Prognostic Value of Prospective Longitudinal CRP to Albumin Ratio among Older Outpatients with Cancer
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Patients
2.2. Cancer-Related and Demographic Data
2.3. Geriatric Assessment (GA)
2.4. Definition of Frailty
2.5. Measurement of the CRP/Albumin Ratio (CAR)
2.6. Outcomes
2.7. Statistical Analyses
3. Results
3.1. Patients
3.2. Baseline Characteristics of Patients and the G8 Frailty Index
3.3. Clustering Longitudinal CAR Trajectories
3.4. Baseline Phenotype Associated with CAR Cluster B
3.5. Long-Term Suvival and CAR Clusters
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
CRP/Albumin Ratio (Mean ± SD) | Mean Change at Peaks ± SD | p * | |||
---|---|---|---|---|---|
Months | Cluster A | Cluster B | Cluster A | Cluster B | |
<0.0001 | |||||
Baseline | 0.50 ± 0.98 | 0.96 ± 2.01 | Reference | Reference | |
Month 1 | 3.89 ± 4.07 | 4.67 ± 4.05 | 3.38 ± 4.29 | 3.71 ± 4.56 | |
Month 3 | 0.26 ± 0.94 | 0.36 ± 1.56 | - | - | |
Month 6 | 3.91 ± 3.58 | 5.84 ± 3.58 | 3.49 ± 3.66 | 5.16 ± 3.78 | |
Month 9 | 2.19 ± 3.08 | 16.3 ± 4.84 | 1.79 ± 3.19 | 15.7 ± 5.03 | |
Month 12 | 2.69 ± 4.67 | 0.53 ± 1.85 | - | - | |
Month 18 | 1.69 ± 2.70 | 2.52 ± 3.16 | - | - | |
Month 24 | 0.99 ± 2.18 | 5.03 ± 3.74 | 0.64 ± 2.35 | 4.32 ± 4.06 | |
Month 36 | 2.25 ± 5.96 | 2.09 ± 5.24 | - | - |
Appendix B
References
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Variables | Whole Cohort N (%) |
---|---|
Age (y), mean ± SD | 81.2 ± 6.1 |
Sex ratio (male/female) | 280 (46)/323 (54) |
G8 index, median ± IQR | 11.0 ± 4.0 |
Cancer site: Colorectal Breast Lung Liver Digestive non-colorectal Genital or urinary tract Haematological malignancies Skin, melanoma Prostate Other * | 109 (18) 105 (17) 92 (15) 85 (14) 80 (13) 40 (7) 34 (6) 16 (3) 16 (3) 26 (4) |
Metastatic (yes) | 271 (45) |
Cancer-treatment modalities: Surgery Chemotherapy Radiotherapy Hormone therapy Targeted therapy Percutaneous resection (liver cancer) Intra-arterial treatment (liver cancer) Exclusively supportive care | 172 (28.5) 200 (33) 131 (22) 96 (16) 43 (7) 41 (7) 22 (4) 124 (20.5) |
ECOG-PS > 2 | 204 (34) |
Living alone (yes) | 241 (40) |
Comorbidities CIRSG total > 14 | 269 (45) |
Polymedication (yes) | 402 (67) |
Dependency ADL ≤ 5/6 IADL ≤ 3/4 | 204 (34) 386 (64) |
Nutrition BMI < 21 kg/m2 CRP (mg/L), median [Q1–Q3] Albumin (g/L), median [Q1–Q3] | 82 (14) 7.1 [1.8–21.5] 38.0 [33.6–42.0] |
Mobility Gait speed < 0.8 m/s Gait speed (m/s), median ± IQR | 345 (57.5) 0.73 ± 0.48 |
Mood (n = 597) Mini-GDS ≥ 1/4 | 261 (44) |
Cognition (n = 429) MMSE < 24/30 | 217 (51) |
Variables | Cluster A N = 349 (%) | Cluster B N = 254 (%) | p * | Adjusted Odd Ratio [95% CI] | p * |
