GNRI And Conut Scores: Simple Predictors of Sarcopenia in Metastatic Colorectal Cancer Patients

Objective To evaluate the correlation between sarcopenia and inflammation- and nutrition-based markers in metastatic colorectal cancer (mCRC) patients. Materials and methods Age, body mass index (BMI), neutrophil/lymphocyte ratio (NLR), modified Glasgow prognostic score (mGPS), prognostic nutrition index (PNI), cachexia index (CIn), skeletal muscle index (SMI), controlling nutritional status (CONUT) score, and geriatric nutritional risk index (GNRI) were evaluated in 185 patients. Ideal cut-off values for the GNRI score were determined with the ROC curve analysis, and the patients were divided into two groups as low and high GNRI. Sarcopenia was diagnosed using CT scanning, the gold standard method. Univariate and multivariate Cox proportional hazard analyses were done based on the above-listed parameters to assess the correlation between sarcopenia and changes in immuno-nutrition and inflammatory response. Kaplan-Meier analysis was also done to evaluate survival. Results Univariate analysis of the 185 patients based on the EGWSOP 2018 threshold values showed correlation between the presence of sarcopenia and male gender, diagnosed colon cancer, history of metastasectomy, BMI = 45, high CONUT score, and low GNRI score (p < 0.05). In multivariate analysis, low GNRI (HR: 2.40; 95% CI: 1.03-5.544; p = 0.040), and high-CONUT scores (HR: 2.01; 95% CI: 1.06-3.73; p = 0.029) were identified as independent prognostic factors for the presence of sarcopenia. Conclusion GNRI and CONUT scores are elementary and practical predictors for sarcopenia, a condition which is associated with poor outcomes in mCRC patients

Prognostic Significance of Hematological Parameters in Patients with Early-Stage Malignant Melanoma

The prognosis of melanoma is extremely poor. There are no biomarker that indicate the prognosis. The indirect markers of the antitumoral response such as the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), derived NLR (dNLR), absolute neutrophil count (ANC), absolute lymphocyte count (ALC) etc. have recently begun to be emphasized. Increased NLR, PLR and dNLR as a consequence of chronic inflammation have been found to be associated with poor prognosis in many cancers. The aim of this study is explore the role of this parameters in patients with early-stage melanoma. We retrospectively evaluated 120 patients admitted to our clinic with stage I-Ill melanoma with ANC, ALC, absolute platelet count(APC), as well as NLR, dNLR, and PLR values at the time of diagnosis, relaps and metastasis and evaluate their impact on prognosis. Patients with active infection, receiving steroids, with a chronic inflammatory disease that may alter the hematological parameters, and those with another malignancy other than melanoma were excluded. The median follow-up was 52 months. OS and DFS were significantly worse in patients with an NLR above 2.84. Also, in patients with a dNLR value above 1.96 (p= 0.007). The were no relationship between PLR value, OS and DFS, and between gender and OS. OS was significantly lower in patients over 65 years of age (p< 0.001). These results suggested that haematological parameters can be used to estimate the prognosis of melanoma. These results suggested that haematological parameters can be used to estimate the prognosis of melanoma

Validity and Reliability of the Turkish Version of National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Ovarian Symptom Index-18 (NFOSI-18) and Neurotoxicity-4 (NTX-4) for Patients with Advanced Ovarian Cancer

Objectives. The aim of this study was to investigate the validity and reliability of the Turkish version of the National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Ovarian Symptom Index-18 (NFOSI-18) and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity 4-item (NTX-4) in patients with advanced ovarian cancer (OC). Methods. Ninety-four women with OC were included. Pearson correlation coefficients were used to examine the convergent validity between the European Quality of Life Survey-5 Dimension-3 Level (EQ-5D-3L) and the Turkish NFOSI-18 and NTX-4. The internal consistencies of the Turkish NFOSI-18 and NTX-4 were calculated using Cronbach's alpha. Turkish NFOSI-18 and Turkish NTX-4 were readministered to 62 (67.4%) patients with OC after 14-21 days to evaluate test-retest reliability.Results. Turkish NFOSI-18 and Turkish NTX-4 showed excellent internal consistency (Cronbach's alpha: 0.919 and 0.917, respectively). The test-retest reliability of Turkish NFOSI-18 and Turkish NTX-4 was detected as good to excellent for total score (ICC [95%] = 0.93 [0.88-0.95] and ICC [95%] = 0.90 [0.85-0.94], respectively). Significant correlations were detected between the EQ-5D-3L total score, NFOSI-18 (r = 0.648, p < 0.01), and NTX-4 (r = 0.694, p < 0.01) indicating sufficient convergent validity. Conclusion. The Turkish NFOSI-18 and Turkish NTX-4 are reliable and valid tools to assess disease-related symptoms in patients with advanced OC

