A Novel Prognostic Marker Based on Risk Stratification with Prognostic Nutritional Index and Age for Nasopharyngeal Carcinoma Patients Who Received Neoadjuvant Chemotherapy

He, Qiao; Huang, Yecai; Wu, Gang; Feng, Mei; Zeng, Huamin; Liu, Mengru; Luo, Huaichao; Yang, Yuanyuan; Song, Xiaoyu; Zhang, Li; Lang, Jinyi

doi:10.2217/bmm-2018-0401

Cited by 17 publications

(18 citation statements)

References 34 publications

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“…Interestingly, this was because the conditional risk of recurrence or death for the older group (initially poorer prognosis) reduced less than that for the younger group (initially better prognosis), which was opposite to other factors. A possible reason was that older patients might experience a higher prolonged risk of recurrence or death due to increased comorbidity burdens, decreased performance status, and reduced tolerance to treatments [17,42–45].…”

Section: Resultsmentioning

confidence: 99%

“…For example, if a patient with an age of <45 years has not experienced recurrence and on follow-up is found to be disease-free, his 3-year conditional risk for having disease failure after 5 years from diagnosis would be 4.5%, while the traditional the older group (initially poorer prognosis) reduced less than that for the younger group (initially better prognosis), which was opposite to other factors. A possible reason was that older patients might experience a higher prolonged risk of recurrence or death due to increased comorbidity burdens, decreased performance status, and reduced tolerance to treatments [17,[42][43][44][45].…”

Section: F I G U R Ementioning

confidence: 99%

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Development and validation of a web‐based calculator to predict individualized conditional risk of site‐specific recurrence in nasopharyngeal carcinoma: Analysis of 10,058 endemic cases

Wu¹,

Li²,

Mao³

et al. 2020

Cancer Communications

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BackgroundConditional survival (CS) provides dynamic prognostic estimates by considering the patients existing survival time. Since CS for endemic nasopharyngeal carcinoma (NPC) is lacking, we aimed to assess the CS of endemic NPC and establish a web‐based calculator to predict individualized, conditional site‐specific recurrence risk.MethodsUsing an NPC‐specific database with a big‐data intelligence platform, 10,058 endemic patients with non‐metastatic stage I–IVA NPC receiving intensity‐modulated radiotherapy with or without chemotherapy between April 2009 and December 2015 were investigated. Crude CS estimates of conditional overall survival (COS), conditional disease‐free survival (CDFS), conditional locoregional relapse‐free survival (CLRRFS), conditional distant metastasis‐free survival (CDMFS), and conditional NPC‐specific survival (CNPC‐SS) were calculated. Covariate‐adjusted CS estimates were generated using inverse probability weighting. A prediction model was established using competing risk models and was externally validated with an independent, non‐metastatic stage I–IVA NPC cohort undergoing intensity‐modulated radiotherapy with or without chemotherapy (n = 601) at another institution.ResultsThe median follow‐up of the primary cohort was 67.2 months. The 5‐year COS, CDFS, CLRRFS, CDMFS, and CNPC‐SS increased from 86.2%, 78.1%, 89.8%, 87.3%, and 87.6% at diagnosis to 87.3%, 87.7%, 94.4%, 96.0%, and 90.1%, respectively, for an existing survival time of 3 years since diagnosis. Differences in CS estimates between prognostic factor subgroups of each endpoint were noticeable at diagnosis but diminished with time, whereas an ever‐increasing disparity in CS between different age subgroups was observed over time. Notably, the prognoses of patients that were poor at diagnosis improved greatly as patients survived longer. For individualized CS predictions, we developed a web‐based model to estimate the conditional risk of local (C‐index, 0.656), regional (0.667), bone (0.742), lung (0.681), and liver (0.711) recurrence, which significantly outperformed the current staging system (P < 0.001). The performance of this web‐based model was further validated using an external validation cohort (median follow‐up, 61.3 months), with C‐indices of 0.672, 0.736, 0.754, 0.663, and 0.721, respectively.ConclusionsWe characterized the CS of endemic NPC in the largest cohort to date. Moreover, we established a web‐based calculator to predict the CS of site‐specific recurrence, which may help to tailor individualized, risk‐based, time‐adapted follow‐up strategies.

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Section: Resultsmentioning

confidence: 99%

Section: F I G U R Ementioning

confidence: 99%

Development and validation of a web‐based calculator to predict individualized conditional risk of site‐specific recurrence in nasopharyngeal carcinoma: Analysis of 10,058 endemic cases

Wu¹,

Li²,

Mao³

et al. 2020

Cancer Communications

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“…[20,21]. PNI has been used as a predictive nutritional marker in patients with various diseases, such as malignancy [22], acute or chronic HF [23,24], heart failure with preserved ejection fraction (HFpEF) [25], pulmonary embolism (PE) [26], stable coronary artery disease (CAD) [27] and ST segment elevation myocardial infarction (STEMI) [28].…”

Section: Resultsmentioning

confidence: 99%

“…Several biomarkers, particularly B-type natriuretic peptide (BNP) [16], increased circulating inflammatory markers such as TNF-α [7,8], IL-6 [17], MCP-1 [18], NLR [9] and MHR [6] [20,21]. PNI has been used as a predictive nutritional marker in patients with various diseases, such as malignancy [22], acute or chronic HF [23,24], heart failure with preserved ejection fraction (HFpEF) [25], pulmonary embolism (PE) [26], stable coronary artery disease (CAD) [27] and ST segment elevation myocardial infarction (STEMI) [28]. The clinical significance of nutritional risk assessment in patients with HCM has not been well established.…”

