Utility of clinico-biological data for long-term prognosis of head and neck terminal cancer

Abstract

Objective: The prognosis of terminal head and neck cancer is traditionally determined using indices such as the palliative prognosis index. We aimed to develop an alternative prognosis index using clinico-biological data.

Methods: This retrospective case-series study included 33 head and neck cancer patients whose cancer recurred despite receiving radiation therapy between April 2010 and April 2014. Clinico-biological data were collected the day patients were diagnosed as terminal. Bivariate correlation analyses were performed on survival times and clinico-biological data. For multivariate regression analyses, patients were divided into two groups: (1) patients who survived >120 days, and (2) those who survived <120 days. Group clinico-biological data were used to determine survival-time cutoff points for the prognosis index.

Results: Bivariate analyses revealed significant correlations between survival time and BMI, hemoglobin, albumin, C-reactive protein (CRP), Onodera’s Prognostic Nutritional Index (O-PNI), modified Glasgow Prognostic Score (mGPS), and Performance Status (PS). Multivariate analyses showed a strong correlation between survival time and BMI. The two groups differed significantly in BMI, albumin, CRP, O-PNI, and mGPS. In multivariate analyses BMI, CRP, and O-PNI differed significantly in the two groups.

Conclusion: BMI ≤16.4, CRP ≥1.01, and O-PNI ≤33.4 are significant predictors of long-term survival in terminal cancer patients.

Chinese abstract

目的: 终末头颈部癌的预后传统上使用指数, 如姑息性预后指数。我们旨在使用临床-生物学数据来开发其它预后指数。

方法: 本回顾性病例系列研究包括33名头颈部癌症患者。尽管他们在2010年4月至2014年4月期间接受了放射治疗, 但其癌症复发了。在病人被诊断为终末期的时候, 我们收集了临床-生物学数据。对生存时间和临床生物学数据进行了双变量相关分析。为进行多变量回归分析, 患者被分为两组: (1) 存活期大于120天的患者；和 (2) 存活期小于120天的患者。这两组的临床生物学数据用于确定预后指数的存活时间截止点。

结果: 双变量分析揭示生存时间和BMI、血红蛋白、白蛋白、C-反应蛋白 (CRP) 、Onodera预后营养​​指数 (O-PNI) 、改进的格拉斯哥预后评分 (mGPS) 和性能状态 (PS) 之间的显著相关性。多变量分析显示生存时间和BMI之间存在强相关性。这两组在BMI、白蛋白、CRP、O-PNI和mGPS方面显著不同。在多变量分析中, BMI、CRP和O-PNI在两组中显著不同。

结论: BMI ≤16.4, CRP ≥1.01和O-PNI ≤33.4是终末癌症患者长期生存的重要预测因子。

Keywords:

• Prognosis index
• BMI
• CRP
• O-PNI
• mortality

Acknowledgements

The authors wish to thank Professor Hiroyuki Mineta for helpful discussions.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.