Prognostic Value of Prognostic Nutritional Index in Patients With Colorectal Cancer Undergoing Surgical Treatment

Xie, Hailun; Wei, Lishuang; Yuan, Guanghui; Liu, Mingxiang; Tang, Shaohui; Gan, Jialiang

doi:10.3389/fnut.2022.794489

Cited by 18 publications

(11 citation statements)

References 29 publications

(34 reference statements)

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“…PNI is a simple index developed by Onodera et al, reflecting immune, inflammatory, and nutritional status (39). According to recent studies, PNI significantly correlates with adverse outcomes in various diseases (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Zheng et al reported that a lower PNI is an independent risk factor for higher mortality in patients with respectable esophageal squamous cell carcinoma (7).…”

Section: Discussionmentioning

confidence: 99%

“…Prognostic Nutritional Index (PNI) is a simple and objective index of inflammatory and nutrition status derived from serum albumin (ALB) and lymphocyte counts. Recently, PNI has been reported to be an independent prognostic predictor for patients with cancer, stroke, heart disease, chronic kidney disease, acute exacerbation of the chronic obstructive pulmonary disease, sepsis, COVID-19, and autoimmune disease (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). However, no research has been conducted to examine the relationship between PNI and the prognosis of patients with DLC.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic nutritional index: A potential biomarker for predicting the prognosis of decompensated liver cirrhosis

Xie

Wang

2023

Front. Nutr.

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BackgroundPrognostic nutritional index (PNI) is an independent predictor of the prognosis of various diseases. However, the prognosis value of PNI in patients with decompensated liver cirrhosis (DLC) remains unknown. The study aimed to investigate the prognostic significance of PNI in patients with DLC.MethodsA total of 214 eligible patients were enrolled in the study’s development cohort between January 2018 and March 2021. The clinical primary study endpoints were mortality at 3 and 6 months. Receiver operating characteristic (ROC) curve analysis was used to assess the PNI’s prediction accuracy, and Youden’s index was utilized to determine the PNI’s optimal cut-off value. Moreover, based on the optimal cut-off value, patients were categorized into high and low PNI groups. Multivariate logistic regression analysis was used to determine independent risk factors for mortality, while the relationship between PNI and the risk of death was identified and demonstrated using restricted cubic splines (RCS). A validation cohort of 139 patients was to verify the predictive power of the PNI.ResultsIn the development cohort, the mortality rate at 3 and 6 months were 10.3% (22) and 14.0% (30), respectively. The PNI had comparable predictive power with the MELD score at all follow-up endpoints. Decreased PNI was an independent predictor of adverse prognosis at all follow-up endpoints. The RCS revealed a linear correlation between PNI and the risk of death. We confirmed that lower PNI was an independent predictor of poor prognosis in the validation cohort.ConclusionThe findings showed that lower PNI is an independent factor of poor outcomes and might be utilized as a potentially promising prognostic predictor in patients with DLC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic nutritional index: A potential biomarker for predicting the prognosis of decompensated liver cirrhosis

Xie

Wang

2023

Front. Nutr.

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“…It is well established that the outcome of cancer patients is determined by many factors, including nutrition status [ 5 ] and anticancer immunity [ 6 ], in addition to the cancer cells themselves; accordingly, it is plausible that prognostic markers could be more reasonable if these factors are comprehensively considered. The prognostic nutritional index (PNI), which is a marker calculated based on serum albumin and lymphocytes, is a robust prognostic indicator in many malignancies, including lung cancer [ 7 ], nasopharyngeal cancer [ 8 ], liver cancer [ 9 ], breast cancer [ 10 ], gastric cancer [ 11 ] and CRC [ 12 , 13 ]. Interestingly, previous studies have indicated that the prognostic efficacy of PNI was superior to that of other inflammation-based prognostic indicators [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Combined preoperative prognostic nutritional index and D-dimer score predicts outcome in colorectal cancer

