Prognostic significance of the postoperative prognostic nutritional index in patients with glioblastoma: a retrospective study

Abstract

Background The prognostic nutritional index (PNI) reflects immunonutritional status. We evaluated the effects of postoperative PNI and perioperative changes in the PNI on overall survival (OS) in glioblastoma (GBM) patients. Methods Demographic, laboratory, and clinical data were retrospectively collected from 335 GBM patients. Preoperative and postoperative PNIs were calculated from serum albumin concentration and lymphocyte count, which were measured within 3 weeks before surgery and 1 month after surgery. Patients were classified into high (n = 206) or low (n = 129) postoperative PNI groups according to the postoperative PNI cutoff value and further classified into four groups according to the cutoff values of the preoperative and postoperative PNIs, as follows: Group HH (both high PNIs, n = 92), Group HL (high preoperative and low postoperative PNI, n = 70), Group LH (low preoperative and high postoperative PNI, n = 37), and Group LL (both low PNIs, n = 136). Results The median OS was significantly longer in the high postoperative PNI (PNI ≥ 50.2) group than the low postoperative PNI (PNI < 50.2) group (24.0 vs. 15.0 months, p < 0.001). In multivariate analysis, high postoperative PNI was a significant predictor of OS. OS was significantly longer in Group HH than in Group LL and seemed longer in Group HH than in Group HL and in Group LH than in Group LL. OS was not different between Groups HH and LH or between Groups HL and LL. Conclusions High postoperative PNI was associated with improved OS and perioperative changes in PNI may provide additional important information for prognostic prediction in GBM patients.

Role of prognostic nutritional index in postoperative radiotherapy for non‐small cell lung cancer

“…At the same time, even in the case of patients with high PNI before PORT, maintaining optimal PNI may be important. Prior studies that focused on pre‐ or postoperative PNI have proposed perioperative interventions such as nutritional support or pulmonary rehabilitation to improve postoperative PNI 7,10,24 . However, such perioperative interventions alone might not be sufficient for patients receiving PORT, as immunonutritional status can still be affected by postoperative treatment.…”

“…Most previous studies have focused on the role of pretreatment PNI, but immunonutritional status can change dramatically after surgery, chemotherapy, and radiotherapy. A few studies have incorporated both pre‐ and post‐treatment PNI and found PNI after surgery or chemotherapy also has a significant impact on survival of NSCLC patients 7,8 as well as those with glioblastoma, renal cell carcinoma, and breast cancer 9–11 . However, to date, there have been no studies of the relationship between PNI and PORT in NSCLC patients.…”

“…A few studies have incorporated both pre‐ and post‐treatment PNI and found PNI after surgery or chemotherapy also has a significant impact on survival of NSCLC patients 7 , 8 as well as those with glioblastoma, renal cell carcinoma, and breast cancer. 9 , 10 , 11 However, to date, there have been no studies of the relationship between PNI and PORT in NSCLC patients.…”

Diagnostic Significance of Pre-Treatment Prognostic Nutritional Index, Platelet/Albumin Ratio and Red Cell Distribution Width in Patients with Differentiated Glioblastoma from Brain Metastasis

“…[21,24] Postoperatively high PNI also showed improved OS and perioperative changes in PNI provides additional important information for prognostic prediction in GBM patients. [25] The decision to resection the brains of metastatic patients must be made urgently but carefully because surgery can potentially cause morbidity and mortality. The increased level of neutrophils suppresses the cytolytic activity of lymphocytes and activated T cells.…”