Predictive value of the preoperative prognostic nutritional index for postoperative progression in patients with pancreatic neuroendocrine neoplasms

Fu, Mengfei; Yu, Li; Yang, Liu; Chen, Yang; Chen, Xiao; Hu, Qinyu; Sun, Hui

doi:10.3389/fnut.2022.945833

Cited by 9 publications

(8 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Initially used to evaluate the immunotrophic status and surgical risks of gastrointestinal surgery patients, PNI has since been applied to other cancer types, including EC (46), GC (26), HCC (47), and pancreatic cancer (48). The success of ICIs in combating tumors is attributed to their ability to alleviate the suppression of tumor cells by the immune system.…”

Section: Discussionmentioning

confidence: 99%

Prognostic nutritional index as a prognostic biomarker for gastrointestinal cancer patients treated with immune checkpoint inhibitors

Zhang

Qiu

et al. 2023

Front. Immunol.

View full text Add to dashboard Cite

ObjectiveOur study represents the first meta-analysis conducted to evaluate the prognostic utility of the baseline prognostic nutritional index (PNI) in patients with gastrointestinal cancer (GIC) who received immune checkpoint inhibitor (ICI) therapy.MethodsWe searched PubMed, the Cochrane Library, EMBASE, and Google Scholar until April 23, 2023, to obtain relevant articles for this study. Our analysis examined several clinical outcomes, including overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR).ResultsIn this analysis, a total of 17 articles with 2883 patients were included. Our pooled results indicated that patients with high PNI levels had longer OS (HR: 0.530, 95% CI: 0.456-0.616, p < 0.001) and PFS (HR: 0.740, 95% CI: 0.649-0.844, p < 0.001), as well as higher ORR (OR: 1.622, 95% CI: 1.251-2.103, p < 0.004) and DCR (OR: 1.846, 95% CI: 1.428-2.388, p < 0.001). Subgroup analysis showed that PNI cutoff values of 40 to 45 showed greater predictive potential. Subgroup analysis also confirmed that the above findings still hold true in patients with esophageal cancer, gastric cancer, and hepatocellular carcinomas.ConclusionThe PNI were reliable predictors of outcomes in GIC patients treated with ICIs.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic nutritional index as a prognostic biomarker for gastrointestinal cancer patients treated with immune checkpoint inhibitors

Zhang

Qiu

et al. 2023

Front. Immunol.

View full text Add to dashboard Cite

show abstract

“…Onodera et al (13) initially used PNI to assess immunotrophic status and surgical risks in patients undergoing gastrointestinal surgery. Subsequently, PNI has been applied in gastric cancer (8), lung cancer (9), liver cancer (10), pancreatic cancer (11), and many other cancers, and research on EC has mostly related to surgical prognosis (24,25). In a meta-analysis of 11 studies involving 3,425 patients with EC (26), low PNI value was associated with poor prognosis and was an independent predictor of PFS and OS; in addition, male gender, older age, and Furthermore, PFS was significantly longer after first-line treatment than after second-or-later-line treatment (median PFS: 14.1 vs. 5 months), which was further confirmed by multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Malnutrition can adversely affect the outcomes of cancer patients by reducing treatment tolerability, increasing side effects, and thus decreasing efficacy (6). The prognostic nutritional index (PNI), a parameter combining serum albumin (ALB) concentration and absolute lymphocyte count, reflects the immune and nutritional status of tumor patients and has been shown to be a positive prognostic marker for various malignant tumors (7)(8)(9)(10)(11). However, it is mainly based on retrospective research and its clinical significance and prognostic value for advanced EC after immunotherapy remain uncertain.…”

Section: Introductionmentioning

confidence: 99%

Prognostic nutritional index predicts the prognosis of patients with advanced esophageal cancer treated with immune checkpoint inhibitors: a retrospective cohort study

