The Prognostic Impact of Nutritional Status on Postoperative Outcomes in Glioblastoma

Huq, Sakibul; Khalafallah, Adham M.; Botros, David; Oliveira, Leonardo A.P.; White, Taija; Dux, Hayden; Jimenez, Adrian E.; Mukherjee, Debraj

doi:10.1016/j.wneu.2020.11.033

Cited by 14 publications

(11 citation statements)

References 43 publications

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“…PNI is an immunonutritional indicator. A recent study demonstrated that nutritional status was associated with postoperative survival in patients with GBM, and PNI rather than other nutritional indices robustly reflected the nutritional status [ 22 ]. However, All previous studies investigating the relationship between the PNI and prognosis of GBM focused only on the effect of preoperative PNI on OS and reported inconsistent results [ 17 – 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…A recent study demonstrated that nutritional status was associated with postoperative survival in patients with GBM, and PNI rather than other nutritional indices robustly reflected the nutritional status [ 22 ]. However, All previous studies investigating the relationship between the PNI and prognosis of GBM focused only on the effect of preoperative PNI on OS and reported inconsistent results [ 17 – 22 ]. In contrast with previous studies, we evaluated the prognostic significance of the postoperative PNI in GBM patients and found a positive association between postoperative PNI and OS.…”

Section: Discussionmentioning

confidence: 99%

“…The prognostic nutritional index (PNI) is calculated from the serum level of albumin and lymphocyte count and reflects immunonutritional status [ 16 ]. Literature reviews have revealed the controversy about the role of preoperative PNI in predicting the prognosis of GBM patients [ 17 – 22 ]. However, no study has investigated the prognostic significance of the postoperative PNI in GBM patients.…”

Section: Introductionmentioning

confidence: 99%

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

Kim

Lee

et al. 2021

BMC Cancer

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Kim

Lee

et al. 2021

BMC Cancer

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“…The JHACG and HFS may partially capture nutritional status by including criteria for "weight loss" and "shrinking," respectively. Several studies have demonstrated that malnutrition is associated with survival, Stupp protocol completion, and LOS in patients with glioblastoma [44][45][46][47]. Ultimately, both sarcopenia and nutrition remain relatively understudied but important concepts within neurosurgical oncology.…”

Section: Related Concepts: Sarcopenia Nutritionmentioning

confidence: 99%

Frailty in Patients Undergoing Surgery for Brain Tumors: A Systematic Review of the Literature

et al. 2022

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“…Inadequate protein intake could result in poor nutritional status. Nutritional status is closely related to the prognosis of cancer patients ( 15 , 16 ). To date, the relationship between pre-operative BUN and post-operative 30-day mortality has yet to be explored in patients undergoing craniotomies for brain tumors.…”

Section: Introductionmentioning

confidence: 99%

Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database

Liu

et al. 2022

Front. Neurol.

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ObjectiveThere is limited evidence to clarify the specific relationship between pre-operative blood urea nitrogen (BUN) and post-operative 30-day mortality in patients undergoing craniotomy for tumors. Therefore, we aimed to investigate this relationship in detail.MethodsElectronic medical records of 18,642 patients undergoing craniotomy for tumors in the ACS NSQIP from 2012 to 2015 were subjected to secondary retrospective analysis. The principal exposure was pre-operative BUN. Outcome measures were post-operative 30-day mortality. We used binary logistic regression modeling to evaluate the association between them and conducted a generalized additive model and smooth curve fitting (penalized spline method) to explore the potential relationship and its explicit curve shape. We also conducted sensitivity analyses to ensure the robustness of the results and performed subgroup analyses.ResultsA total of 16,876 patients were included in this analysis. Of these, 47.48% of patients were men. The post-operative 30-day mortality of the included cases was 2.49% (420/16,876), and the mean BUN was 16.874 ± 6.648 mg/dl. After adjusting covariates, the results showed that pre-operative BUN was positively associated with post-operative 30-day mortality (OR = 1.020, 95% CI: 1.004, 1.036). There was also a non-linear relationship between BUN and post-operative 30-day mortality, and the inflection point of the BUN was 9.804. For patients with BUN < 9.804 mg/dl, a 1 unit decrease in BUN was related to a 16.8% increase in the risk of post-operative 30-day mortality (OR = 0.832, 95% CI: 0.737, 0.941); for patients with BUN > 9.804 mg/dl, a 1 unit increase in BUN was related to a 2.8% increase in the risk of post-operative 30-day mortality (OR = 1.028, 95% CI: 1.011, 1.045). The sensitivity analysis proved that the results were robust. The subgroup analysis revealed that all listed subgroups did not affect the relationship between pre-operative BUN and post-operative 30-day mortality (P > 0.05).ConclusionOur study demonstrated that pre-operative BUN (mg/dl) has specific linear and non-linear relationships with post-operative 30-day mortality in patients over 18 years of age who underwent craniotomy for tumors. Proper pre-operative management of BUN and maintenance of BUN near the inflection point (9.804 mg/dl) could reduce the risk of post-operative 30-day mortality in these cases.

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The Prognostic Impact of Nutritional Status on Postoperative Outcomes in Glioblastoma

Cited by 14 publications

References 43 publications

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

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

Frailty in Patients Undergoing Surgery for Brain Tumors: A Systematic Review of the Literature

Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database

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