Prognostic significance of preoperative Naples prognostic score on short-and long-term outcomes after pancreatoduodenectomy for ampullary carcinoma  

作　　者：Jikuan Jin Hebin Wang Feng Peng Xiaoxiang Wang Min Wang Feng Zhu Guangbing Xiong Renyi Qin 

机构地区：[1]Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China

出　　处：《Hepatobiliary Surgery and Nutrition》2021年第6期825-838,I0011,共15页肝胆外科与营养（英文）

基　　金：This study was supported by grants from National Natural Science Foundation of China(No.81772950 and No.81874205).

摘　　要：Background:The Naples prognostic score(NPS)is an effective and objective tool to assess the immune-nutritional status of patients with malignant tumors.The aim of this study was to investigate the clinical significance of preoperative NPS on short-and long-term outcomes after pancreatoduodenectomy(PD)for ampullary carcinoma.Methods:We retrospectively analyzed 404 consecutive patients with ampullary carcinoma who underwent PD between January 2012 and June 2018.Preoperative NPS was calculated from serum albumin and total cholesterol concentrations,and the neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio(LMR).Patients were then divided into three groups according to their NPS.Clinicopathological variables,postoperative outcomes,and survival data were compared between the three groups.Univariate and multivariate Cox analysis of overall survival(OS)and recurrence-free survival(RFS)were also conducted,and time-dependent receiver operating characteristic(ROC)curves were created to evaluate the discriminatory ability of the prognostic scoring systems.Results:Patients with higher NPS had worse prognosis,and significant OS difference(group 0 vs.1,P=0.02;group 1 vs.2,P<0.001;group 0 vs.2,P<0.001)and RFS difference(group 0 vs.1,P=0.088;group 1 vs.2,P<0.001;group 0 vs.2,P<0.001).Multivariate analysis revealed that NPS was an independent significant predictor of OS(grade 2 vs.grade 1 or 0,hazard ratio:3.067;P<0.001)and RFS(grade 2 vs.grade 1 or 0,hazard ratio:2.732;P<0.001).The time-dependent receiver operating curve analysis showed that NPS had better prognostic performance for OS and RFS than other prognostic models.Additionally,significant differences in the incidence of postoperative morbidity were observed between the three groups,and the NPS was an independent risk factor of overall postoperative complications(grade 2 vs.grade 1 or 0,odds ratio:1.692;P=0.02).Conclusions:The NPS was an independent predictor of overall-and RFS in patients undergoing PD for ampullary carcinoma,and was independently associated with

关 键 词：Naples prognostic score(NPS) ampullary carcinoma prognostic factor immune-nutritional status postoperative outcomes 

分 类 号：R73[医药卫生—肿瘤]