Long-term and short-term prognostic value of the prognostic nutritional index in cancer: a narrative review

Li, Yan; Nakamura, Tomoki; Casadei-Gardini, Andrea; Bruixola, Gema; Huang, Yuan-Lan; Hu, Zhi-De

doi:10.21037/atm-21-4528

Cited by 25 publications

(24 citation statements)

References 61 publications

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“…Different biochemical parameters have been proposed to evaluate the immune-nutritional status such as blood neutrophil, lymphocyte, monocyte, platelet count, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), and platelet-lymphocyte ratio (PLR) [34][35][36]. Immune-nutritional scores such as the Prognostic Nutritional Index (PNI) and the Controlling Nutritional Status (CONUT) have also recently been evaluated in human cancer [20][21][22][23][24][25][26]37]. The latter has recently been implemented as a tool of nutritional screening, emerging as an independent prognostic factor for OS in several types of solid tumors [38] as well as in hematological cancer [39,40].…”

Section: Discussionmentioning

confidence: 99%

CONUT Score: A New Tool for Predicting Prognosis in Patients with Advanced Thyroid Cancer Treated with TKI

Dalmiglio

Brilli

Campanile

et al. 2022

Cancers

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(1) Background: The Controlling Nutritional Status (CONUT) score is an immuno-nutritional screening tool based on serum albumin, total cholesterol, and lymphocyte count. The aim of the study was to assess the CONUT score as a potential prognostic factor of response to therapy in patients with advanced thyroid cancer treated with tyrosine kinase inhibitors (TKIs). (2) Methods: We retrospectively evaluated 42 metastatic thyroid cancer patients (54.8% female). The median age at the time of TKI treatment was 69 years. Histological diagnosis was differentiated thyroid cancer in 66.7%, poorly differentiated thyroid cancer in 21.4%, and medullary thyroid cancer in 11.9% of patients. CONUT score was assessed before starting TKI therapy. (3) Results: Progression-free survival (PFS) and overall survival (OS) were significantly influenced by baseline CONUT score. The best CONUT cut-off able to predict the response to treatment was 3. Both PFS and OS were better in patients with CONUT score <3 than in those with CONUT score ≥3 (p < 0.0001). CONUT score was the only independent prognostic factor associated with PFS (p = 0.021) and OS (p = 0.007). (4) Conclusions: CONUT score represents a relatively new screening tool, easily applicable in clinical practice and potentially useful in predicting prognosis in thyroid cancer patients treated with TKIs.

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Section: Discussionmentioning

confidence: 99%

CONUT Score: A New Tool for Predicting Prognosis in Patients with Advanced Thyroid Cancer Treated with TKI

Dalmiglio

Brilli

Campanile

et al. 2022

Cancers

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“…A meta-analysis has shown that the PNI is a useful indicator for assessing nutritional and immunological conditions in lung cancer [ 55 ]. PNI is an inexpensive, easy-to-perform, non-invasive, rapid, and standardised tool for estimating cancer prognosis [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Nutritional Status and Treatment Response and Survival in Patients Treated with Immunotherapy for Lung Cancer: A Retrospective French Study

Gouez

Delrieu

Bouleuc

et al. 2022

Cancers

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Malnutrition is associated with a greater risk of morbidity and mortality and lower tolerance to chemotherapy. Our purpose was to study the association between nutritional status and the efficiency and tolerance of immunotherapy in non-small cell lung cancer (NSCLC). Nutritional and oncological data were reported at 2 months (M2) and 4 months (M4) after the initiation of immunotherapy (M0). The influence of nutritional status at M0 was estimated with the efficacy and toxicity of immunotherapy at M2 to M4. In total, 127 patients were included in the study, and nutritional status was estimated at M0 for 120 patients: 67% were not malnourished, 20% presented with moderate malnutrition, and 13% presented with severe malnutrition. There was no significant link between the nutritional status at M0 and the toxicity of immunotherapy at M2 and M4. However, severe malnutrition was significantly associated with treatment efficacy at M2 (p = 0.04) and with a lower survival rate with an HR (Hazard Ratio) = 2.32–95% C.I: 1.13–4.75 (p = 0.02). Furthermore, a monthly decrease of 1% of the weight had an HR = 1.17–95% C.I: 1.13–1.21 (p = 0.0001). Severe malnutrition and weight loss are independent factors associated with lower survival. Studies integrating the systemic detection of sarcopenia with a closer nutritional follow-up could highlight an improvement in survival.

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“…Calculated from serum albumin levels and absolute lymphocyte counts, this simple and comprehensive index reflects not only protein stores but also the immunological status. Its prognostic value has been examined in malignancy [ 5 ], autoimmune disease [ 6 ], and heart failure [ 7 – 12 ] and has been reported in several small-scale studies for patients with acute coronary syndrome (ACS) or stable CAD [ 13 – 16 ].…”

Section: Backgroudmentioning

confidence: 99%

Association of prognostic nutritional index level and diabetes status with the prognosis of coronary artery disease: a cohort study

Yuan

Wang

et al. 2023

Diabetol Metab Syndr

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Background Malnutrition and inflammation are associated with adverse clinical outcomes in patients with diabetes or coronary artery disease (CAD). Prognostic nutritional index (PNI) is a comprehensive and simple indicator reflecting nutritional condition and immunological status. Whether there is a crosstalk between nutritional-immunological status and diabetes status for the impact on the prognosis of coronary artery disease (CAD) is unclear. Methods A total of 9429 consecutive CAD patients undergoing percutaneous coronary intervention were grouped by diabetes status [diabetes (DM) and non-diabetes (non-DM)] and preprocedural PNI level [high PNI (H-PNI) and low PNI (L-PNI)] categorized by the statistically optimal cut-off value of 48.49. The primary endpoint was all-cause death. Results During a median follow-up of 5.1 years (interquartile range: 5.0–5.1 years), 366 patients died. Compared with the non-DM/H-PNI group, the DM/L-PNI group yielded the highest risk of all-cause death (adjusted hazard ratio: 2.65, 95% confidence interval: 1.97–3.56, p < 0.001), followed by the non-DM/L-PNI group (adjusted hazard ratio: 1.44, 95% confidence interval: 1.05–1.98, p = 0.026), while DM/H-PNI was not associated with the risk of all-cause death. The negative effect of L-PNI on all-cause death was significantly stronger in diabetic patients than in nondiabetic patients (p for interaction = 0.037). Preprocedural PNI category significantly improved the Global Registry of Acute Coronary Events (GRACE) risk score for predicting all-cause death in patients with acute coronary syndrome, especially in those with diabetes. Conclusions CAD patients with diabetes and L-PNI experienced the worst prognosis. The presence of diabetes amplifies the negative effect of L-PNI on all-cause death. Poor nutritional-immunological status outweighs diabetes in increasing the risk of all-cause death in CAD patients. Preprocedural PNI can serve as an assessment tool for nutritional and inflammatory risk and an independent prognostic factor in CAD patients, especially in those with diabetes.

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Long-term and short-term prognostic value of the prognostic nutritional index in cancer: a narrative review

Cited by 25 publications

References 61 publications

CONUT Score: A New Tool for Predicting Prognosis in Patients with Advanced Thyroid Cancer Treated with TKI

CONUT Score: A New Tool for Predicting Prognosis in Patients with Advanced Thyroid Cancer Treated with TKI

Association between Nutritional Status and Treatment Response and Survival in Patients Treated with Immunotherapy for Lung Cancer: A Retrospective French Study

Association of prognostic nutritional index level and diabetes status with the prognosis of coronary artery disease: a cohort study

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