Search Results (14)

Background and Objectives: The Naples prognostic score (NPS), which incorporates inflammatory and nutritional indicators, is increasingly used as a prognostic score for various malignancies. Nonetheless, few studies have specifically evaluated the NPS as a prognostic factor for cervical cancer. This study aimed to assess the value of NPS at diagnosis as a predictor of cancer progression. Materials and Methods: This study included patients diagnosed with cervical cancer at Korea University Anam Hospital from January 2019 to December 2023. Patients with incomplete data or those who were lost to follow-up were excluded. The NPS was calculated based on laboratory results at the time of diagnosis, categorizing patients into the low-NPS group (NPS 0–1) and high-NPS group (NPS ≥ 2). Survival analysis was performed using the Kaplan–Meier method and log-rank test. Univariate and multivariate Cox proportional hazards models were used to identify independent prognostic factors. Results: Out of 178 patients, 98 and 80 were categorized into the low-NPS and high-NPS groups, respectively. Kaplan–Meier survival analysis showed that the high-NPS group had significantly lower disease-free survival (DFS) (p < 0.001) and overall survival (OS) (p = 0.02) rates than the low-NPS group. Multivariate Cox regression analysis identified the NPS as an independent prognostic factor for DFS (adjusted hazard ratio, 1.98; p = 0.017), but not for OS. Conclusions: This study demonstrated that the NPS measured at diagnosis may serve as a useful independent prognostic factor for cancer progression in patients with cervical cancer. Full article

Objectives: Early identification of myocardial ischemia is critical for the management of patients with stable angina pectoris (SAP). The Naples Prognostic Score (NPS) and the Systemic Immune-Inflammation (SII) index are emerging biomarkers that may improve risk stratification prior to myocardial perfusion scintigraphy (MPS) Methods: We retrospectively analyzed 615 patients with SAP who underwent MPS to assess the predictive value of the NPS and SII index for myocardial ischemia. Clinical, laboratory, and imaging data were collected. The associations between the NPS, SII, and ischemia detected on MPS were evaluated through univariate and multivariate logistic regression analyses. Results: A higher NPS was strongly associated with the presence of myocardial ischemia (p < 0.001). Male sex, elevated SII, and increased C-reactive protein (CRP) and neutrophile-to-lymphocyte ratio (NLR) values were also significantly related to ischemia. In multivariate analysis, NPS (p < 0.001), SII (p = 0.023), CRP (0.005), and NLR (0.037) values remained independent predictors of ischemia. Albumin levels were significant in univariate analysis but lost independent significance after adjustment. The incorporation of the NPS and SII index provided additional value in identifying patients at high risk of ischemia. Conclusions: The NPS and the SII index are inexpensive, very simple, non-invasive, and valuable markers of myocardial ischemia in patients with SAP. Their integration into clinical practice may enhance risk stratification and optimize diagnostic pathways, minimizing unnecessary invasive procedures. Full article

Objectives: This study aimed to investigate the prognostic value of the Naples Prognostic Score (NPS), a composite index of inflammation and nutrition markers, in patients with non-small cell lung cancer (NSCLC) and to assess its role in predicting survival across clinical subgroups. Methods: A retrospective analysis was conducted on 250 patients diagnosed with NSCLC between 2018 and 2023. Patients were categorized into low (≤2) and high (>2) NPS groups based on the scoring system derived from neutrophil–lymphocyte ratio (NLR), lymphocyte–monocyte ratio (LMR), serum albumin, and total cholesterol levels. Survival outcomes were analyzed using Kaplan–Meier curves, log-rank tests, and univariate and multivariate Cox regression analyses. Receiver operating characteristic (ROC) analysis was performed to determine the discriminatory ability of NPS. Results: Patients with high NPS (>2) had significantly lower overall survival (median OS: 10.4 vs. 18.2 months, p < 0.001) and progression-free survival (median PFS: 7.3 vs. 12.5 months, p < 0.001) than those with low NPS. High NPS was found to be an independent prognostic factor in multivariate Cox regression analysis (HR: 1.98, 95% CI: 1.42–2.76, p < 0.001). ROC analysis showed an AUC of 0.78 for NPS in predicting survival. Subgroup analyses demonstrated the consistent prognostic impact of high NPS across histological subtypes, TNM stages, smoking status, albumin levels, and age groups. Conclusions: NPS is an independent and practical prognostic tool in NSCLC. Its use may enhance risk stratification and support personalized treatment planning, particularly in advanced-stage patients. Full article

