PNI as a Potential Add-On Biomarker to Improve the IMDC Intermediate Prognostic Score
Abstract
:1. Introduction
2. Methods
2.1. Study Subjects
2.2. Statistical Analysis
3. Results
3.1. Study Patients
3.2. Univariate and Multivariate Analysis for Progression-Free Survival
3.3. Univariate and Multivariate Analysis for Overall Survival
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Progression-Free Survival | Overall Survival | |||||
---|---|---|---|---|---|---|
Median (95%CI) | HR (95% CI) | p-Value | Median (95%CI) | HR (95% CI) | p-Value | |
Age | ||||||
<60 | 6.4 (3.6–9.2) | Ref. | 0.92 | 21.9 (2.1–40.2) | Ref. | 0.3 |
≥60 | 7.7 (4.6–10.8) | 1.023 (0.633–1.652) | 22.3 (12.2–32.5) | 1.264 (0.811–1.970) | ||
Gender | ||||||
Female | 6.4 (2.8–9.9) | Ref. | 0.41 | 17.5 (9.1–25.9) | Ref. | 0.12 |
Male | 6.9 (5.1–8.6) | 0.826 (0.523–1.305) | 25.4 (17.7–33.1) | 0.684 (0.423–1.107) | ||
ECOG performance score | ||||||
0–1 | 7.2 (5.6–8.7) | Ref. | 0.11 | 25.4 (19.1–31.7) | Ref. | <0.001 |
≥2 | 3.5 (2.8–4.2) | 2.096 (0.844–5.206) | 4.1 (3.1–5.1) | 7.657 (3.529–16.612) | ||
Histopathology | ||||||
Clear cell | 7.4 (5.8–9.0) | Ref. | 0.4 | 23.9 (14.4–33.4) | Ref. | 0.85 |
Non-clear cell | 4.3 (2.4–6.1) | 1.233 (0.753–2.018) | 19.7 (9.0–30.4) | 1.051 (0.606–1.824) | ||
IMDC score, n (%) | ||||||
Favorable | 20.4 (16.6–24.2) | Ref. | <0.001 | 41.3 (0.5–82.1) | Ref. | 0.004 |
Intermediate | 6.4 (4.8–8.0) | 3.698 (1.893–7.226) | <0.001 | 20.1 (10.4–29.7) | 1.717 (0.959–3.074) | 0.07 |
Poor | 3.8 (2.9–4.7) | 6.201 (2.824–13.615) | <0.001 | 12.4 (1.2–23.7) | 3.411 (1.641–7.089) | 0.001 |
PNI | ||||||
<48 | 3.8 (3.3–4.2) | Ref. | <0.001 | 12.5 (5.5–19.5) | Ref. | 0.001 |
≥48 | 10.9 (7.7–14.0) | 0.444 (0.298–0.662) | 32.3 (17.2–47.5) | 0.460 (0.291–0.726) | ||
Adjusted IMDCC and PNI model | ||||||
Favorable | 20.4 (16.6–24.2) | Ref. | <0.001 | 41.3 (0.5–82.1) | Ref. | 0.001 |
Intermediate (PNI-High) | 10.8 (8.8–12.8) | 2.648 (1.302–5.386) | 0.007 | 30.3 (18.0–42.6) | 1.219 (0622–2.390) | 0.564 |
Intermediate (PNI-Low) | 3.8 (3.6–3.9) | 5.497 (2.722–11.103) | <0.001 | 12.5 (5.6–19.4) | 2.315 (1.223–4.382) | 0.01 |
Poor | 3.8 (2.9–4.7) | 6.108 (2.803–13.311) | <0.001 | 12.4 (1.2–23.7) | 3.510 (1.685–7.312) | 0.001 |
Primary nephrectomy, n (%) | ||||||
Absent | 3.7 (2.6–4.7) | Ref. | 0.85 | 7.8 (4.5–11.1) | Ref. | <0.001 |
Present | 7.7 (6.2–9.1) | 0.955 (0.571–1.595) | 30.3 (21.0–39.6) | 0.366 (0.228–0.588) | ||
Sarcomatoid differentiation, n (%) | ||||||
Absent | 7.1 (4.0–10.3) | Ref. | 0.59 | 37.0 (26.8–47.2) | Ref. | 0.08 |
Present | 7.5 (6.5–8.5) | 0.849 (0.465–1.550) | 15.1 (11.1–19.1) | 2.097 (0.913–4.815) | ||
Metastasectomy, present | 11.6 (4.5–18.8) | 0.616 (0.398–0.952) | 0.03 | 27.5 (15.4–39.6) | 0.728 (0.446–1.187) | 0.2 |
Lung, present | 11.7 (3.0–20.5) | 0.707 (0.325–1.540) | 0.38 | 34.5 (25.3–43.7) | 0.570 (0.224–1.451) | 0.23 |
Bone, present | 6.4 (2.8–10.0) | 1.912 (0.828–4.418) | 0.12 | 20.0 (2.7–37.3) | 1.496 (0.552–4.056) | 0.42 |
Metastatic site | ||||||
