zhu, Yinjie ^{[1
]}

Xun Shangguan ^{[1
]}

Xin, Zhixiang ^{[1
]}

Hu, Jianian ^{[1
]}

Xie, Shaowei ^{[1
]}

Wang, Rui ^{[3
]}

Zhou, Lixin ^{[1
]}

Dong, Baijun ^{[1
]}

Xue, Wei ^{[1
]}

机构：

[1] Shanghai Jiao Tong Univ, Sch Med, Renji Hosp, Dept Urol, Shanghai 200127, Peoples R China

[2] Shanghai Jiao Tong Univ, Sch Med, RenJi Hosp, Key Lab Oncogenes & Related Genes,Renji Med X Cli, Shanghai, Peoples R China

[3] Shanghai Jiao Tong Univ, Dept Ultrasound Med, Affiliated Peoples Hosp 6, Shanghai Inst Ultrasound Med, Shanghai, Peoples R China

来源：

PROSTATE | 2017年 / 77卷 / 12期

基金：

中国国家自然科学基金;

关键词：

abiraterone acetate; metastatic castration-resistant prostate cancer; prognostic model; PSA flare; INCREASED SURVIVAL; DOUBLE-BLIND; ACETATE; CHEMOTHERAPY; LYMPHOCYTE; FLARE; ENZALUTAMIDE; CABAZITAXEL; PREDNISONE; OUTCOMES;

D O I：

10.1002/pros.23381

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

ObjectiveTo determine if prognostic nutritional index (PNI) and its variation could predict initial response to treatment and prognosis in metastatic castration-resistant prostate cancer (mCRPC) patients treated with Abiraterone (AA). Patients and MethodsOne-hundred-twelve chemotherapy pretreated or chemotherapy-naive patients were scheduled for systemic treatment with AA. PNI levels were measured before and after one month of AA treatment. Univariate and multivariate logistic regression analyses were used to identify predictive factors of initial response to AA treatment. Univariable and Multivariable Cox regression analyses were performed to determine prognostic factors that were associated with PSA progression-free survival (PSA-PFS), radiographic PFS (rPFS) and overall survival (OS). The Harrell concordance index with variables only or combined PNI data were used to evaluate the prognostic accuracy. ResultsEighty-one (72.3%) of 112 patients showed initial response to AA treatment, in which 15 experienced PSA flare during AA treatment. In multivariate logistic regression analyses, high baseline PNI level, PSA level decrease during the first month of AA treatment and PNI level elevation during the first month of AA treatment were significantly correlated with initial response to AA treatment. In multivariate Cox regression analysis, low PNI level remained significant predictors of OS, rPFS and PSA-PFS. The estimated c-index of the multivariate model for OS increased from 0.82 without PNI to 0.83 when PNI added. ConclusionIndependent of PSA level variation, PNI level elevation during the first month of AA treatment and high baseline PNI level were significantly correlated with initial response to AA treatment. In addition, low pretreatment PNI level is a negative independent prognosticator of survival outcomes in mCRPC treated with AA and also increases the accuracy of established prognostic model.

引用

页码：1233 / 1241

页数：9