Background/Objectives: High-risk coronary plaques (HRP), identified through coronary CT angiography (CCTA), are closely linked to cardiovascular events. Nutritional status and systemic inflammation may play a critical role in the development of HRP. The Naples Prognostic Score (NPS), which integrates markers of nutritional status and systemic inflammation, has emerged as a potential predictor of outcomes in various cardiovascular conditions. This study aimed to investigate the association between NPS and HRP as assessed by CCTA. Methods: A retrospective analysis was performed on 753 patients with chronic coronary syndrome (CCS) who underwent CCTA. The patients were categorized into two groups: those with high-risk plaques (HRP present), and those without (HRP absent). Additionally, they were further stratified based on their NPS. Univariable and multivariable logistic regression analyses were conducted to identify the most relevant clinical factors and the role of NPS in relation to HRP and the need for revascularization. Results: The study population had a mean age of 56.9 ± 10.7 years, with 40% being female. The NPS was significantly higher in the HRP-present group compared to the HRP-absent group (p = 0.001). Stratification by NPS groups revealed that higher NPS groups were associated with increased coronary artery calcification scores (CAC) and revascularization rates (p < 0.001 and p = 0.003, respectively). Multivariable regression analysis demonstrated a significant association between NPS and HRP (OR = 1.228, 95% CI: 1.013–1.489, p = 0.036). Conclusions: The NPS is independently associated with the presence of high-risk coronary plaques in patients with chronic coronary syndrome. NPS may serve as a complementary risk stratification tool by reflecting systemic inflammation and nutritional status. Further prospective studies are needed to validate its prognostic value. Full article

Objectives: Non-ST-elevation myocardial infarction (NSTEMI) is a common and severe condition that requires rapid and accurate risk assessment and treatment. The Naples prognostic score (NPS) is a novel risk score that integrates nutritional and inflammatory parameters. The aim of this study was to investigate the NPS as a predictor of one-year mortality in NSTEMI patients undergoing percutaneous coronary intervention (PCI). Methods: This retrospective study included 197 NSTEMI patients who underwent selective PCI from January 2020 to December 2020. The NPS was calculated based on the total cholesterol, serum albumin, neutrophil/lymphocyte ratio, and lymphocyte/monocyte ratio. Patients were categorized into two groups based on their NPS values: Group 1 (NPS 0–2) and Group 2 (NPS 3 or 4). The one-year mortality status of the patients was determined through phone calls or by querying the national death registry system. Results: During the follow-up period, the overall mortality rate was 19.3% (n = 38). The high NPS group exhibited a significantly higher mortality rate compared to the low NPS group, with rates of 33.7% and 8.1%, respectively (p < 0.001). A Cox regression analysis indicated that a high NPS score is an independent predictor of one-year mortality, with a hazard ratio of 4.52 (95% CI: 1.93–10.58; p < 0.001). Conclusions: The NPS is a simple, cheap, and easily accessible tool that can be used for risk stratification and treatment selection in NSTEMI patients. It also highlights the importance of inflammatory and nutritional status in influencing the prognosis of NSTEMI patients. Full article