Section: Resultsmentioning

confidence: 99%

Düşük prognostik nütrisyonel indeks hipertrofik kardiyomiyopatili hastalarda kötü sonuçlar ile ilişkilidir

Tak¹,

Ekizler²,

Kafes³

et al. 2020

Turkish Journal of Clinics and Laboratory

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The aim of the study was to investigate poor nutritional status assessed by prognostic nutritional index (PNI) on the prognosis of patients with hypertrophic cardiomyopathy(HCM). Material and Methods: A total of 420 patients with HCM were assessed. The primary end point was defined as the occurrence of CV death that included sudden cardiac death (SCD), death due to HF and cardioembolic stroke-related death. Results: During the follow-up, primary end point was developed in 25 (6.0%) patients. Receiver operating characteristic (ROC) analysis showed that using a cutoff level of 40, PNI predicted the occurrence of primary end point with a sensitivity of 76% and specificity of 76.7%. In the multivariate model, low PNI was significant predictor of the primary end point. Conclusion: This study showed that lowerPNI level is an independent predictor of CV death in patients with HCM.

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“…Wei et al (21) and Topkan et al (22) also revealed PNI is independent prognostic factors for OS in metastatic NPC patients. Followed by He et al (23), a total of 377 newly diagnosed NPC patients treated with neoadjuvant chemotherapy plus CCRT at the Sichuan Cancer Hospital were reviewed, and revealed that the novel prognosis index PNI was related to OS (P<0.001)and PFS (P=0.008) for metastatic NPC patients. Furthermore, 539 patients with newly diagnosed non-metastatic NPC treated by CCRT were retrospectively analyzed by Miao et al (24) and demonstrated that the 5-year LRFS, DMFS, DSS, and OS of PNI ≤52.0 group were significantly worse than the PNI >52.0 group.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of pretreatment prognostic nutritional index and lactated dehydrogenase in locally advanced nasopharyngeal carcinoma patients

Xiong¹,

Shi²,

Zhu³

et al. 2021

Ann Palliat Med

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Background: To evaluate the prognostic value of pretreatment prognostic nutritional index (PNI), lactated dehydrogenase (LDH) and their combination (PNI-LDH) in patients with locally advanced NPC receiving induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT). Methods: A total of 213 patients diagnosed with locally advanced (III-IVA) NPC between January 2013 and December 2017 were retrospectively reviewed. The optimal PNI and LDH cutoff values were determined by the quartiles. The association between PNI and LDH and the clinicopathological characteristics of the patients was examined. Survival curves were analyzed using the Kaplan-Meier method and compared by the log-rank test between the different PNI and LDH subgroups. Univariate and multivariate analyses were performed by the Cox proportional hazards regression model to evaluate the prognostic impact on overall survival (OS), progression-free survival (PFS), locoregional recurrence free survival (LRFS) and distant metastasis-free survival (DMFS). Furthermore, the prognostic values of the PNI, LDH, and PNI-LDH were evaluated by comparing the AUC area. Results: The optimal cut-off values of PNI and LDH were 52 and 177, respectively. Multivariate analyses revealed that patients with a higher PNI had inferior OS (P=0.027), PFS (P=0.040), LRFS (P=0.015) and DMFS (P=0.040), and patients with a higher LDH level had poorer OS (P=0.040), PFS (P=0.001), LRFS (P=0.001) and DMFS (P=0.001). Furthermore, EBV DNA positive, stage IVA were independent prognostic factors for survival outcomes in the multivariate analyses. Moreover, we further demonstrated that low PNIhigh LDH in locally advanced NPC patients was significantly related to poor OS (P=0.012), PFS (P=0.001), LRFS (P=0.001) and DMFS (P=0.001). The AUC of the PNI, LDH and PNI-LDH were 0.653 (P=0.021), 0.647 (P=0.028) and 0.751 (P=0.001), respectively, indicating that PNI-LDH is superior to either score alone.Conclusions: Pretreatment PNI and LDH could be considered as valuable predictors for survival outcomes in locally advanced NPC patients. The combination of them, superior to either score alone, can be used as a supplement to the traditional TNM staging system.

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A Novel Prognostic Marker Based on Risk Stratification with Prognostic Nutritional Index and Age for Nasopharyngeal Carcinoma Patients Who Received Neoadjuvant Chemotherapy

Cited by 17 publications

References 34 publications

Development and validation of a web‐based calculator to predict individualized conditional risk of site‐specific recurrence in nasopharyngeal carcinoma: Analysis of 10,058 endemic cases

Development and validation of a web‐based calculator to predict individualized conditional risk of site‐specific recurrence in nasopharyngeal carcinoma: Analysis of 10,058 endemic cases

Düşük prognostik nütrisyonel indeks hipertrofik kardiyomiyopatili hastalarda kötü sonuçlar ile ilişkilidir

Prognostic value of pretreatment prognostic nutritional index and lactated dehydrogenase in locally advanced nasopharyngeal carcinoma patients

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