Low pretreatment PNI correlates with worse survival in patients with stage III/IV NSCLC who received chemotherapy

Abstract

The aim of this study was to investigate the prognostic value of the prognostic nutritional index (PNI) on the long-term survival of non-small cell lung cancer (NSCLC) patients who received platinum-based chemotherapy. Data on nutritional parameters and clinicopathological characteristics [e.g., albumin, total protein, body mass index (BMI), eastern cooperative oncology group (ECOG) performance status, stage, pathology, treatment strategy] were analyzed and retrospectively correlated with overall survival (OS). The PNI was calculated based on the concentration of albumin and lymphocyte count [10 × albumin, (g/dl) + 0.005 × lymphocyte (count/mm 3)]. A receiver operating characteristic curve (ROC) analysis was used to find the optimal cutoff value of PNI. Univariate and multivariate analyses were used to evaluate the prognostic value of PNI. A total of 186 patients met the inclusion criteria. The optimal cutoff value for PNI was 50.45. Compared with the parameters of the low PNI group (n=76), high PNI was significantly associated with adenocarcinoma type, stage III, better ECOG and comprehensive treatment modality. The univariate analysis demonstrated that OS was superior when PNI ≥50.45, albumin ≥35 g/l, platelet-lymphocyte ratio (PLR) ≥163 and ECOG <2, and when the patient received a comprehensive treatment modality. In the multivariate analysis, PNI, TNM stage and treatment strategy were identified as independent predictors of survival in this study. This retrospective study demonstrated that a low PNI was related to worse overall survival in patients with stage III/IV NSCLC who received platinum-based chemotherapy. These data provided a conceptual basis for further research on the clinical application of the PNI index for patients receiving chemotherapy for intermediateand advanced-stage NSCLC.

The Prognostic Value of Lymphocyte-to-Monocyte Ratio and Nutritional Index for Ovarian Cancer Patients with Normal CA125 Level

“…Taken together, this current literature has demonstrated that a severely compromised immune system may be affected by starvation and lymphocytopenia. The NI cutoff value reported in previous studies was 40-60 for other cancer forms [18][19][20]. In our study, patients with NI < 47.5 had dramatically decreased survival when multivariate regression was corrected for other prognostic factors.…”

Change in Body Weight and Serum Albumin Levels in Febrile Neutropenic Lung Cancer Patients

“…Good nutritional status before treatment is important when undergoing chemotherapy (Chlebowski, 1985). Serum total protein and albumin levels are used as indicators of nutritional status (Sasatani, Okauchi, Ohara, Kagohashi, & Satoh, 2020;Shen et al, 2020). Several studies have used body weight and BMI as indicators of general condition in patients receiving chemotherapy (Castillo-Martínez et al, 2018).…”

Low prognostic nutrition index predicts poorer quality of life in late-stage lung cancer

“…The calculation of the PNI is based on the concentration of albumin and the lymphocyte count [10 × albumin (g/dL) + 0.005 × lymphocyte count (/mm 3 )]. Thus, the PNI comprehensively reflects both the nutritional and immune status of the patient and has proven reliable in predicting survival of lung cancer patients (17,18). However, the predictive value of the PNI for the QOL of late-stage lung cancer patients is unclear, so we investigated the relationships among PNI, the clinicopathological characteristics and QOL in late-stage lung cancer patients.…”