Clinical impact of pretreatment prognostic nutritional index (PNI) in small cell lung cancer patients treated with platinum‐based chemotherapy

Shi, Jin; Cao, Shoubo; Xu, Shanqi; Wang, Chunyan; Meng, Qingwei; Yu, Yan

doi:10.1111/crj.12925

Cited by 36 publications

(30 citation statements)

References 27 publications

(67 reference statements)

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“…Additionally, lymphocyte, as important immune cells, plays a key role in the immune monitoring of tumor cell proliferation, invasion and migration [28,29]. PNI, which combines albumin and lymphocyte, also has been proved to be significantly related to the prognosis of various tumors including liver cancer, lung cancer and breast cancer et al [15,16,30]. The results of this study also found that ALB and PNI may be useful tools to define the risk of death in oral cancer patients.…”

Section: Discussionsupporting

confidence: 55%

“…Traditional nutritional indicators such as body mass index (BMI) and serum albumin (ALB) have been widely used in clinical to assess the nutritional status of the cancer patients and have been shown to be associated with the prognosis of a variety of tumors such as rectal cancer, head neck, oral cancer and gynecologic malignancies [9][10][11][12][13]. In addition to BMI and ALB, two comprehensive indicators prognostic nutritional index (PNI) which includes albumin and lymphocyte and nutritional risk index (NRI) which combines weight, height and serum albumin levels, have also been reported as simple but sensitive methods that can objectively assess the nutritional status of cancer patients and predict their prognosis in esophageal squamous cell carcinoma, liver cancer, lung cancer, and gastric cancer et al [11,[14][15][16][17][18][19]. However, there are few studies comprehensively explored the relationship between different nutritional indicators and prognosis of oral cancer patients.…”

Section: Introductionmentioning

confidence: 99%

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Nutritional assessment and prognosis of oral cancer patients: a large-scale prospective study

et al. 2020

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Background: To evaluate and compare the prognostic performance of four nutritional indicators body mass index (BMI), serum albumin (ALB), prognostic nutritional index (PNI) and nutritional risk index (NRI) in oral cancer patients, and to predict the response to chemotherapy in patients with different nutritional status. Methods: This prospective study which involved 1395 oral cancer patients was conducted in Fujian, China from September 2007 to November 2018. The BMI, PNI and NRI were calculated according to the following formulas: BMI = weight / height 2 (kg/m 2), PNI = albumin (g/l) + 0.005 × lymphocyte (count/μl) and NRI = (1.519 × albumin, g/ l) + (41.7× present/ideal body weight), respectively. The univariate and multivariate Cox proportional hazards models were used to compare the prognostic value of BMI, ALB, PNI and NRI in overall survival (OS) in oral cancer. Results: Patients with BMI < 18.5 kg/m 2 (VS 18.5 kg/m 2 ≤ BMI < 24 kg/m 2) had a poor survival outcome (HR = 1.585; 95% CI: 1.207-2.082). ALB, PNI, NRI were inversely correlated with OS of oral cancer (HR = 0.716; 95% CI: 0.575-0.891; HR = 0.793; 95% CI: 0.633-0.992; HR = 0.588; 95% CI: 0.469-0.738, respectively). In addition, the prognostic predictive performance of NRI was superior to BMI or ALB or PNI. Interestingly, compared with patients with better nutritional status, chemotherapy was significantly associated with poorer OS in malnourished oral cancer patients. Conclusions: BMI, ALB, PNI and NRI are of prognostic value in patients with oral cancer and the prognostic performance of NRI was superior to BMI or ALB or PNI. Malnutrition (BMI < 18.5 kg/m 2 or ALB< 40 g/l or PNI < 49.3 or NRI < 97.5) could predict an unfavorable response to chemotherapy in oral cancer patients.

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Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Nutritional assessment and prognosis of oral cancer patients: a large-scale prospective study

et al. 2020

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“…PNI is an index reflecting systemic immunonutritional status of patients. Large amounts of evidence indicate that higher PNI values are independently associated with better survival in malignancies, including gastric cancer [27], colorectal cancer [28,29], lung cancer [30,31], head and neck cancer [32] and renal cell cancer [33]. A similar study conducted by Hong et al [14] found that PNI ≥52.48 was an independent predictor of longer OS compared with low PNI group in patients with small cell lung cancer (SCLC), yielding a significant reduction in mortality risk of 38%.…”

Section: Discussionmentioning

confidence: 99%

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

Shen¹,

Li²,

Yuan³

et al. 2020

neo

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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.

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“…Serum samples are easy to access, and the identification of serum biomarkers as prognostic factors has more important meaning for clinicians. As systematic inflammatory response indicators, serum neutrophils, lymphocytes, monocytes and platelets, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) have been demonstrated to be closely associated with prognosis of many malignancies 2,16–19. Systemic immune–-inflammation index (SII) (SII=N×P/L), known as systemic immune–inflammation index, which is calculated on neutrophil (N), platelet (P) and lymphocyte (L) counts, has been found to be a better prognosis predicting factor 20–23.…”

Section: Introductionmentioning

confidence: 99%

<p>High systemic immune–inflammation index represents an unfavorable prognosis of malignant pleural mesothelioma</p>

Ma¹,

Yu²,

Wu³

2019

CMAR

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Background: Malignant pleural mesothelioma (MPM) represents a fatal disease with high aggressiveness, and limited biomarkers have yet been identified for MPM. The present study aims to explore potential serum prognostic factors of MPM. Materials and methods: A retrospective analysis of 97 pathologically diagnosed MPM was performed. The optimal cutoff value of pretreatment systemic immune–inflammation index (SII) was determined by receiver operating characteristic curve. Kaplan–Meier curves and Cox regression analysis were performed to assess the potential prognostic roles of parameters. Results: A total of 59.8% (n=58) patients are male, with a median age of 56.0 years (range 18–77). The optimal cutoff value of SII was 988.6×10 9 /L. High and low SII were found in 44 (45.4%) and 53 (54.6%) patients, respectively. Median survival time for total 97 cases was 18.5 months. The median overall survival for patients with low and high SII was 47.0 and 13.0 months, respectively. The 1-, 2- and 3-year survival rates for patients with low SII were 85.8%, 57.8% and 52.0% compared to that of 53.9%, 23.6% and 13.8% in patients with high SII. On univariate analysis, Eastern Cooperative Oncology Group performance status (ECOG PS)<2 points, low SII and adjuvant treatment ( P <0.05) were found to be closely correlated with a better prognosis of MPM. Only ECOG PS ( P =0.036) and SII ( P =0.009) held statistical significance on multivariate analysis. Conclusion: Pretreatment SII is easy to access to, and it represents an efficiency and noninvasive biomarker of MPM. High SII represents an unfavorable independent prognostic factor of MPM, and this needs to be validated in further studies.

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Clinical impact of pretreatment prognostic nutritional index (PNI) in small cell lung cancer patients treated with platinum‐based chemotherapy

Cited by 36 publications

References 27 publications

Nutritional assessment and prognosis of oral cancer patients: a large-scale prospective study

Nutritional assessment and prognosis of oral cancer patients: a large-scale prospective study

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

<p>High systemic immune–inflammation index represents an unfavorable prognosis of malignant pleural mesothelioma</p>

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