Which preoperative immunonutritional index best predicts postoperative mortality after palliative surgery for malignant bowel obstruction in patients with late-stage cancer? A single-center study in Japan comparing the modified Glasgow prognostic score (mGPS), the prognostic nutritional index (PNI), and the controlling nutritional status (CONUT)

Nagashima, Y.; Funahashi, Kimihiko; Kagami, Satoru; Ushigome, Mitsunori; Kaneko, Tomoaki; Miura, Yasuyuki; Yoshida, Kimihiko; Koda, Takamaru; Kurihara, Akira

doi:10.1007/s00595-022-02534-3

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…On the other hand, in the cohort with mismatch repair-deficient colorectal cancer there was no statistically significant difference between the High CAR Group vs. Low CAR Group, either in terms of overall survival or in terms of survival time without disease relapse [ 32 ]. The results of the study by Nagashima et al indicated that the mGPS was a good predictor not only of 60-day mortality, but also of the overall survival of patients with late-stage cancer and malignant bowel obstruction [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Combined Hematological/Biochemical Indexes and Tumor Clinicopathologic Features in Colorectal Cancer Patients—A Pilot Single Center Study

Čuk

Karamarković

Juloski

et al. 2023

Cancers

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Colorectal cancer (CRC) is a significant public health problem. There is increasing evidence that the host’s immune response and nutritional status play a role in the development and progression of cancer. The aim of our study was to examine the prognostic value of clinical markers/indexes of inflammation, nutritional and pathohistological status in relation to overall survival and disease free-survival in CRC. The total number of CRC patients included in the study was 111 and they underwent laboratory analyses within a week before surgery. Detailed pathohistological analysis and laboratory parameters were part of the standard hospital pre-operative procedure. Medical data were collected from archived hospital data. Data on the exact date of death were obtained by inspecting the death registers for the territory of the Republic of Serbia. All parameters were analyzed in relation to the overall survival and survival period without disease relapse. The follow-up median was 42 (24−48) months. The patients with the III, IV and V degrees of the Clavien–Dindo classification had 2.609 (HR: 2.609; 95% CI: 1.437−4.737; p = 0.002) times higher risk of death. The modified Glasgow prognostic score (mGPS) 2 and higher lymph node ratio carried a 2.188 (HR: 2.188; 95% CI: 1.413−3.387; p < 0.001) and 6.862 (HR: 6.862; 95% CI: 1.635−28.808; p = 0.009) times higher risk of death in the postoperative period, respectively; the risk was 3.089 times higher (HR: 3.089; 95% CI: 1.447−6.593; p = 0.004) in patients with verified tumor deposits. The patients with tumor deposits had 1.888 (HR: 1.888; 95% CI: 1024−3481; p = 0.042) and 3.049 (HR: 3.049; 95% CI: 1.206−7.706; p = 0.018) times higher risk of disease recurrence, respectively. The emphasized peritumoral lymphocyte response reduced the risk of recurrence by 61% (HR: 0.391; 95% CI: 0.196−0.780; p = 0.005). Standard perioperative laboratory and pathohistological parameters, which do not present any additional cost for the health system, may provide information on the CRC patient outcome and lay the groundwork for a larger prospective examination.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Combined Hematological/Biochemical Indexes and Tumor Clinicopathologic Features in Colorectal Cancer Patients—A Pilot Single Center Study

Čuk

Karamarković

Juloski

et al. 2023

Cancers

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“…Plenty of studies are researching gastrointestinal, [13,14,24] cardiovascular, [10,18] urogenital, [19] cerebrovascular, [12] hematopoietic [11,25] system disorders, oncological malignancies, [9,[26][27][28] and nutritional status. To the best of our knowledge, our study is the first to systematically evaluate the indications for intensive care unit hospitalization and compare them with the nutritional score.…”

Section: Discussionmentioning

confidence: 99%

Assessment of nutritional status and clinical outcomes: A comprehensive retrospective analysis of critically ill patients

