Impact of prognostic nutritional index on long-term outcomes in patients with breast cancer

Abstract

BackgroundPrognostic nutritional index has been shown to be a prognostic marker for various solid tumors. However, few studies have investigated the impact of the prognostic nutritional index on survival of patients with breast cancer. The aim of this study was to investigate the impact of the prognostic nutritional index on the long-term outcomes in patients with breast cancer.MethodsThis study reviewed the medical records of 212 patients with breast cancer who underwent mastectomy. The prognostic nutritional index was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm3). Receiver operating characteristic curve analysis was performed to determine the cutoff value of the prognostic nutritional index. The survival curves were calculated by the Kaplan–Meier method. Differences between the curves were analyzed by the log-rank test. Multivariate Cox proportional hazard model was used to evaluate the prognostic significance of prognostic nutritional index in patients with breast cancer.ResultsThe mean prognostic nutritional index just before the operation was 51.9, and the median follow-up after surgery was 47.7 months. The optimal cutoff value of the prognostic nutritional index for predicting the overall survival was 52.8 from the receiver operating characteristic curve analysis. The 5-year overall survival rate was 98.3 % in the prognostic nutritional index >52.8 and 92.0 % in the prognostic nutritional index <52.8 (P = 0.013). In the multivariate analysis, a low prognostic nutritional index was an independent predictor for poor overall survival (HR, 5.88; 95 % CI, 1.13–108.01; P = 0.033).ConclusionsThe prognostic nutritional index is a simple and useful marker for predicting the long-term outcomes of breast cancer patients, independent of the tumor stage.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-016-0920-7) contains supplementary material, which is available to authorized users.

Comparison of the prognostic values of selected inflammation based scores in patients with medullary thyroid carcinoma: A pilot study

“…Inflammation in the tumor microenvironment contributes substantially to tumor proliferation, angiogenesis, invasion, metastasis, and survival, suggesting that the systemic inflammatory factors may act as the prognostic markers in malignancies. Indeed, increasing evidence has demonstrated the correlations between preoperative inflammation based prognostic scores and clinical outcomes with various carcinomas . however, unlike other types of cancer, only a few studies have examined the significance of the inflammation based scores in thyroid cancer, especially MTC.…”

“…Indeed, increasing evidence has demonstrated the correlations between preoperative inflammation based prognostic scores and clinical outcomes with various carcinomas. 15,16,18,24,25,29 however, unlike other types of cancer, only a few studies have examined the significance of the inflammation based scores in thyroid cancer, especially MTC.…”

“…Increasing evidence has demonstrated that a low PNI can predict poor long-term outcomes of a variety of malignancies, such as breast cancer, 24 hepatocellular carcinoma, 34 colorectal carcinoma, 35 and gastric cancer. 36 The results of the present study are consistent with these previous investigations.…”

“…Prognostic nutritional index (PNI), a combination of albumin and lymphocyte counts, is thought to determine the perioperative immunological and nutritional status . A low PNI has been found to be associated with a poor prognosis in various malignancies . Moreover, other inflammation based scores such as derived neutrophil‐to‐lymphocyte ratio (dNLR) and lymphocyte‐to‐monocyte ratio (LMR) were also confirmed to be valuable in predicting tumor outcomes …”

“…22 A low PNI has been found to be associated with a poor prognosis in various malignancies. 23,24 Moreover, other inflammation based scores such as derived neutrophil-to-lymphocyte ratio (dNLR) and lymphocyte-to-monocyte ratio (LMR) were also confirmed to be valuable in predicting tumor outcomes. 25,26 However, to our knowledge, dNLR, LMR, PNI, and plasma fibrinogen have never been investigated in patients with MTC.…”