Critical weight loss predicts poor prognosis in nasopharyngeal carcinoma.
Critical weight loss predicts poor prognosis in nasopharyngeal carcinoma.
复制标题
严重体重减轻预示鼻咽癌预后不良
DOI：
10.1186/s12885-016-2214-4
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发表时间：
2016-02-29
期刊：
影响因子：
3.8
通讯作者：
Wu PH
中科院分区：
文献类型：
--
作者：
Zeng Q;Shen LJ;Guo X;Guo XM;Qian CN;Wu PH
背景体重减轻对鼻咽癌预后的影响尚不清楚。因此，本研究进行了调查之间的关联NPC patients.MethodsThe符合条件的2399 NPC患者的临界体重减轻和长期生存。体重变化分为临界体重减轻（CWL）和非临界体重减轻（Non-CWL）。通过考克斯回归分析整个患者和两个亚组的CWL与长期生存的关系。倾向评分匹配进行，以减少混淆factors.ResultsCWL的影响被定义为体重减轻≥ 4.6%。与无CWL患者相比，CWL患者的5年OS（72.4 vs. 79.3%，P< 0.001）、FFS（71.1 vs. 78.4%，P<0.001）和LR-FFS（78.1 vs. 84.8%，P<0.001）分别显著降低。校正潜在混杂因素后，CWL仍然是OS的独立预后因素（HR= 1.352; 95% CI 1.160-1.576;P< 0.001）、FFS（HR= 3.275; 95% CI 1.101-9.740;P= 0.033）和LR-FFS（HR= 6.620; 95% CI 2.990-14.658;P< 0.001）。此外，在接受同步放化疗或单独放疗的患者队列中进行的亚组分析证实了整个患者的结果，即使在倾向评分匹配后。在IMRT队列中，CWL与较低的OS（P= 0.04）和FFS（P= 0.04）显著相关。
BackgroundThe impacts of weight loss on prognosis in nasopharyngeal carcinoma (NPC) remain unclear. The present study was therefore undertaken to investigate the association between critical weight loss and long-term survival in NPC patients.MethodsThe eligible 2399 NPC patients were reviewed. Weight change was categorized into critical weight loss (CWL) and non-critical weight loss (Non-CWL). The associations of CWL with long-term survival were analyzed by Cox regression in the entire patient and two subsets. Propensity score matching was performed to reduce the effects of confounding factors.ResultsCWL was defined as body weight loss of ≥4.6 %. Compared with patients without CWL, patients with CWL had significantly lower 5-year OS (72.4 vs. 79.3 %,P< 0.001), FFS (71.1 vs. 78.4 %,P<0.001), and LR-FFS (78.1 vs. 84.8 %,P<0.001), respectively. After adjustment for potential confounders, CWL remained an independence prognostic factor for OS (HR= 1.352; 95 % CI 1.160–1.576;P< 0.001), FFS (HR= 3.275; 95 % CI 1.101–9.740;P= 0.033), and LR-FFS (HR= 6.620; 95 % CI 2.990–14.658;P< 0.001), respectively. Furthermore, subgroup analysis in the cohort of patients received concurrent chemoradiotherapy or radiotherapy alone confirmed the results in the entire patient even after the propensity-score matching. In IMRT cohort, CWL was also significantly associated with a lower OS (P= 0.04) and FFS (P= 0.04).ConclusionsCWL has a significant and independent impact on long-term survival in nasopharyngeal carcinoma patients.