Wu¹,

Zhu²,

Chen³

et al. 2023

J Gastrointest Oncol

View full text Add to dashboard Cite

Background: Immune checkpoint inhibitors (ICIs) play an important role in the treatment of esophageal cancer (EC). However, their efficacy is variable, and there are still no effective and convenient biomarkers to identify and assess their efficacy. In recent years, programmed cell death-ligand 1 (PD-L1) expression, tumor mutation burden (TMB) and other commonly used biomarkers still cannot meet clinical needs. PNI is easy to obtain and its predictive value for the prognosis of immunotherapy has been confirmed in many cancer species, but the relationship between PNI and the efficacy of immunotherapy for esophageal cancer is still unclear. Therefore, this study aims to explore the predictive value of PNI in advanced esophageal cancer treated with ICIs. Methods:The clinicopathological features of 78 patients with advanced EC who received immunotherapy in the 900th Hospital of the Joint Logistics Team from September 2018 to May 2022 were retrospectively analyzed. The laboratory test results within 10 days prior to the start of ICI treatment were recorded, including absolute lymphocyte count and albumin (ALB) level. Meanwhile, the effects of pre-treatment prognostic nutritional index (PNI) and body mass index (BMI) on the overall survival (OS) and progressionfree survival (PFS) in patients with advanced EC were analyzed. Results:The median age of the enrolled patients was 58 years, and 38 patients (48.7%) received secondor-later-line therapy. The median progression-free survival (mPFS) and median overall survival (mOS) were 7.4 months and 13 months, respectively. The mPFS and mOS were 8.8 months and 15 months, respectively, in the high baseline PNI subgroup, which were significantly higher than those in the low baseline PNI subgroup (4.7 and 8.2 months, respectively; both P<0.05). Multivariate regression analysis showed that low baseline PNI was an independent predictor of poor PFS [hazard studio (HR) =0.35, 95% CI: 0.14-0.85, P=0.020) and poor OS (HR =0.41, 95% CI: 0.17-0.99, P=0.047) and treatment line was an independent predictor of PFS. Baseline BMI was not significantly associated with prognosis.Conclusions: PNI is a simple and effective biomarker for predicting the prognosis of immunotherapy in patients with advanced EC, although further prospective studies are warranted.

show abstract

“…The PNI is a systemic immunonutrition index based on peripheral lymphocyte counts and serum albumin levels [ 21 ], which provides a reliable and comprehensive assessment of the nutritional and inflammatory status of patients [ 22–23 ]. In addition, the PNI has been shown to be a prognostic biomarker for all-cause mortality in patients with decompensated liver cirrhosis [ 24 ], type-2 diabetes [ 25 ] and various cancers [ 26–29 ]. The PNI is also a predictor of the progression of diabetic nephropathy, and PNI is inversely associated with the incidence of end-stage nephropathy [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Association between the prognostic nutritional index (PNI) and all-cause mortality in patients with chronic kidney disease

Yu,

Chen,

Yin

2023

Renal Failure

View full text Add to dashboard Cite

Background Nutrition and immunity play an important role in many chronic diseases. The prognostic nutritional index (PNI) has been proposed as a comprehensive indicator of an individual’s immune and nutritional status. However, there is a lack of evidence regarding the association between the PNI and mortality in patients with chronic kidney disease (CKD). Methods We used National Health and Nutrition Examination Survey (NHANES) data from 2001–2014 for participants with CKD. Mortality data were obtained from the National Death Index and matched to NHANES participants. Cox proportional hazards models were used to estimate hazard ratios for all-cause mortality. Results: The patients were 72.5 ± 9.8 years old, and 47.57% were male. The median follow-up was 58 months, and the mortality rate in patients with CKD was 30.27%. A higher PNI protected against all-cause mortality in patients with CKD, with an adjusted hazard ratio (aHR) of 0.98 (95% confidence interval (CI): 0.97–0.99). After grouping according to PNI quartiles, statistically significant between-group differences were observed in survival probabilities. The aHR for the lowest PNI quartile compared to the highest PNI quartile was 1.64 (95% CI: 1.26–2.14). Sensitivity analysis further supported this association. Restricted cubic spline analysis revealed an L-shaped association between the PNI and all-cause mortality in patients with CKD, with a critical value of 50.5. Conclusions The PNI is a protective factor in patients with CKD, with an L-shaped decrease in all-cause mortality with an increasing PNI.

show abstract

Predictive value of the preoperative prognostic nutritional index for postoperative progression in patients with pancreatic neuroendocrine neoplasms

Cited by 9 publications

References 45 publications

Prognostic nutritional index as a prognostic biomarker for gastrointestinal cancer patients treated with immune checkpoint inhibitors

Prognostic nutritional index as a prognostic biomarker for gastrointestinal cancer patients treated with immune checkpoint inhibitors

Prognostic nutritional index predicts the prognosis of patients with advanced esophageal cancer treated with immune checkpoint inhibitors: a retrospective cohort study

Association between the prognostic nutritional index (PNI) and all-cause mortality in patients with chronic kidney disease

Contact Info

Product

Resources

About