HALP score and GNRI: Simple and easily accessible indexes for predicting prognosis in advanced stage NSCLC patients. The Izmir oncology group (IZOG) study

ObjectiveThe Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score and the Geriatric Nutrition Risk Index (GNRI) are used as prognostic factors in different types of cancers. In this study we analyzed the prognostic value of the HALP Score and the GNRI calculated prior to first-line treatment in patients diagnosed with de novo metastatic non-small cell lung cancer (mNSCLC). Materials and methodsDe novo mNSCLC patients were retrospectively evaluated from January 2016 to December 2019. Patients with Driver's mutation, severe comorbidities, active infection, or insufficient organ function, and those receiving anti-inflammatory treatment were excluded from the study. Optimal cut-off points for the HALP score and the GNRI were calculated with the receiver operating characteristic (ROC) curve analysis. Predictive factors for overall survival (OS) were assessed with univariate and multivariate Cox proportional hazard analyses, and OS was studied with the Kaplan-Meier analysis. ResultsThe study included 401 patients in total. In the ROC curve analysis, the cut-off points were found 23.24 (AUC = 0.928; 95% CI: 0.901-0.955, p < 0.001) for HALP, and 53.60 (AUC = 0.932; 95% CI: 0.908-0.955, p < 0.001) for GNRI. Groups with lower HALP scores and lower GNRI had significantly shorter OS compared to those with higher HALP scores and GNRIs. Univariate analysis showed that male gender, smoking, high ECOG score, low HALP score and low GNRI were associated with worse survival rates. Multivariate analysis showed that low HALP score (HR = 2.988, 95% CI: 2.065-4.324, p < 0.001); low GNRI score (HR = 2.901, 95% CI: 2.045-4.114, p < 0.001) and smoking history (HR = 1.447, 95% CI: 1.046-2.001, p = 0.025) were independent factors associated with worse OS rates. ConclusionOur study showed the HALP score and the GNRI to be of prognostic value as simple, cost-effective, and useful markers that predict OS in de novo mNSCLC patients

The relationship between sarcopenia detected in newly diagnosed colorectal cancer patients and FGF21, irisin and CRP levels

Key summary pointsAim We aimed to investigate the relationship between irisin and FGF21 in detecting sarcopenia in colorectal cancer patients. Findings Correlation analysis was performed between skeletal muscle mass index and FGF21, irisin and CRP, there was a positive correlation between skeletal muscle mass index and irisin and FGF21, while there was a negative correlation between skeletal muscle mass index and CRP. Message Irisin and FGF-21 and CRP may play a role in the pathophysiology of sarcopenia

Breast cancer survivors suffer from persistent postmastectomy pain syndrome and posttraumatic stress disorder (ORTHUS study): a study of the palliative care working committee of the Turkish Oncology Group (TOG)

Persistent postmastectomy pain syndrome (PMPS) is one of the most important disturbing symptoms. Posttraumatic stress disorder (PTSD) is an anxiety disorder which is characterized by reactions to reminders of the trauma that has been experienced. The purpose of this study is to evaluate the predictors of PMPS and PTSD in Turkish breast cancer survivors and the correlation between PMPS and PTSD

Worse patient-physician relationship is associated with more fear of cancer recurrence (Deimos Study): A study of the Palliative Care Working Committee of the Turkish Oncology Group (TOG)

Objective Fear of cancer recurrence (FCR) is an important psychological trauma associated with reduction in the quality of life, disruptions in the level of adjustment, emotional distress and anxiety. The purpose of the study was to evaluate the impact of patient-physician relationship on FCR. Methods The study was designed as a multicentre survey study. The cancer survivors, who were under remission, were evaluated with structured questionnaires. Patient-physician relationship (PPR) scale in which higher scores indicate better relationship and FCR inventory was used. Results Between January and April 2019, 1,580 patients were evaluated. The median age was 57.0 (19-88), and 66% were female. There was high level of FCR scores in 51% of participants. There was a negative correlation between PPR and FCR scores (r = -.134,p < .001). In multivariate analysis, young age, female gender, history of metastasectomy and worse PPR were associated with high levels of FCR. Conclusion It is the first data showing the adverse impact of worse PPR on FCR. The strategies to improve the PPR should be practised. In addition, the cancer survivors, who are under the risk of FCR, should be evaluated and managed