Nutrición Hospitalaria 03983 / http://dx.doi.org/10.20960/nh.03983

Resumen| PDF (ENGLISH)

Trabajo Original

A novel nomogram based on the nutritional risk screening 2002 score to predict survival in hepatocellular carcinoma treated with transarterial chemoembolization

Xinxin Chen

Prepublicado: 2022-08-02

Publicado: 2022-08-02

VOLUMEN 39, NÚM. 4, julio-agosto (2022), PAG. 835-842

Logo Descargas Número de descargas: 90 Logo Visitas Número de visitas: 1711 Citas Citas: 0

Compártelo:

Objective: transarterial chemoembolization (TACE) is one of the common treatments for hepatocellular carcinoma (HCC). Predicting prognosis for HCC patients who received TACE is challenging because of huge differences in outcome. At present, the Nutritional Risk Screening 2002 (NRS-2002) is widely used to screen nutritional risk in hospitalized patients, which has been confirmed to be related to prognosis. Here, the objective of this research is to construct a prognostic nomogram using the NRS-2002 score for HCC patients receiving TACE. Methods: we enrolled 359 HCC patients who received TACE at the Xingtai People's Hospital between January 2015 and December 2020. According to the preoperative NRS-2002 score, patients were divided into an NRS ≥ 3 group (n = 190; 52.9 %) and an NRS < 3 group (n = 167, 47.1 %). Meanwhile, variables associated with survival were analyzed by univariate and multivariate Cox regression. Beyond that, a nomogram incorporating independent variables was established. The concordance index (C-index) and calibration curves were used to assess the prediction performance of the nomogram. Results: the median survival of the NRS ≥ 3 group was significantly lower than that of the NRS < 3 group. As shown by multivariate analysis, in the Barcelona Clinic Liver Cancer stage an NRS-2002 score ≥ 3, γ-glutamyl transpeptidase, and alpha-fetoprotein were significantly associated with survival in HCC patients after TACE. In addition, the C-index was 0.708 (95 % confidence interval: 0.672-0.743), and the calibration curves showed a good consistency between the observed and predicted survivals at 1, 2, and 3 years, respectively. Conclusions: NRS-2002 ≥ 3 could identify high-risk patients with HCC who received TACE. The NRS-2002-based nomogram model had good prognostic prediction accuracy. Keywords:

Palabras Clave: Hepatocellular carcinoma. Transcatheter arterial chemoembolization. Nutritional risk. Nutritional risk screening 2002.

Descargar PDF (ENGLISH)

Bibliografía
Artículos Relacionados

Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin 2015;65:87-108.
DOI: 10.3322/caac.21262

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol 2018;69:182-236.
DOI: 10.1016/j.jhep.2018.03.019

Lencioni R, de Baere T, Soulen MC, Rilling WS, Geschwind JF. Lipiodol transarterial chemoembolization for hepatocellular carcinoma: A systematic review of efficacy and safety data. Hepatology 2016;64:106-16.
DOI: 10.1002/hep.28453

Villanueva A. Hepatocellular Carcinoma. N Engl J Med 2019;380:1450-62.
DOI: 10.1056/NEJMra1713263

Tsochatzis EAP, Bosch JP, Burroughs AKP. Liver cirrhosis. The Lancet (British edition) 2014;383:1749-61.
DOI: 10.1016/S0140-6736(14)60121-5

Cao J, Xu H, Li W, Guo Z, Lin Y, Shi Y, et al. Nutritional assessment and risk factors associated to malnutrition in patients with esophageal cancer. Curr Probl Cancer 2021;45:100638.
DOI: 10.1016/j.currproblcancer.2020.100638

Zhang Z, Wan Z, Zhu Y, Zhang L, Zhang L, Wan H. Prevalence of malnutrition comparing NRS2002, MUST, and PG-SGA with the GLIM criteria in adults with cancer: A multi-center study. Nutrition 2021;83:111072.
DOI: 10.1016/j.nut.2020.111072

Zhang X, Tang M, Zhang Q, Zhang K, Guo Z, Xu H, et al. The GLIM criteria as an effective tool for nutrition assessment and survival prediction in older adult cancer patients. Clin Nutr 2021;40:1224-32.
DOI: 10.1016/j.clnu.2020.08.004

Kondrup J. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 2003;22:321-36.
DOI: 10.1016/S0261-5614(02)00214-5

Wu Y, Zhu Y, Feng Y, Wang R, Yao N, Zhang M, et al. Royal Free Hospital-Nutritional Prioritizing Tool improves the prediction of malnutrition risk outcomes in liver cirrhosis patients compared with Nutritional Risk Screening 2002. Br J Nutr 2020;124:1293-302.
DOI: 10.1017/S0007114520002366

Kollar D, Benedek-Toth Z, Drozgyik A, Molnar FT, Olah A. Perioperative nutritional state as a surgical risk in oncologic patients. Orv Hetil 2021;162:504-13.

