Value of the prognostic nutritional index and weight loss in predicting metastasis and long-term mortality in nasopharyngeal carcinoma

Abstract

BackgroundTo evaluate the influence of the progonistic nutritional index (PNI) and weight loss on metastasis and long-term mortality in nasopharyngeal carcinoma (NPC).MethodsWe retrospectively reviewed 694 newly diagnosed patients with non-disseminated, biopsy-proven NPC. Survival analysis was used to evaluate the predictive value of PNI and weight loss.ResultsMultivariate analysis demonstrated that a low pre-therapy PNI (< 55.0) was an independent predictor of poor overall survival (OS) (P = 0.012), distant metastasis-free survival (DMFS) (P = 0.011) and progression-free survival (P = 0.012). High weight loss (HWL, weight loss during treatment ≥10 %) was an independent predictor of poor OS (P = 0.001) and DMFS (P = 0.014). Advanced stage disease, female gender, chemotherapy, high white blood cell count, high serum globulin concentration and pre-therapy body-mass index were predictors of HWL.ConclusionPre-therapy PNI and weight loss have significant predictive value for metastasis and mortality in patients with NPC.

The value of the Prognostic Nutritional Index (PNI) in predicting outcomes and guiding the treatment strategy of nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiotherapy (IMRT) with or without chemotherapy

“…However, our study failed to identify a cut-off value for LRRFS, which may be explained by the high loco-regional control rate (>90%) in the era of IMRT. These results were similar to the previous study (Du et al 2015). Although radiotherapy combined with chemotherapy has been widely accepted as the standard treatment modality for advanced NPC, the optimal chemotherapy regimen for this disease has yet to be defined.…”

“…Therefore, the PNI is considered a good index that reflects both the nutritional and immune status of the host (Ikeya et al 2015). Although the PNI was originally proposed by Onodera to assess postoperative complications of patients who underwent gastrointestinal surgery (Onodera et al 1984), increasing evidence has shown that the PNI is closely related to long-term outcomes and represents an independent prognostic factor for the survival of patients with various cancers (Ikeya et al 2015;Goodwin and Torres 1984;Hong et al 2015;Hofbauer et al 2015;Jiang et al 2014;Du et al 2015). In the current study, we conducted a retrospective study to investigate the significance of the PNI in predicting the prognosis of NPC patients.…”

Benefit of percutaneous endoscopic gastrostomy in patients undergoing definitive chemoradiotherapy for locally advanced nasopharyngeal carcinoma

“…Several retrospective studies demonstrated that weight loss is the strongest independent predictor of survival in patients with HNC 21,24. Recently, two reports from China indicated that NPC patients with high weight loss during treatment have significantly poor survival 25,26. Therefore, it is necessary to maintain weight in cancer patients during the treatment period.…”

The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer: A meta-analysis

“…5,6 The prognostic nutritional index (PNI), which was first designed by Buzby et al, 7 was calculated based on the serum albumin concentration and lymphocyte count in the peripheral blood. 8 Recently, emerging evidence has demonstrated the prognostic value of PNI in different types of malignant tumors, including hepatocellular carcinoma, 9 nasopharyngeal carcinoma, 10 and colorectal cancer. 11 Moreover, Sun et al 12 have performed a pooled analysis to estimate the prognostic value of PNI in cancer.…”