Background/Objectives: Acute pulmonary embolism (APE) is a clinical syndrome characterized by the obstruction of blood flow in the pulmonary artery, whose main pathophysiological features are respiratory and circulatory dysfunction. Acute pulmonary embolism is associated with a high mortality rate. Diagnostic and therapeutic delays can exacerbate mortality and result in prolonged hospitalization. With the increasing understanding that APE is associated with inflammation, various indices based on systemic inflammation have been shown to predict prognosis in patients with APE. The NAPLES Prognostic Score (NPS) is a new scoring system that indicates the inflammatory and nutritional status of the patient based on albumin (ALB) levels, total cholesterol (TC) levels, lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR). Our study aimed to examinate the effect of NPS on APE prognosis, so the relationship between NPS and APE prognosis was evaluated in our study. In addition, this study seeks to lay the groundwork for further investigations into this association and expand the existing body of knowledge. Methods: The clinical data of patients who applied to the Dicle University Faculty of Medicine and were diagnosed with APE between March 2014 and April 2024 were evaluated retrospectively, with 436 patients aged 18 years and over included in the study. Patients were divided into two groups according to NPS. It was statistically investigated whether there was a significant difference in long-term mortality between the two groups. Statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) version 21.0. Results: Survival was found to be statistically significantly lower in patients with NPS 3–4 (p < 0.05). In the multivariate regression analyses, no statistically significant effect of NPS or other parameters except lactate on 3-month mortality was found (p > 0.05). The short-term prognostic value of the NPS has been found to be equivalent to that of the sPESI score. It may be considered that APE patients with high NPS scores should be monitored more frequently. Conclusions: Increased NPS was found to be associated with poor APE prognosis in our study. Full article

Objectives: Chronic limb-threatening ischemia (CLTI) is the most severe manifestation of peripheral artery disease (PAD) and is associated with high morbidity and mortality. The Naples prognostic score (NPS), a composite marker incorporating serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR), has shown prognostic value in various cardiovascular conditions. This study aimed to evaluate the prognostic significance of the NPS in predicting all-cause mortality and any kind of amputation in patients with CLTI undergoing endovascular treatment (EVT) for below-the-knee (BTK) lesions. Methods: In this retrospective analysis, 191 patients diagnosed with CLTI and treated with EVT for BTK lesions between 2017 and 2023 were stratified into three groups based on the NPS: low (0–1), intermediate (2), and high (3–4). The primary endpoint was all-cause mortality, while the secondary endpoint was any kind of amputation. Results: A higher NPS was significantly associated with increased all-cause mortality (hazard ratio: 3.66; 95% confidence interval: 1.72–7.78; p < 0.001), while no significant association was observed between the NPS and major amputation. Independent predictors of mortality included a high NPS, reduced left ventricular ejection fraction, and impaired renal function. Conclusions: The NPS is an independent predictor of long-term mortality in CLTI patients undergoing EVT for BTK lesions. Full article

Background/Objectives: The Naples prognostic score (NPS), reflecting inflammation and nutritional status, has prognostic value, especially in cancer. This study evaluated its ability to predict in-hospital mortality in acute ischemic stroke (AIS) patients undergoing endovascular treatment (EVT). Methods: We retrospectively studied 244 patients with AIS who were admitted between April 2020 and December 2023. Patients were included if they presented within 6 h of symptom onset with evidence of intracranial proximal arterial occlusion. The EVT was performed using aspiration catheters, stent retrievers, or both. The NPS was calculated based on the neutrophil–lymphocyte ratio, lymphocyte–monocyte ratio, and albumin and total cholesterol levels. Results: We found a significant association between higher NPS scores and in-hospital mortality. Patients with a high NPS (3 or 4) had a mortality rate of 41.6% compared to 21.0% in the low-NPS group (0, 1, or 2). The full model incorporating NPS showed superior predictive ability for in-hospital mortality compared with the baseline model (areas under the curve 0.881 vs. 0.808). A receiver-operating characteristic analysis at a cutoff of >2.5 for the NPS showed a sensitivity of 86.6% and specificity of 41.9%. This study demonstrated that incorporating the NPS into the predictive model improved the accuracy and calibration for predicting in-hospital mortality. A decision curve analysis showed the net benefit of using the full model incorporating NPS over the baseline model, emphasizing its potential clinical application in prognostication. Conclusions: NPS is a reliable predictor of in-hospital mortality in AIS patients undergoing EVT. Incorporating NPS into clinical practice could help to identify high-risk patients and improve outcomes through tailored interventions. Full article

