Prognostic impact of the prognostic nutritional index in cases of resected oral squamous cell carcinoma: a retrospective study

Abstract

Background The systemic inflammatory response and nutritional status of patients with malignant tumors are related to postoperative results. We examined the usefulness of the prognostic nutritional index (PNI) as a prognostic tool in patients with oral squamous cell carcinoma who underwent radical surgery. Methods From 2008 to 2019, 102 patients (73 males, 29 females; age, 65.6 ± 9.8 years) who visited our hospital and underwent surgical therapy were included in this study. The endpoint was the total survival period, and the evaluation markers included the lymphocyte count and albumin level in peripheral blood obtained 4 weeks preoperatively, age, sex, alcohol consumption, smoking history, site of the tumor, pathological stage, and surgery status. The PNI was calculated using serum albumin levels and the peripheral blood lymphocyte count. The relationship between the PNI and patient characteristics were analyzed using Fisher's exact test. The Kaplan–Meier method was used to evaluate the survival rate. The survival periods were compared using the log-rank method. We evaluated the prognostic factors for overall survival (OS) and disease-free survival (DFS) in a logistic regression model. Results The tumor sites included the maxilla (n = 12), buccal mucosa (n = 11), mandible (n = 17), floor of the mouth (n = 9), and tongue (n = 53). The number of patients with stage I, II, III, and IV oral cancers was 28 (27.5%), 34 (27.5%), 26 (33.3%), and 14 (13.7%), respectively. During the observation period, 21 patients died of head and neck cancer. The optimal cut-off PNI value was 42.9, according to the receiver operating characteristic analysis. The proportion of patients with a short OS was lower in those with PNI higher than 42.9, and the 5-year OS in patients with PNI higher and lower than the cut-off value was 62.3% and 86.0%, respectively (P = 0.0105). Conclusions The OS of patients with PNI < 42.9 was lower than that of patients with PNI ≥ 42.9. The PNI, which is a preoperative head-to-foot inflammatory marker, can help in estimating the prognosis of oral cancer.

Prognostic impact of prognostic nutritional index on renal cell carcinoma: A meta-analysis of 7,629 patients

“…Onodera firstly introduced PNI in the prognostication of patients with cancer [ 14 ]. The prognostic significance of pretreatment PNI has been verified in many tumors including non-small cell lung cancer (NSCLC) [ 15 ], breast cancer [ 12 ], glioblastoma [ 16 ], oral squamous cell carcinoma [ 17 ], gastric cancer [ 18 ], and thyroid carcinoma [ 19 ]. The low PNI was shown as a significant prognostic factor.…”

Prognostic nutritional index as a potential prognostic marker for pancreatic cancer after distal pancreatectomy: A single-center, retrospective cohort study

“…Therefore, we speculate that PNI is a good indicator of survival in pancreatic cancer, irrespective of whether the patients have pancreatic head cancer or PBTC and have undergone resection or chemoradiotherapy. PNI has also been used to predict the prognosis of other cancers, including gastric cancer [23], malignant melanoma [24], oral squamous cell carcinoma [25], and colorectal cancer [26]. However, the cut-off value of PNI varies among studies, which may be attributed to differences in testing reagents, testing kits, and the impact of different cancers on the immunological and nutritional status of patients.…”

Prognostic Nutritional Index in Patients With End-Stage Oral Cancer

“…A low PNI value is associated with poorer tumor prognosis (increased tumor depth, lymph node metastasis, and poor TNM staging) and extensive hematic and lymphatic spread. 11 The PNI may be useful for predicting nutritional status and immunocompetence in oral cancer patients. There have been few reports on the use of the PNI to predict survival in terminal oral cancer, suggesting a need for further research with larger samples.…”