Assessment of albumin and overall survival in advanced non-small cell lung cancer patients with anlotinib treatment using generalized additive model: A retrospective cohort study

Congyi Xie; Jinzhan Chen; Zhisheng Chen; Yijiao Xu; Jiaxin Liu; Huijun Zhang; Hongni Jiang; Feiyang Ye; Lin Tong

Clinical eHealth (Dec 2023)

Assessment of albumin and overall survival in advanced non-small cell lung cancer patients with anlotinib treatment using generalized additive model: A retrospective cohort study

Congyi Xie,
Jinzhan Chen,
Zhisheng Chen,
Yijiao Xu,
Jiaxin Liu,
Huijun Zhang,
Hongni Jiang,
Feiyang Ye,
Lin Tong

Affiliations

Congyi Xie: Department of Pulmonary Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian 361000, People’s Republic of China; Xiamen Clinical Research Center for Cancer Therapy, Xiamen, Fujian 361000, People’s Republic of China
Jinzhan Chen: Department of Pulmonary Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian 361000, People’s Republic of China
Zhisheng Chen: Department of Pulmonary Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian 361000, People’s Republic of China
Yijiao Xu: Department of Pulmonary Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian 361000, People’s Republic of China
Jiaxin Liu: Department of Pulmonary Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian 361000, People’s Republic of China
Huijun Zhang: Department of Pulmonary Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian 361000, People’s Republic of China; Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China
Hongni Jiang: Department of Pulmonary Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian 361000, People’s Republic of China; Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China
Feiyang Ye: College of Computer and Data Science, Fuzhou University, Fuzhou, Fujian 350108, People’s Republic of China
Lin Tong: Department of Pulmonary Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian 361000, People’s Republic of China; Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China; Corresponding author at: Department of Pulmonary Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, 361000, People’s Republic of China. Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China.

Journal volume & issue: Vol. 6
pp. 121 – 129

Abstract

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Background: Albumin is believed to be associated with the prediction of various cancers. This retrospective cohort study aimed to explore the non-linear relationship between albumin level and overall survival (OS) in advanced non-small cell lung cancer (NSCLC) patients with anlotinib therapy, utilizing the Generalized additive model (GAM) approach. Specifically, we investigated the potential non-linear associations that might not be captured by conventional linear analyses. Methods: A retrospective cohort of 211 patients undergoing anlotinib treatment for advanced NSCLC was included in this study. A wide range of albumin levels was considered, and the GAM method was applied to account for potential confounding clinical variables and unveil the non-linear relationship between albumin and OS. Results: A non-linear relationship with inflection points of 40 g/L and 48 g/L was detected between albumin level and OS after adjusting for potential confounders. The hazard ratio (HR) of the left, middle and right of the inflection points were 0.95 (95 % confidence interval [CI], 0.87 to 1.04, p = 0.2819, n = 71), 0.75 (95 % CI, 0.64 to 0.89, p = 0.0007, n = 133) and 2.79 (95 % CI, 1.39 to 5.61, p = 0.0039, n = 7), respectively. The findings indicate a negative correlation between albumin level and OS when albumin level was between 40 g/L and 48 g/L. For every unit increase in albumin, there was a 25 % reduction in the risk of death. Subgroup analysis revealed that the negative relationship was enhanced with blood urea nitrogen (BUN) level increase and diminished with D-dimer increase. Conclusions: The relationship between albumin level and OS was non-linear. Albumin level is an independent prognostic factor for OS. In addition, BUN level and D-dimer level could modify the effect of albumin level on the risk of death in advanced NSCLC patients treated with anlotinib.

Published in Clinical eHealth

ISSN: 2588-9141 (Online)
Publisher: KeAi Communications Co., Ltd.
Country of publisher: China
LCC subjects: Medicine
Website: https://www.keaipublishing.com/en/journals/clinical-ehealth/

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