Knudsen AW, Naver A, Bisgaard K, Nordgaard-Lassen I, Becker U, Krag A, et al. Nutrition impact symptoms, handgrip strength and nutritional risk in hospitalized patients with gastroenterological and liver diseases. Scand J Gastroenterol 2015;50:1191-8.
DOI: 10.3109/00365521.2015.1028994

Wang Z, Xu J, Song G, Pang M, Guo B, Xu X, et al. Nutritional status and screening tools to detect nutritional risk in hospitalized patients with hepatic echinococcosis. Parasite 2020;27:74.
DOI: 10.1051/parasite/2020071

Zacharias T, Ferreira N. Nutritional risk screening 2002 and ASA score predict mortality after elective liver resection for malignancy. Arch Med Sci 2017;13:361-9.
DOI: 10.5114/aoms.2017.65273

Chua DW, Koh YX, Liew YX, Chan CY, Lee SY, Cheow PC, et al. Pre‐operative predictors of early recurrence/mortality including the role of inflammatory indices in patients undergoing partial hepatectomy for spontaneously ruptured hepatocellular carcinoma. J Surg Oncol 2018;118:1227-36.
DOI: 10.1002/jso.25281

Iasonos A, Schrag D, Raj GV, Panageas KS. How To Build and Interpret a Nomogram for Cancer Prognosis. J Clin Oncol 2008;26:1364-1370.
DOI: 10.1200/JCO.2007.12.9791

Wang J, Li Z, Liao Y, Li J, Dong H, Peng H, et al. Prediction of Survival and Analysis of Prognostic Factors for Patients With Combined Hepatocellular Carcinoma and Cholangiocarcinoma: A Population-Based Study. Front Oncol 2021;11:686972.
DOI: 10.3389/fonc.2021.686972

El SM, Ahmed T, Varey A, Elias SG, Witkamp AJ, Sigurdsson V, et al. Development and Validation of Nomograms to Predict Local, Regional, and Distant Recurrence in Patients With Thin (T1) Melanomas. J Clin Oncol 2021;39:1243-52.
DOI: 10.1200/JCO.20.02446

Ding ZY, Li GX, Chen L, Shu C, Song J, Wang W, et al. Association of liver abnormalities with in-hospital mortality in patients with COVID-19. J Hepatol 2021;74:1295-302.
DOI: 10.1016/j.jhep.2020.12.012

Gaba RC, Lewandowski RJ, Hickey R, Baerlocher MO, Cohen EI, Dariushnia SR, et al. Transcatheter Therapy for Hepatic Malignancy: Standardization of Terminology and Reporting Criteria. J Vasc Interv Radiol 2016;27:457-73.
DOI: 10.1016/j.jvir.2015.12.752

Gaba RC, Lokken RP, Hickey RM, Lipnik AJ, Lewandowski RJ, Salem R, et al. Quality Improvement Guidelines for Transarterial Chemoembolization and Embolization of Hepatic Malignancy. J Vasc Interv Radiol 2017;28:1210-23.
DOI: 10.1016/j.jvir.2017.04.025

Child CG, Turcotte JG. Surgery and portal hypertension. Major Probl Clin Surg 1964;1:1-85.

Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S, et al. Diagnostic criteria for malnutrition – An ESPEN Consensus Statement. Clin Nutr 2015;34:335-40.
DOI: 10.1016/j.clnu.2015.03.001

Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz N, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr 2017;36:1187-96.
DOI: 10.1016/j.clnu.2017.06.017

Schutte K, Tippelt B, Schulz C, Rohl FW, Feneberg A, Seidensticker R, et al. Malnutrition is a prognostic factor in patients with hepatocellular carcinoma (HCC). Clin Nutr 2015;34:1122-7.
DOI: 10.1016/j.clnu.2014.11.007

Chen ZY, Gao C, Ye T, Zuo XZ, Wang GH, Xu XS, et al. Association between nutritional risk and routine clinical laboratory measurements and adverse outcomes: a prospective study in hospitalized patients of Wuhan Tongji Hospital. Eur J Clin Nutr 2015;69:552-7.
DOI: 10.1038/ejcn.2014.239