Inflammatory acute phase proteins have been reported to play a crucial role in cancer progression. Various hematologic and inflammatory markers and scores, such as the lymphocyte-to-monocyte ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic inflammation score (SIS), prognostic nutritional index (PNI), Glasgow prognostic score, and, more recently, the Naples prognostic score, have been reported as significant prognostic markers. The aim of this prospective study was to evaluate the prognostic significance of the C reactive protein-to-albumin ratio (CAR) in patients with colon cancer. Materials and Methods: We conducted a prospective observational study on a series of patients who underwent curative surgery for colon cancer. The C reactive protein-to-albumin ratio was determined preoperatively, and we evaluated the correlations between the CAR and various clinical and pathological parameters, as well as the correlation with Overall and Relapse-free survival. Furthermore, we compared the accuracy of the CAR with that of the Naples score. Results: One hundred and ten patients were included in the study. We set 0.4927 as the cut-off value for the CAR according to a receiver operating characteristic curve analysis. Based on the cut-off value, patients were divided into a low CAR group and a high CAR group. The preoperative CAR exhibited statistically significant correlation with tumor volume, T and N stage, number of positive lymph nodes, and grade of tumor differentiation. We also demonstrated a positive correlation between high CAR values and a higher Naples score (p = 0.0005), even when a subgroup analysis was performed for each group individually. Conclusions: The preoperative CAR is a useful prognostic marker in patients with colon cancer. These results may help to design strategies to personalize targeted management approaches among colon cancer patients. Full article

Different prognostic scores have been applied to identify patients with non-small cell lung cancer who have a higher probability of poor outcomes. In this study, we evaluated whether the Naples Prognostic Score, a novel index that considers both inflammatory and nutritional values, was associated with long-term survival. This study presents a retrospective propensity score matching analysis of patients who underwent curative surgery for non-small cell lung cancer from January 2016 to December 2021. The score considered the following four pre-operative parameters: the neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, serum albumin, and total cholesterol. The Kaplan–Meier method and Cox regression analysis were performed to evaluate the relationship between the score and disease-free survival, overall survival, and cancer-related survival. A total of 260 patients were selected for the study, though this was reduced to 154 after propensity score matching. Post-propensity Kaplan–Meier analysis showed a significant correlation between the Naples Prognostic Score, overall survival (p = 0.018), and cancer-related survival (p = 0.007). Multivariate Cox regression analysis further validated the score as an independent prognostic indicator for both types of survival (p = 0.007 and p = 0.010, respectively). The Naples Prognostic Score proved to be an easily achievable prognostic factor of long-term survival in patients with non-small cell lung cancer after surgical treatment. Full article

Background: The Naples prognostic score (NPS) is a scoring system that reflects a patient’s systemic inflammatory and nutritional status. This study aimed to evaluate whether postoperative NPS is effective in assessing the prognosis of stage II–III colorectal cancer (CRC) patients compared with preoperative NPS. Methods: Between 2005 and 2012, a total of 164 patients diagnosed with stage II–III CRC, who underwent curative resection followed by adjuvant chemotherapy, were divided into two groups: Group 0–1 (NPS = 0–2) and Group 2 (NPS = 3 or 4). Preoperative NPS was calculated based on the results before surgeries, and postoperative NPS was assessed using the results obtained before adjuvant chemotherapy. Results: The overall survival of Group 0–1 was higher than that of Group 2 in both pre- and postoperative NPS assessments. According to the ROC curve analysis, the Area Under the Curve (AUC) ratio for postoperative NPS was 0.64, compared with 0.57 for preoperative NPS, 0.52 for the preoperative neutrophil–lymphocyte ratio (p = 0.032), and 0.51 for the preoperative platelet–lymphocyte ratio (p = 0.027). Conclusions: Postoperative NPS is effective in predicting the prognosis of stage II–III CRC patients who underwent curative resection followed by adjuvant chemotherapy. The use of NPS could be beneficial in evaluating the prognosis of CRC patients after surgeries. Full article

Background and Objectives: Aortic stenosis (AS) is a widespread valvular disease in developed countries, primarily among the elderly. Transcatheter aortic valve replacement (TAVR) has become a viable alternative to aortic valve surgery for patients with severe AS who are deemed a high surgical risk or for whom the AS is found to be inoperable. Predicting outcomes after TAVR is essential. The Naples Prognostic Score (NPS) is a new scoring method that evaluates nutritional status and inflammation. Our study is aims to examine the relationship between the NPS and outcomes for patients receiving TAVR. Material and Methods: We conducted a retrospective study of 370 patients who underwent TAVR across three tertiary medical centres from March 2019 to March 2023. The patients were divided into two groups based on their NPS, namely, low (0, 1, and 2) and high (3 and 4). Our study is primarily aimed to determine the one-year mortality rate. Results: Within one year, the mortality rate for the entire group was 8.6%. Nonetheless, the low-NPS group had a rate of 5.0%, whereas the high-NPS group had a rate of 13%. The difference between the two groups was statistically significant, with a p-value of 0.06. Conclusions: Our results show that NPS is an independent predictor of one-year mortality in patients undergoing TAVR. Full article

