Role of the prognostic nutritional index in the treatment prediction of stage II colon cancer

Abstract

Background The prognostic nutritional index (PNI), estimated using serum albumin concentration and peripheral blood cell count, is a promising predictor of outcomes in patients with colon cancer. We aimed to show the difference in survival times based on adjuvant chemotherapy status in the low PNI group.Method The study enrolled 179 adult patients diagnosed with stage II colon cancer between January 2010 and September 2019. The PNI was calculated using the formula: 10 x serum albumin value (g/dL) + 0.005 x total lymphocyte count in the peripheral blood (per mm3). The ROC curve allowed us to validate the PNI for predicting survival with a threshold level of 47.255. The association between PNI and survival was evaluated with univariate and multivariate analysis. Subgroup analyses were conducted according to receipt of adjuvant chemotherapy (chemotherapy or no chemotherapy).Result The patients' mean age was 60.97,±11.53, and 67% were male. The cut-ff for the PNI obtained using the Roc curve method was 47.255. In 59.2% of the patients, the PNI was 47.255. In multivariate Cox regression analysis, a statistically significant difference was found between chemotherapy status and OS (mOS:168.36 m vs. 107.36 m, HR:0.39 (CI95%:0.16–0.94), p = 0.013, received and not received, respectively) and PFS (mPFS:168.36 m vs. 107.36 m, HR:0.38 (CI 95%:0.16–0.90), p = 0.014, received and no received, respectively).Conclusion The overall and progression-free survival duration of patients who did not get chemotherapy in the PNI subgroup was shorter than that of patients who did receive chemotherapy, according to the PNI established before surgery in stage II colon cancer patients.