International journal of women's health · 2026
Pretreatment Pan-Immune-Inflammation Value and Corrected Prognostic Nutritional Index for 24-Month Recurrence Risk Stratification After Neoadjuvant Chemotherapy and Surgery in Stage III Endometrial Cancer.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lin Ruyin, Hu Xinxin, Zhou Liangyu, Ye Kai
Аннотация
OBJECTIVE: To evaluate pretreatment pan-immune-inflammation value (PIV) and corrected prognostic nutritional index (PNI) as exploratory markers of postoperative 24-month recurrence risk after neoadjuvant chemotherapy (NACT) and interval surgery for stage III endometrial cancer.
METHODS: This retrospective single-center cohort included 362 consecutive women treated from January 2014 through December 2022. Complete blood count and albumin values were obtained within 7 days before the first NACT cycle. The fixed-window analysis included 311 patients with definitive 24-month recurrence status; all 362 patients were retained for recurrence-specific and recurrence/death time-to-event analyses. Internal validation used 100 repetitions of stratified 10-fold cross-validation, nested penalty tuning for comprehensive models, training-fold threshold selection, and 1000 bootstrap resamples for optimism correction.
RESULTS: Among 311 patients with definitive status, 119 (38.3%) had documented recurrence. The PIV-corrected PNI model had a mean repeated-cross-validation AUC of 0.762 and a bootstrap-corrected AUC of 0.763. A penalized comprehensive clinical-pathological-molecular-treatment model had a mean held-out AUC of 0.787; adding PIV and corrected PNI increased it to 0.828 (paired held-out ΔAUC 0.042; bootstrap interval 0.013-0.070). The combined-biomarker model had a repeated-cross-validation calibration slope of 0.828 and intercept of -0.085; its bootstrap-corrected slope and intercept were 0.961 and -0.015. In full-cohort Cox analyses, higher PIV and lower corrected PNI remained associated with documented recurrence and with the composite recurrence/death endpoint. Seventeen deaths without prior documented recurrence were included as composite events, whereas 34 patients censored before 24 months were retained in time-to-event analyses.
CONCLUSION: Pretreatment PIV and corrected PNI provided complementary internally validated prognostic information and improved risk stratification within this cohort. The thresholds and models remain exploratory because model development, calibration, and decision-curve assessment were performed in the same single-center cohort; independent external validation is required before clinical use.
METHODS: This retrospective single-center cohort included 362 consecutive women treated from January 2014 through December 2022. Complete blood count and albumin values were obtained within 7 days before the first NACT cycle. The fixed-window analysis included 311 patients with definitive 24-month recurrence status; all 362 patients were retained for recurrence-specific and recurrence/death time-to-event analyses. Internal validation used 100 repetitions of stratified 10-fold cross-validation, nested penalty tuning for comprehensive models, training-fold threshold selection, and 1000 bootstrap resamples for optimism correction.
RESULTS: Among 311 patients with definitive status, 119 (38.3%) had documented recurrence. The PIV-corrected PNI model had a mean repeated-cross-validation AUC of 0.762 and a bootstrap-corrected AUC of 0.763. A penalized comprehensive clinical-pathological-molecular-treatment model had a mean held-out AUC of 0.787; adding PIV and corrected PNI increased it to 0.828 (paired held-out ΔAUC 0.042; bootstrap interval 0.013-0.070). The combined-biomarker model had a repeated-cross-validation calibration slope of 0.828 and intercept of -0.085; its bootstrap-corrected slope and intercept were 0.961 and -0.015. In full-cohort Cox analyses, higher PIV and lower corrected PNI remained associated with documented recurrence and with the composite recurrence/death endpoint. Seventeen deaths without prior documented recurrence were included as composite events, whereas 34 patients censored before 24 months were retained in time-to-event analyses.
CONCLUSION: Pretreatment PIV and corrected PNI provided complementary internally validated prognostic information and improved risk stratification within this cohort. The thresholds and models remain exploratory because model development, calibration, and decision-curve assessment were performed in the same single-center cohort; independent external validation is required before clinical use.