Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer
Abstract Background Systemic nutrition and inflammation status is recognized for its influence on cancer survival, yet its role in perioperative outcomes remains poorly defined. This study aimed to refine the assessment of systemic nutrition and inflammation status in non-small cell lung cancer (NSC...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-02-01
|
| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-025-03925-2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850185133410222080 |
|---|---|
| author | Peiyu Wang Shaodong Wang Qi Huang Xiankai Chen Yongkui Yu Ruixiang Zhang Mantang Qiu Yin Li Xue Pan Xiao Li Xiangnan Li |
| author_facet | Peiyu Wang Shaodong Wang Qi Huang Xiankai Chen Yongkui Yu Ruixiang Zhang Mantang Qiu Yin Li Xue Pan Xiao Li Xiangnan Li |
| author_sort | Peiyu Wang |
| collection | DOAJ |
| description | Abstract Background Systemic nutrition and inflammation status is recognized for its influence on cancer survival, yet its role in perioperative outcomes remains poorly defined. This study aimed to refine the assessment of systemic nutrition and inflammation status in non-small cell lung cancer (NSCLC) patients and to elucidate its impact on perioperative outcomes. Methods All patients underwent video-assisted thoracoscopic lobectomy, with their nutrition and inflammation status assessed based on preoperative blood tests. The development cohort, comprising 1497 NSCLC patients from two centers, evaluated the predictive value of systemic nutrition/inflammation indicators for perioperative endpoints and formulated the systemic nutrition-inflammation index (SNII). The tertiles of SNII were used to classify the nutrition/inflammation risk as high (< 15.6), moderate (15.6–23.1), and low (> 23.1). An external validation cohort of 505 NSCLC patients was utilized to confirm the effectiveness of SNII in guiding perioperative management. Results In the development cohort, the SNII tool, calculated as the product of total cholesterol and total lymphocytes divided by total monocytes, demonstrated a stronger correlation with perioperative outcomes compared to 11 existing nutrition/inflammation indicators. A low SNII score, indicative of high nutrition/inflammation risk, was independently predictive of increased complication incidence and severity, as well as prolonged chest tube duration and hospital stay. These findings were corroborated in the validation cohort. Upon combining the development and validation cohorts, the superiority of the SNII in predicting perioperative outcomes was further confirmed over the existing nutrition/inflammation indicators. Additionally, comprehensive subgroup analyses revealed the moderately variable efficacy of SNII across different patient populations. Conclusions This study developed and validated the SNII as a tool for identifying systemic nutrition and inflammation risk, which can enhance perioperative managements in NSCLC patients. Patients identified with high risk may benefit from prehabilitation and intensive treatments, highlighting the need for further research. |
| format | Article |
| id | doaj-art-e7689650a57c4d96bcd79f13652f2554 |
| institution | OA Journals |
| issn | 1741-7015 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj-art-e7689650a57c4d96bcd79f13652f25542025-08-20T02:16:49ZengBMCBMC Medicine1741-70152025-02-0123111810.1186/s12916-025-03925-2Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancerPeiyu Wang0Shaodong Wang1Qi Huang2Xiankai Chen3Yongkui Yu4Ruixiang Zhang5Mantang Qiu6Yin Li7Xue Pan8Xiao Li9Xiangnan Li10Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou UniversityThoracic Oncology Institute/Department of Thoracic Surgery, Peking University People’s HospitalDepartment of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer HospitalDepartment of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer HospitalDepartment of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer HospitalThoracic Oncology Institute/Department of Thoracic Surgery, Peking University People’s HospitalDepartment of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer HospitalSchool of Nursing and Health, Zhengzhou UniversityThoracic Oncology Institute/Department of Thoracic Surgery, Peking University People’s HospitalDepartment of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou UniversityAbstract Background Systemic nutrition and inflammation status is recognized for its influence on cancer survival, yet its role in perioperative outcomes remains poorly defined. This study aimed to refine