Low Prognostic Nutritional Index PNI Predicts Unfavorable Distant Metastasis-Free Survival in Nasopharyngeal Carcinoma: A Propensity Score-Matched AnalysisReportar como inadecuado




Low Prognostic Nutritional Index PNI Predicts Unfavorable Distant Metastasis-Free Survival in Nasopharyngeal Carcinoma: A Propensity Score-Matched Analysis - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background

Poor nutritional status is associated with progression and advanced disease in patients with cancer. The prognostic nutritional index PNI may represent a simple method of assessing host immunonutritional status. This study was designed to investigate the prognostic value of the PNI for distant metastasis-free survival DMFS in patients with nasopharyngeal carcinoma NPC.

Methods

A training cohort of 1,168 patients with non-metastatic NPC from two institutions was retrospectively analyzed. The optimal PNI cutoff value for DMFS was identified using the online tool -Cutoff Finder-. DMFS was analyzed using stratified and adjusted analysis. Propensity score-matched analysis was performed to balance baseline characteristics between the high and low PNI groups. Subsequently, the prognostic value of the PNI for DMFS was validated in an external validation cohort of 756 patients with NPC. The area under the receiver operating characteristics curve AUC was calculated to compare the discriminatory ability of different prognostic scores.

Results

The optimal PNI cutoff value was determined to be 51. Low PNI was significantly associated with poorer DMFS than high PNI in univariate analysis P<0.001 as well as multivariate analysis P<0.001 before propensity score matching. In subgroup analyses, PNI could also stratify different risks of distant metastases. Propensity score-matched analyses confirmed the prognostic value of PNI, excluding other interpretations and selection bias. In the external validation cohort, patients with high PNI also had significantly lower risk of distant metastases than those with low PNI Hazards Ratios, 0.487; P<0.001. The PNI consistently showed a higher AUC value at 1-year 0.780, 3-year 0.793 and 5-year 0.812 in comparison with other prognostic scores.

Conclusion

PNI, an inexpensive and easily assessable inflammatory index, could aid clinicians in developing individualized treatment and follow-up strategies for patients with non-metastatic NPC.



Autor: Lin Yang , Liangping Xia , Yan Wang , Shaodong Hong, Haiyang Chen, Shaobo Liang, Peijian Peng, Yong Chen

Fuente: http://plos.srce.hr/



DESCARGAR PDF




Documentos relacionados