Efthymiou A, Hersberger L, Reber E, Schonenberger KA, Kagi-Braun N, Tribolet P, et al. Nutritional risk is a predictor for long-term mortality: 5-Year follow-up of the EFFORT trial. Clin Nutr 2021;40:1546-54.
DOI: 10.1016/j.clnu.2021.02.032

Liang J, Jin G, Liu T, Wen J, Li G, Chen L, et al. Clinical characteristics and risk factors for mortality in cancer patients with COVID-19. Front Med 2021;15:264-74.
DOI: 10.1007/s11684-021-0845-6

Tournoux-Facon C, Paoletti X, Barbare JC, Bouche O, Rougier P, Dahan L, et al. Development and validation of a new prognostic score of death for patients with hepatocellular carcinoma in palliative setting. J Hepatol 2011;54:108-14.
DOI: 10.1016/j.jhep.2010.06.015

Guglielmi A, Ruzzenente A, Pachera S, Valdegamberi A, Sandri M, D'Onofrio M, et al. Comparison of Seven Staging Systems in Cirrhotic Patients With Hepatocellular Carcinoma in a Cohort of Patients Who Underwent Radiofrequency Ablation With Complete Response. The American Journal of Gastroenterology 2008;103:597-604.
DOI: 10.1111/j.1572-0241.2007.01604.x

Xue J, Cao Z, Cheng Y, Wang J, Liu Y, Yang R, et al. Acetylation of alpha-fetoprotein promotes hepatocellular carcinoma progression. Cancer Lett 2020;471:12-26.
DOI: 10.1016/j.canlet.2019.11.043

Zhong CQ, Zhang XP, Ma N, Zhang EB, Li JJ, Jiang YB, et al. FABP4 suppresses proliferation and invasion of hepatocellular carcinoma cells and predicts a poor prognosis for hepatocellular carcinoma. Cancer Med 2018;7:2629-40.
DOI: 10.1002/cam4.1511

Audureau E, Carrat F, Layese R, Cagnot C, Asselah T, Guyader D, et al. Personalized surveillance for hepatocellular carcinoma in cirrhosis - using machine learning adapted to HCV status. J Hepatol 2020;73:1434-45.
DOI: 10.1016/j.jhep.2020.05.052

Wang X, Mao M, He Z, Zhang L, Li H, Lin J, et al. Development and Validation of a Prognostic Nomogram in AFP-negative hepatocellular carcinoma. Int J Biol Sci 2019;15:221-8.
DOI: 10.7150/ijbs.28720

Artículos Relacionados:

Trabajo Original: Relación entre la escala de riesgo nutricional nutric y el hipercatabolismo proteico en pacientes críticos ventilados

Dino Moretti , Melisa D. Ré , Nicolás S. Rocchetti , Daniel Horacio Bagilet , Claudio Jesus Settecase , Martín Buncuga , Marta Quaglino

Trabajo Original

A novel nomogram based on the nutritional risk screening 2002 score to predict survival in hepatocellular carcinoma treated with transarterial chemoembolization

Artículos Relacionados:

Trabajo Original: Relación entre la escala de riesgo nutricional nutric y el hipercatabolismo proteico en pacientes críticos ventilados

Trabajo Original: Screening of nutritional risk: assessment of predictive variables of nutritional risk in hospitalized patients in a second-level care center in Mexico

Trabajo Original: Nutritional diagnosis of patients with hepatocellular carcinoma: what is the best method?

Revisión: Selenium concentration, dietary intake and risk of hepatocellular carcinoma – A systematic review with meta-analysis

Trabajo Original: Impact of nutritional risk on 28-day mortality and the prevalence of underfeeding in critically ill patients: A prospective cohort study

Trabajo Original: Body composition by bioelectrical impedance, muscle strength, and nutritional risk in oropharyngeal dysphagia patients

Trabajo Original: Detection of nutritional risk and hospital stay in the hospitalized elderly adult

Trabajo Original: Cribado nutricional del paciente con patología vascular hospitalizado: relación del riesgo nutricional con los resultados clínicos y económicos en un servicio quirúrgico

Trabajo Original: High nutritional risk using NUTRIC-Score is associated with worse outcomes in COVID-19 critically ill patients

Trabajo Original: Exploration of three different nutritional scores in predicting postoperative complications after pancreaticoduodenectomy