the assessment of systemic nutrition and inflammation status in non-small cell lung cancer (NSCLC) patients and to elucidate its impact on perioperative outcomes. Methods All patients underwent video-assisted thoracoscopic lobectomy, with their nutrition and inflammation status assessed based on preoperative blood tests. The development cohort, comprising 1497 NSCLC patients from two centers, evaluated the predictive value of systemic nutrition/inflammation indicators for perioperative endpoints and formulated the systemic nutrition-inflammation index (SNII). The tertiles of SNII were used to classify the nutrition/inflammation risk as high (< 15.6), moderate (15.6–23.1), and low (> 23.1). An external validation cohort of 505 NSCLC patients was utilized to confirm the effectiveness of SNII in guiding perioperative management. Results In the development cohort, the SNII tool, calculated as the product of total cholesterol and total lymphocytes divided by total monocytes, demonstrated a stronger correlation with perioperative outcomes compared to 11 existing nutrition/inflammation indicators. A low SNII score, indicative of high nutrition/inflammation risk, was independently predictive of increased complication incidence and severity, as well as prolonged chest tube duration and hospital stay. These findings were corroborated in the validation cohort. Upon combining the development and validation cohorts, the superiority of the SNII in predicting perioperative outcomes was further confirmed over the existing nutrition/inflammation indicators. Additionally, comprehensive subgroup analyses revealed the moderately variable efficacy of SNII across different patient populations. Conclusions This study developed and validated the SNII as a tool for identifying systemic nutrition and inflammation risk, which can enhance perioperative managements in NSCLC patients. Patients identified with high risk may benefit from prehabilitation and intensive treatments, highlighting the need for further research.https://doi.org/10.1186/s12916-025-03925-2Non-small cell lung cancerNutritionInflammationPerioperative management |
| spellingShingle | Peiyu Wang Shaodong Wang Qi Huang Xiankai Chen Yongkui Yu Ruixiang Zhang Mantang Qiu Yin Li Xue Pan Xiao Li Xiangnan Li Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer BMC Medicine Non-small cell lung cancer Nutrition Inflammation Perioperative management |
| title | Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer |
| title_full | Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer |
| title_fullStr | Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer |
| title_full_unstemmed | Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer |
| title_short | Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer |
| title_sort | development and validation of the systemic nutrition inflammation index for improving perioperative management of non small cell lung cancer |
| topic | Non-small cell lung cancer Nutrition Inflammation Perioperative management |
| url | https://doi.org/10.1186/s12916-025-03925-2 |
| work_keys_str_mv | AT peiyuwang developmentandvalidationofthesystemicnutritioninflammationindexforimprovingperioperativemanagementofnonsmallcelllungcancer AT shaodongwang developmentandvalidationofthesystemicnutritioninflammationindexforimprovingperioperativemanagementofnonsmallcelllungcancer AT qihuang developmentandvalidationofthesystemicnutritioninflammationindexforimprovingperioperativemanagementofnonsmallcelllungcancer AT xiankaichen developmentandvalidationofthesystemicnutritioninflammationindexforimprovingperioperativemanagementofnonsmallcelllungcancer AT yongkuiyu developmentandvalidationofthesystemicnutritioninflammationindexforimprovingperioperativemanagementofnonsmallcelllungcancer AT ruixiangzhang developmentandvalidationofthesystemicnutritioninflammationindexforimprovingperioperativemanagementofnonsmallcelllungcancer AT mantangqiu developmentandvalidationofthesystemicnutritioninflammationindexforimprovingperioperativemanagementofnonsmallcelllungcancer AT yinli developmentandvalidationofthesystemicnutritioninflammationindexforimprovingperioperativemanagementofnonsmallcelllungcancer AT xuepan developmentandvalidationofthesystemicnutritioninflammationindexforimprovingperioperativemanagementofnonsmallcelllungcancer AT xiaoli developmentandvalidationofthesystemicnutritioninflammationindexforimprovingperioperativemanagementofnonsmallcelllungcancer AT xiangnanli developmentandvalidationofthesystemicnutritioninflammationindexforimprovingperioperativemanagementofnonsmallcelllungcancer |