A Novel Prognostic Index for Metastatic Colon Cancer: The Prognostic Immune Nutritional Index

Abstract

Systemic inflammation and nutrition are associated with survival outcomes in metastatic colon cancer (mCC) patients. A new and strong prognostic marker named the Prognostic Immune Nutritional Index (PINI) was proposed as the best marker for outcomes in metastatic colon cancer patients. This study aimed to evaluate the prognostic significance of PINI in mCC patients. MethodsThe data of 190 patients who were admitted to our center and diagnosed with mCC between 2010 and 2020 abiding by our inclusion criteria were reviewed retrospectively. Receiver operating characteristic (ROC) analysis was used to identify the optimum cutoff value of PINI for overall survival (OS). ResultsThe mean age of the participants was 62.64±11.99 years. The median follow-up time was 25.81 months. According to PINI, the median OS in patients who had PINI<3 was 22.70 months (95% confidence interval (CI): 16.05-29.35), and the median OS in patients who had PINI≥3 was 38.83 months (95% CI: 26.98-37.01) (p<0.001). PINI score lower than 3 was an independent prognostic indicator in multivariate analysis. ConclusionsPINI was discovered to be an independent prognostic factor in metastatic colorectal cancer. We believe that PINI, which can be calculated using a simple formula, will provide clinicians with important clues when deciding on individual treatment.

The prognostic value of immune-nutritional status in metastatic colorectal cancer: Prognostic Nutritional Index (PNI)

“…Recent studies have shown that not only clinicopathological features but also immune and nutritional status are effective in predicting the prognosis and treatment of cancer [ 18 ]. Various indices have been developed to evaluate the immunonutritional status, and the PNI was created by using the absolute lymphocyte value reflecting the immune status and the serum albumin value reflecting the nutritional status [ 7 , 18 , 19 ].…”

“…Recent studies have shown that not only clinicopathological features but also immune and nutritional status are effective in predicting the prognosis and treatment of cancer [ 18 ]. Various indices have been developed to evaluate the immunonutritional status, and the PNI was created by using the absolute lymphocyte value reflecting the immune status and the serum albumin value reflecting the nutritional status [ 7 , 18 , 19 ]. The prognostic and predictive values of PNI have been investigated in various types of cancer [ 7 , 20 – 22 ], and in this study, the prognostic value of PNI in patients diagnosed with metastatic colorectal cancer was evaluated and it was observed that the overall survival was significantly longer in the group with a higher PNI value consistent with the literature.…”

“…In addition to these inflammatory biomarkers, the PNI, a simple and inexpensive immunonutritional index developed by Onodera et al, is a marker that evaluates the nutritional status with the albumin in its formulation and the immune status with the absolute lymphocyte count, and has been shown to be an independent prognostic factor in many cancer types [ 7 – 9 , 11 – 13 , 20 – 22 ]. Its prognostic and predictive value in colorectal cancer, as in other types of cancer, has been investigated in various studies and its effect has been shown [ 18 , 23 – 26 ].…”