---|---|---|---|---|---|
Age (y), mean ± SD | 80.9 ± 6.1 | 81.6 ± 6.2 | 0.20 | ||
Sex ratio (male/female) | 164 (47)/185 (53) | 116 (46)/138 (54) | 0.75 | ||
Frailty-G8 index (≤14) G8 index, median ± IQR | 303 (87) 11.5 ± 4.0 | 232 (91) 11.0 ± 4.5 | 0.08 0.01 | 0.94 [0.88–0.99] | 0.04 |
Cancer site: Breast Colorectal Lung Liver Digestive non-colorectal Genital or urinary tract Haematological malignancies Skin, melanoma Prostate Other ** | 70 (20) 74 (21) 51 (15) 44 (13) 38 (11) 19 (5) 17(5) 6 (1.5) 14 (4) 16 (4.5) | 35 (14) 35 (14) 41 (16) 41 (16) 42 (16) 21 (8) 17 (7) 10 (4) 2 (1) 10 (4) | 0.007 | 1 (reference) 0.80 [0.44–1.43] 1.15 [0.63–2.12] 1.57 [0.85–2.86] 1.87 [1.01–3.45] 1.57 [0.73–3.40] 1.43 [0.63–3.22] 2.59 [0.84–7.98] 0.17 [0.03–0.85] 0.90 [0.36–2.27] | 0.02 |
Metastatic (yes) | 138 (39.5) | 133 (52) | 0.001 | 1.80 [1.27–2.55] | 0.001 |
Cancer-treatment modalities: Surgery Chemotherapy Radiotherapy Hormone therapy Targeted therapy Percutaneous resection (liver cancer) Intra-arterial treatment (liver cancer) Exclusively supportive care | 114 (33) 122 (35) 84 (24) 67 (19) 27 (8) 25 (7) 9 (2.5) 59 (17) | 58 (23) 78 (31) 47 (18.5) 29 (11) 16 (6) 16 (6) 13 (5) 65 (25.6) | 0.008 0.27 0.10 0.009 0.50 0.67 0.10 0.009 | - - - - - | |
ECOG-PS > 2 | 107 (31) | 97 (38) | 0.05 | - | |
Living alone (yes) | 154 (44) | 87 (34) | 0.01 | 0.69 [0.48–0.98] | 0.03 |
Comorbidities CIRSG total > 14 | 151 (43) | 118 (46) | 0.44 | ||
Polymedication (yes) | 238 (68) | 164 (64.5) | 0.35 | ||
Dependency ADL ≤ 5/6 IADL ≤ 3/4 | 106 (30) 213 (61) | 98 (38.5) 173 (68) | 0.03 0.07 | - - | |
Nutrition BMI < 21 kg/m2 | 44 (13) | 41 (16) | 0.21 | ||
Mobility Gait speed < 0.8 m/s Gait speed (m/s), median ± IQR | 200 (57) 0.75 ± 0.46 | 145 (57) 0.70 ± 0.50 | 0.91 0.22 | ||
Mood (n = 597) Mini-GDS ≥ 1/4 | 152 (43.5) | 109 (43) | 0.96 | ||
Cognition (n = 429) MMSE < 24/30 | 131 (37.5) | 86 (34) | 0.83 |
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Burgassi, F.; Paillaud, E.; Poisson, J.; Bousquet, G.; Pamoukdjian, F. Prognostic Value of Prospective Longitudinal CRP to Albumin Ratio among Older Outpatients with Cancer. Cancers 2021, 13, 5782. https://doi.org/10.3390/cancers13225782
Burgassi F, Paillaud E, Poisson J, Bousquet G, Pamoukdjian F. Prognostic Value of Prospective Longitudinal CRP to Albumin Ratio among Older Outpatients with Cancer. Cancers. 2021; 13(22):5782. https://doi.org/10.3390/cancers13225782
Chicago/Turabian StyleBurgassi, Fiamma, Elena Paillaud, Johanne Poisson, Guilhem Bousquet, and Frédéric Pamoukdjian. 2021. "Prognostic Value of Prospective Longitudinal CRP to Albumin Ratio among Older Outpatients with Cancer" Cancers 13, no. 22: 5782. https://doi.org/10.3390/cancers13225782