bims-meluca 2020-11-15 papers

BMC Cancer. 2020 Nov 12. 20(1): 1100

Preoperative AminoIndex Cancer Screening (AICS) abnormalities predict postoperative recurrence in patients undergoing curative resection for non-small cell lung cancer.

Masahiko Higashiyama, Ryohei Miyazaki, Hiroshi Yamamoto, Takashi Anayama, Shinya Kikuchi, Kentaro Hirohashi, Jiro Okami, Tomohiro Maniwa, Toru Kimura, Kazumasa Orihashi, Fumio Imamura.

BACKGROUND: AminoIndex™ Cancer Screening (AICS (lung)) was developed as a screening test for lung cancer using a multivariate analysis of plasma-free amino acid (PFAA) profiles. According to the developed index composed of PFAA, the probability of lung cancer was categorized into AICS (lung) ranks A, B, and C in order of increasing risk. The aim of the present study was to investigate the relationship between the preoperative AICS (lung) rank and surgical outcomes in patients who underwent curative resection for non-small cell lung cancer (NSCLC).
METHODS: Preoperative blood samples were collected from 297 patients who underwent curative resection for NSCLC between 2006 and 2015. PFAA concentrations were measured. The relationship between the preoperative AICS (lung) rank and clinicopathological factors was examined. The effects of the preoperative AICS (lung) rank on postoperative outcomes were also analyzed.
RESULTS: The AICS (lung) rank was A in 93 patients (31.3%), B in 82 (27.6%), and C in 122 (41.1%). The AICS (lung) rank did not correlate with any clinicopathological factors, except for age. Based on follow-up data (median follow-up period of 6 years), postoperative recurrence was observed in 22 rank A patients (23.7%), 15 rank B (18.3%) and 49 rank C (40.2%). In the univariate analysis, preoperative AICS (lung) rank C was a worse factor of recurrence-free survival (p = 0.0002). The multivariate analysis identified preoperative AICS (lung) rank C (HR: 2.17, p = 0.0005) as a significant predictor of postoperative recurrence, particularly in patients with early-stage disease or adenocarcinoma.
CONCLUSION: Preoperative AICS (lung) rank C is a high-risk predictor of postoperative recurrence in patients undergoing curative resection for NSCLC.

Keywords: AICS; AICS (lung); Lung cancer; Non-small cell lung cancer; Prognosis; Recurrence; Surgery

DOI: https://doi.org/10.1186/s12885-020-07575-w

Ann Palliat Med. 2020 Nov 10. pii: apm-20-1892. [Epub ahead of print]

Low prognostic nutrition index predicts poorer quality of life in late-stage lung cancer.

Zhaohui Zhang, Aiping Chen, Fenglan Xie, Xuefei Li, Guoxiang Hu, Gengpeng Lin.

BACKGROUND: Quality of life (QOL) is one of the most important endpoints in lung cancer care. Both nutritional and immune status reportedly correlate with QOL, so we investigated whether the prognostic nutritional index (PNI), a reliable marker of nutritional and immune status, can predict QOL in late-stage lung cancer.
METHODS: We enrolled 80 lung cancer patients and their clinical data including PNI were obtained. The FACT-L questionnaire in Chinese version 4 was administered to every patient.
RESULTS: Of the 80 lung cancer patients, 16 were stage III and 64 were stage IV. The average PNI value was 44.24±5.53. The average FACT-L score was 99.58±21.84, indicating impaired QOL. The FACT-L score in the stage IV group was significantly lower than that in the stage III group (P=0.001), especially for the four subscales of physical, social/family, emotional, and functioning well-being. In the stage IV group, the FACT-L score in the high PNI group was significantly higher than that in the low PNI group (P=0.042), with especially higher score for the physical well-being subscale. PNI was significantly related to both the FACT-L score (r=0.3265, P=0.0085) and physical well-being subscale (r=0.4746, P<0.0001).
CONCLUSIONS: PNI is a simple but valuable biomarker of QOL in stage IV lung cancer patients. A lower PNI may indicate the need for detailed QOL evaluation and intervention.

Keywords: Lung cancer; prognostic nutrition index (PNI); quality of life (QOL)

DOI: https://doi.org/10.21037/apm-20-1892

Curr Opin Support Palliat Care. 2020 Dec;14(4): 304-308

Optimising patient fitness: strategies to reduce the effects of cancer cachexia in patients with advanced lung cancer.

Iain Phillips, Samantha Kestenbaum.

PURPOSE OF REVIEW: Outcomes for patients with advanced lung cancer have traditionally been very poor. This patient group are often comorbid, less fit and experience multiple symptoms. This review discusses strategies for minimizing the impact of cachexia on patients with advanced lung cancer. This is timely, as in recent years there has been a rapid increase in available systemic therapy options, with the potential of long-term survival for some patients.
RECENT FINDINGS: The review discusses current strategies in combating cachexia, including: symptom control, systemic therapy for cancer and for cachexia, nutritional interventions and exercise interventions. It discusses current clinical trials, combining interventions and the paradigm of prehabilitation.
SUMMARY: It is likely that the optimal way of minimizing the impact of cachexia in advanced lung cancer is through a combination of early interventions including symptom management.

DOI: https://doi.org/10.1097/SPC.0000000000000525