Zhu

Yin

et al. 2023

BMC Surg

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Background The prognostic nutritional index (PNI) and D-dimer (DD) levels represent useful prognostic indicators in colorectal cancer (CRC); however, a combination of these indicators, namely, the PNI and DD score (PDS) was less addressed. Methods A retrospective study with 183 patients after curative surgery was conducted. Patients were divided into 3 subgroups: PDS 0, decreased PNI and increased DD levels; PDS 1, decreased or increased PNI and DD levels; PDS 2, increased PNI and decreased DD levels. The differences in disease-free survival (DFS) and overall survival (OS) were compared among these subgroups, and risk factors for outcome were determined. Results A total of 56, 65 and 62 patients were assigned to the PDS 0, 1 and 2 subgroups, respectively. PDS was significant in predicting both the DFS (area under the curve (AUC) = 0.68, P < 0.001) and OS (AUC = 0.74, P < 0.001). PDS 0 patients were more likely to be associated with old age (P = 0.032), laparotomy (P < 0.001), elevated CEA (P = 0.001), T3 + T4 (P = 0.001) and advanced TNM stage (P = 0.031). PDS 0 patients had significantly inferior DFS (log rank = 18.35, P < 0.001) and OS (log rank = 28.34, P < 0.001) than PDS 1 or 2 patients. PDS was identified as an independent risk factor for both DFS (PDS 1: HR = 0.54, 95% CI: 0.30–1.00, P = 0.049; PDS 2: HR = 0.40, 95% CI: 0.20–0.79, P = 0.009) and OS (PDS 1: HR = 0.44, 95% CI: 0.22–0.88, P = 0.020; PDS 2: HR = 0.17, 95% CI: 0.06–0.45, P < 0.001). Conclusion The PDS is a useful prognostic indicator for CRC patients after curative surgery, and PDS 0 patients have inferior survival. Additional future studies are needed to validate these findings.

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“…Prognostic nutritional index (PNI) is obtained by the level of serum albumin and peripheral lymphocytes and is proposed to assess immune-nutritional status ( 20 ). A few studies have shown that low PNI status is associated with an unfavorable prognosis in gastrointestinal and colorectal cancer ( 21 , 22 ).…”

Section: Introductionmentioning

confidence: 99%

Use of the prognostic nutrition index as a predictive biomarker in small-cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the Chinese alpine region

Yang²,

Qiao³

et al. 2023

Front. Oncol.

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BackgroundWhether the prognostic nutritional index (PNI), which is suggested to reflect systemic inflammation and nutritional status of patients, could be used as an effective prognostic factor for small-cell lung cancer (SCLC) has not yet been clarified. The purpose of this study was to verify the prognostic value of the PNI in SCLC patients treated with programmed cell death ligand-1/programmed cell death 1 (PD-L1/PD-1) inhibitors in the alpine region of China.MethodsSCLC patients treated with PD-L1/PD-1 inhibitors monotherapy or combined with chemotherapy between March 2017 and May 2020 were included. Based on the values of serum albumin and total lymphocyte count, the study population was divided into two groups: high and low PNI. The Kaplan-Meier method was used to compute the median survival time and the log-rank test was used to compare the two groups. To evaluate the prognostic value of the PNI, univariable and multivariable analyses of progression-free survival (PFS) and overall survival (OS) were performed. The correlations between PNI and DCR or ORR were calculated by Point biserial correlation analysis.ResultsOne hundred and forty patients were included in this study, of which, 60.0% were high PNI (PNI > 49.43) and 40.0% were low PNI (PNI ≤ 49.43). Results indicated that the high PNI group had better PFS and OS than the low PNI group in the patients who received PD-L1/PD-1 inhibitors monotherapy (median PFS: 11.0 vs. 4.8 months, p < 0.001 and median OS: 18.5 vs. 11.0 months, p = 0.004). Similarly, better PFS and OS were associated with an increase in PNI level in the patients who accepted PD-L1/PD-1 inhibitors combined with chemotherapy (median PFS: 11.0 vs. 5.3 months, p < 0.001 and median OS: 17.9 vs. 12.6 months, p = 0.005). Multivariate Cox-regression model showed that high PNI was significantly related to better PFS and OS in patients who accepted PD-L1/PD-1 inhibitors monotherapy or combined with chemotherapy (PD-L1/PD-1 inhibitors monotherapy: PFS: HR = 0.23, 95% CI: 0.10–0.52, p < 0.001 and OS: HR = 0.13, 95% CI: 0.03–0.55, p = 0.006; PD-L1/PD-1 inhibitors combined with chemotherapy: PFS: HR = 0.34, 95% CI: 0.19–0.61, p < 0.001 and OS: HR = 0.53, 95% CI: 0.29–0.97, p = 0.040, respectively). Additionally, Point biserial correlation analysis between PNI and disease control rate (DCR) showed that PNI status was positively correlated with DCR in SCLC patients receiving PD-L1/PD-1 inhibitors or combined with chemotherapy (r = 0.351, p < 0.001; r = 0.285, p < 0.001, respectively).ConcussionsPNI may be a promising biomarker of treatment efficacy and prognosis in SCLC patients treated with PD-L1/PD-1 inhibitors in the alpine region of China.

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Prognostic Value of Prognostic Nutritional Index in Patients With Colorectal Cancer Undergoing Surgical Treatment

Cited by 18 publications

References 29 publications

Prognostic nutritional index: A potential biomarker for predicting the prognosis of decompensated liver cirrhosis

Prognostic nutritional index: A potential biomarker for predicting the prognosis of decompensated liver cirrhosis

Combined preoperative prognostic nutritional index and D-dimer score predicts outcome in colorectal cancer

Use of the prognostic nutrition index as a predictive biomarker in small-cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the Chinese alpine region

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