Trabajo Original: Nutritional risk and clinical outcomes in critically ill adult patients with COVID-19

Trabajo Original: Nutritional status and its association with in-hospital major adverse cardiac events in patients with severe heart failure: a prospective study

Trabajo Original: Riesgo nutricional y desenlaces clínicos en pacientes con diagnóstico de COVID-19 en una red hospitalaria de alta complejidad

Trabajo Original: Assessing risk screening methods of malnutrition in geriatric patients; Mini Nutritional Assessment (MNA) versus Geriatric Nutritional Risk Index (GNRI)

Trabajo Original: Nutritional risk and status of surgical patients; the relevance of nutrition training of medical students

Trabajo Original: Association between nutritional risk based on the NRS-2002 test and hospital morbidity and mortality

Trabajo Original: Nutritional screening in clinical patients at a University Hospital in Northeastern Brazil

Trabajo Original: Study on the nutritional risk of autonomous non-institutionalized adult elder people

Trabajo Original: Factores de riesgo nutricional en pacientes con cáncer de cabeza y cuello en el Centro de Atención Oncológica del estado de Michoacán

Trabajo Original: Proceso completo de implantación de un sistema de cribado de riesgo nutricional en el hospital universitario La Paz de Madrid

Trabajo Original: Estudio de dos variantes de la puntuacion de riesgo nutricional “NUTRIC” en pacientes criticos ventilados

Trabajo Original: Efecto de la intervención nutricional temprana en el resultado clínico de pacientes en riesgo nutricional

Trabajo Original: Evaluación del riesgo nutricional de los adolescentes escolarizados en Cantabria

Revisión: Menú de textura modificada y su utilidad en pacientes con situaciones de riesgo nutricional

Revisión: Cribado nutricional; control de la desnutrición clínica con parámetros analíticos

Trabajo Original: Prevalencia de riesgo de desnutrición evaluada con NRS-2002 en población oncológica mexicana

Trabajo Original: Nutritional risk among surgery patients and associations with hospital stay and postoperative complications

Trabajo Original: Factores asociados al riesgo nutricional en adultos mayores autónomos no institucionalizados

Trabajo Original: Factores de riesgo nutricionales para dismorfia muscular en usuarios de sala de musculación

Trabajo Original: Un instrumento sencillo y fiable para detectar riesgo nutricional en pacientes hospitalizados

Trabajo Original: Riesgo de malnutrición en una población mayor de 75 años no institucionalizada con autonomía funcional

Trabajo Original: Nutritional assessment of patients with aneurysmal subarachnoid hemorrhage using the modified “Nutrition Risk in the Critically Ill" score, and its association with outcomes

Trabajo Original: Factores pronósticos de desnutrición en pacientes con cáncer colorrectal

Trabajo Original: Adaptación en español y validación en México de la herramienta de tamizaje nutricional STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics)

Trabajo Original: Association between nutritional status and platelet-to-lymphocyte ratio in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization

Trabajo Original: Evaluación sensorial de un suplemento nutricional oral específico para diabetes con aceite de oliva virgen extra en pacientes en riesgo nutricional y diabetes mellitus tipo 2: ensayo clínico doble ciego, aleatorizado, cruzado y multicéntrico (DIACARE

Trabajo Original: Glycaemic and insulinaemic impact of a diabetes-specific oral nutritional supplement with extra-virgin olive oil in patients with type 2 diabetes mellitus at nutritional risk: a randomized, double-blind, crossover, multicentre clinical trial (DIACARE)

Trabajo Original: Mini nutritional assessment-short form test: criterion and predictive validity in older adults from a long-term care unity

Trabajo Original: Comparación del riesgo nutricional alto por tres variantes del puntaje NUTRIC en pacientes críticos ventilados

Trabajo Original: Symptom clusters and nutritional status in primary liver cancer patients receiving transcatheter arterial chemoembolization

Trabajo Original: Nutritional status and its relationship with COVID-19 prognosis in hemodialysis patients

Trabajo Original: Association between nutritional risk status and both diaphragmatic dysfunction and diaphragm atrophy in medical ıntensive care unit patients

Trabajo Original: Individualized nutritional intervention improves the nutritional status of liver cancer patients after transcatheter arterial chemoembolization

Artículos más populares

Revisión: La importancia de la alimentación en la prevención de la endometriosis: revisión sistemática

Artículo Especial: Componentes bioactivos del grano integral y su efecto en la salud