Bone, present | 4.3 (2.1–6.4) | 1.01 (0.677–1.481) | 0.99 | 15.1 (12.0–18.3) | 1.865 (1.190–2.923) | 0.007 |
Visceral, present | 6.4 (4.4–8.4) | 1.192 (0.599–2.368) | 0.61 | 20.1 (12.2–27.9) | 1.597 (0.768–3.320) | 0.21 |
Visceral metastasis | ||||||
Lung, present | 6.8 (5.1–8.5) | 0.934 (0.548–1.593) | 0.8 | 22.3 (12.1–32.6) | 1.183 (0.663–2.109) | 0.56 |
Liver, present | 4.3 (1.8–6.7) | 1.725 (1.069–2.784) | 0.02 | 13.2 (10.0–16.4) | 1.710 (1.032–2.831) | 0.03 |
Brain, present | 12.4 (6.9–17.9) | 0.632 (0.318–1.258) | 0.19 | 16.0 (6.6–25.4) | 1.184 (0.569–2.466) | 0.65 |
Metastasis site number | ||||||
<3 | 7.4 (5.4–9.4) | Ref. | 0.36 | 32.3 (16.0–48.6) | Ref. | 0.007 |
≥3 | 4.2 (1.3–7.2) | 1.208 (0.801–1.819) | 15.1 (7.1–23.2) | 1.831 (1.177–2.851) | ||
First-line tyrosine kinase option | ||||||
Sunitinib | 6.0 (3.9–8.0) | Ref. | 0.78 | 25.4 (16.7–34.1) | Ref. | 0.21 |
Pazopanib | 7.3 (3.6–11.1) | 0.944 (0.618–1.441) | 15.2 (12.5–18.0) | 1.325 (0.846–2.076) |
Model 1 | Model 2 | |||
---|---|---|---|---|
HR (95% CI) | p-Value | HR (95% CI) | p-Value | |
Histopathology, clear cell | 0.660 (0.380–1.145) | 0.13 | 0.652 (0.378–1.126) | 0.12 |
IMDC score | 0.008 | |||
Favorable | 0.308 (0.133–0.714) | 0.006 | ||
Intermediate | 0.890 (0.508–1.561) | 0.68 | ||
Poor | Ref. | |||
PNI ≥ 48 | 0.503 (0.328–0.773) | 0.002 | ||
Adjusted IMDCC and PNI model | <0.001 | |||
Favorable | 0.226 (0.099–0.516) | <0.001 | ||
Intermediate (PNI-High) | 0.484 (0.270–0.866) | 0.01 | ||
Intermediate (PNI-Low) | 1.006 (0.556–1.822) | 0.98 | ||
Poor | Ref. | |||
Metastasectomy, present | 0.680 (0.433–1.068) | 0.09 | 0.683 (0.437–1.067) | 0.09 |
Liver, present | 1.436 (0.859–2.401) | 0.16 | 1.518 (0.909–2.533) | 0.11 |
HR (95% CI) | p-Value | |
---|---|---|
Nephrectomy, present | 0.449 (0.270–0.748) | 0.002 |
Adjusted IMDCC and PNI model | 0.01 | |
Favorable/Intermediate (PNI-High) | 0.547 (0.334–0.896) | |
ECOG 2 and more, present | 4.220 (1.815–9.814) | 0.001 |
Bone metastasis, present | 1.997 (1.252–3.185) | 0.004 |
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Bayoğlu, İ.V.; Hüseynov, J.; Topal, A.; Sever, N.; Majidova, N.; Çelebi, A.; Yaşar, A.; Arıkan, R.; Işık, S.; Hacıoğlu, M.B.; et al. PNI as a Potential Add-On Biomarker to Improve the IMDC Intermediate Prognostic Score. J. Clin. Med. 2023, 12, 6420. https://doi.org/10.3390/jcm12196420
Bayoğlu İV, Hüseynov J, Topal A, Sever N, Majidova N, Çelebi A, Yaşar A, Arıkan R, Işık S, Hacıoğlu MB, et al. PNI as a Potential Add-On Biomarker to Improve the IMDC Intermediate Prognostic Score. Journal of Clinical Medicine. 2023; 12(19):6420. https://doi.org/10.3390/jcm12196420
Chicago/Turabian StyleBayoğlu, İbrahim Vedat, Javid Hüseynov, Alper Topal, Nadiye Sever, Nargiz Majidova, Abdussamet Çelebi, Alper Yaşar, Rukiye Arıkan, Selver Işık, Muhammet Bekir Hacıoğlu, and et al. 2023. "PNI as a Potential Add-On Biomarker to Improve the IMDC Intermediate Prognostic Score" Journal of Clinical Medicine 12, no. 19: 6420. https://doi.org/10.3390/jcm12196420