TORNA ALL’ELENCO

External validation of the Hemo-Eosinophils-Inflammation index as a prognosticator in anal cancer in Radiotherapy and Oncology

2022
AOU Alessandria

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (25)Vedi tutti...

Franco P
University of Eastern Piedmont, Department of Translational Medicine, Novara, Italy
Porreca A
"G. D'Annunzio" University of Chieti-Pescara, Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, Chieti, Italy
Di Nicola M
"G. D'Annunzio" University of Chieti-Pescara, Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, Chieti, Italy

et alii...

Abstract

Purpose or Objective Few prognostic factors has been recognised in squamous cell carcinoma of the anus (ASCC). Some are related to patient (gender), others to tumor (size, nodal involvement, HPV status). No laboratory index is currently validated as a prognosticator to guide clinical decision-making. We recently developed a prognostic scoring system based on laboratory inflammation parameters, [Hemo-Eosinophils-Inflammation (HEI) index], including baseline hemoglobin level, the systemic inflammatory index (platelet x neutrophil/lymphocyte), and eosinophil count. HEI was shown to discriminate prognostic groups for disease-free (DFS) and overall (OS) survival in ASCC treated with concurrent chemoradiation (CHT-RT). We tested the accuracy of the model on a multicentric cohort for external validation. Materials and Methods Patients treated with CHT-RT with intensity-modulated techniques were enrolled from a national network and characteristics were collected, with baseline serum biomarkers. The Kaplan–Meier curves for DFS and OS according to HEI risk groups were calculated and the log-rank test was used to test the difference in survival estimates. Cox proportional hazards models were used to assess the influence of prognostic factors on DFS and OS. The exponential of the regression coefficients provided an estimate of the hazard ratio (HR) and the 95% confidence interval (95%CI). All p-values were twotailed and a p-value<0.05 was statistically significant. For model discrimination, we determined Harrell's C-index, Gönen & Heller K Index and the explained variation on the log relative hazard scale based on D statistic. Results A total of 635 patients was available for the analysis. Proportional hazards were adjusted for age, gender, tumor stage, chemotherapy and radiotherapy. Two-year DFS was 77%(95%CI:72.0-82.4) and 88.3%(95%CI:84.8-92.0%) in the HEI high- and low- risk groups, respectively. Two-year OS was 87.8%(95%CI:83.7-92.0) and 94.2%(95%CI:91.5-97) in t

DOI : 10.1016/S0167-8140(22)02530-0

Keywords

biological marker; adult; anus cancer; cancer prognosis; cancer staging; cancer survival; chemoradiotherapy; chemotherapy; cohort analysis; conference abstract; controlled study; disease free survival; eosinophil; eosinophil count; female; gender; hemoglobin blood level; high risk population; human; human cell; human tissue; inflammation; Kaplan Meier method; log rank test; low risk population; lymphocyte; major clinical study; male; neutrophil; radiotherapy; risk assessment; scoring system; thrombocyte; validation process;