The prevalence and role of malnutrition in periprosthetic joint infection (PJI) remain unclear. This study aimed to use measurable nutritional screening tools to assess the prevalence of malnutrition in PJI patients during two-stage exchange arthroplasty and to explore the association between malnutrition and treatment failure. Our study retrospectively included 183 PJI cases who underwent 1st stage exchange arthroplasty and had available nutritional parameters, of which 167 proceeded with 2nd stage reimplantation. The recently proposed Musculoskeletal Infection Society (MSIS) Outcome Reporting Tool was used to determine clinical outcomes. The Controlling Nutritional Status (CONUT), Nutritional Risk Index (NRI), and Naples Prognostic Score (NPS) were used to identify malnutrition at 1st and 2nd stage exchange, respectively. Multivariate logistic regression analyses were performed to determine the association between malnutrition and treatment failure. Restricted cubic spline models were further used to explore the dose–response association. Additionally, risk factors for moderate-to-severe malnutrition were evaluated. Malnourished patients identified by CONUT, NPS, and NRI accounted for 48.1% (88/183), 98.9% (181/183), and 55.7% (102/183) of patients at 1st stage, and 9.0% (15/167), 41.9% (70/167), and 43.1% (72/167) at 2nd stage, indicating a significant improvement in nutritional status. We found that poorer nutritional status was a predictor of treatment failure, with CONUT performing best as a predictive tool. Moderate-to-severe malnutrition at 1st stage identified by CONUT was significantly related to treatment failure directly caused by PJI (odds ratio [OR] = 5.86), while the OR was raised to 12.15 at 2nd stage (OR = 12.15). The linear dose–response associations between them were also confirmed (P for nonlinearity at both 1st and 2nd stage > 0.05). As for total treatment failure, moderate-to-severe malnutrition as determined by CONUT was associated with a 1.96-fold and 8.99-fold elevated risk at the 1st and 2nd stages, respectively. Age ≥ 68 years (OR = 5.35) and an increased number of previous surgeries (OR = 2.04) may be risk factors for moderate-to-severe malnutrition. Overall, the prevalence of malnutrition in PJI patients is very high. Given the strong association between moderate-to-severe malnutrition identified by CONUT and PJI treatment failure, COUNT could be a promising tool to evaluate the nutritional status of PJI patients to optimize treatment outcomes. Full article

Despite recent progresses, locally advanced gastric cancer remains a daunting challenge to embrace. Perioperative chemotherapy and D2-gastrectomy depict multimodal treatment of gastric cancer in Europe, shows better results than curative surgery alone in terms of downstaging, micrometastases elimination, and improved long-term survival. Unfortunately, preoperative chemotherapy is useless in about 50% of cases of non-responder patients, in which no effect is registered. Tumor regression grade (TRG) is directly related to chemotherapy effectiveness, but its understanding is achieved only after surgical operation; accordingly, preoperative chemotherapy is given indiscriminately. Conversely, Naples Prognostic Score (NPS), related to patient immune-nutritional status and easily obtained before taking any therapeutic decision, appeared an independent prognostic variable of TRG. NPS was calculated in 59 consecutive surgically treated gastric cancer patients after neoadjuvant FLOT4-based chemotherapy. 42.2% of positive responses were observed: all normal NPS and half mild/moderate NPS showed significant responses to chemotherapy with TRG 1–3; while only 20% of the worst NPS showed some related benefits. Evaluation of NPS in gastric cancer patients undergoing multimodal treatment may be useful both in selecting patients who will benefit from preoperative chemotherapy and for changing immune-nutritional conditions in order to improve patient’s reaction against the tumor. Full article