Özkan,

Koca,

Tekeli

2023

Medicine

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Assessing nutritional status is vital for understanding and managing patients’ clinical conditions. Controlling Nutritional Status (CONUT) score is one of the most frequently used scores that evaluate caloric status, protein reserve, and immunological response estimation. This study assesses the critically ill patients’ nutritional status and its relationship with patient-related factors and mortality. Electronic medical records of 1687 Intensive Care Unit (ICU) patient files were reviewed from January 2019 to May 2023 retrospectively. Patient demographic information, clinical characteristics, and laboratory data were extracted and anonymized for analysis. The patients were divided according to the CONUT scores, and retrieved data were compared. The study population’s demographic features and clinical outcomes were stratified by CONUT scores. The gender distribution was similar; however, there was a significant age difference between the Low-CONUT and High-CONUT groups (P < .001). High CONUT values are linked to an increased risk of death, intubation, age, APACHE-II scores, and the number of comorbidities. Malnutrition is prevalent in ICU patients with gastrointestinal illnesses and urogenital system disorders, including infections. Patients with a high CONUT score at admission had an increased risk of ICU death even after correcting for covariates. The CONUT score is a trustworthy and practical tool for assessing ICU patients’ nutritional status, which is highly associated with ICU mortality. Patients admitted to the ICU with gastrointestinal, urogenital, or infectious disorders should have their nutritional condition assessed carefully. According to our study, the rate of intubated patients admitted to the intensive care unit is higher in malnourished patients. This suggests it should be reviewed in clinical settings, particularly in elderly, frail patients and those with numerous comorbidities.

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“…In a systematic review and meta-analysis, low PNI was associated with a higher risk of poor overall survival and cancer-specific survival, regardless of cancer type, site, surgery type, cutoff value, and sample size [16]. Accordingly, many studies have been conducted targeting different cancer patients and treatment methods, questioning the prognostic importance of PNI, but the findings obtained so far are not consistent [11,12,17,18]. Hence, we examined the prognostic importance of PNI on mortality in cancer patients treated with immune checkpoint blockade in this study.…”

Section: Introductionmentioning

confidence: 99%

“…Conventional prognostic methods such as medical imaging, pathology, demographics, and laboratory tests have limitations such as invasiveness, high cost, special training requirement, and subjectivity, and are not sufficient alone to predict patient outcomes [10]. Noninvasive, cost-effective, and easy-to-use markers such as the prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), inflammatory prognostic index (IPI), and controlling nutritional status (CONUT) are promising tools for predicting prognosis and mortality in cancer patients [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Relationship between prognostic nutritional index and mortality in cancer patients treated with immunotherapy

Melekoglu,

Kolsuz,

Salcan

et al. 2023

Med-Science

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Immunotherapy, in addition to surgery, chemotherapy, radiotherapy, and targeted therapies in cancer treatment, has emerged over the last decade as a significant contributor to improving patient survival. The prognostic nutritional index (PNI), which is a simple and useful tool that provides information about the general health status of patients and helps the treatment process, is used for many different types of cancer. This study aimed to evaluate the prognostic importance of PNI on mortality in cancer patients treated with immunotherapy. A total of 100 patients who were treated with immune checkpoint blockade in the oncology outpatient clinic were included retrospectively. According to our findings, only 23% of patients responded to immunotherapy, while 72% progressed. When PNI values were compared according to mortality status, it was determined that PNI values at baseline, first, third, sixth, and twelfth months were statistically significantly lower in patients who died during their follow-up. We also determined 44 as the cut-off value for the PNI in our study. The mortality rate was 76.7% in patients with PNI>44 and 43.5% in patients with PNI≤44. PNI appears to be a simple and useful tool for predicting mortality in cancer patients treated with immunotherapy.

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Cited by 6 publications

References 23 publications

Prognostic Value of Combined Hematological/Biochemical Indexes and Tumor Clinicopathologic Features in Colorectal Cancer Patients—A Pilot Single Center Study

Prognostic Value of Combined Hematological/Biochemical Indexes and Tumor Clinicopathologic Features in Colorectal Cancer Patients—A Pilot Single Center Study

Assessment of nutritional status and clinical outcomes: A comprehensive retrospective analysis of critically ill patients

Relationship between prognostic nutritional index and mortality in cancer patients treated with immunotherapy

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