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Development of Novel Prognostic Prediction Models including the Prognostic Nutritional Index for Patients with Colorectal Cancer after Curative Resection.

ABSTRACT: OBJECTIVES:It has been reported that there is an association between the nutritional condition and the prognosis of cancer. Here, we evaluated the relation between the prognostic nutritional index (PNI) and colorectal cancer (CRC). METHODS:A total of 184 patients with CRC who underwent curative surgery from October 2011 to December 2012 at the Osaka University Hospital were investigated. According to the median PNI value of our data set, patients were classified into a high-PNI (?46) group and a low-PNI (<46) group. The relationship between the PNI and the disease-free survival (DFS) and overall survival (OS) was analyzed by a Cox regression model. RESULTS:A low PNI was significantly associated with poor DFS (P = 0.006) and OS (P < 0.001). A multivariate analysis showed that low PNI, venous invasion (present), and tumor location (rectum) were independent risk factors for recurrence. Low PNI, advanced age, and venous invasion were found to be independent risk factors for mortality. Using these clinicopathological factors, we developed nomograms to predict DFS and OS. The concordance index was 0.828 for DFS and 0.756 for OS. CONCLUSIONS:A low PNI is a prognostic indicator for recurrence and mortality in CRC. Nomograms constructed by clinicopathological factors including the PNI can provide individual prognostic outcomes.

SUBMITTER: Sasaki M

PROVIDER: S-EPMC6774735 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Development of Novel Prognostic Prediction Models including the Prognostic Nutritional Index for Patients with Colorectal Cancer after Curative Resection.

Sasaki Masaru M Miyoshi Norikatsu N Fujino Shiki S Ishikawa Satoshi S Saso Kazuhiro K Takahashi Hidekazu H Haraguchi Naotsugu N Hata Taishi T Matsuda Chu C Mizushima Tsunekazu T Doki Yuichiro Y Mori Masaki M

Journal of the anus, rectum and colon 20190730 3

<h4>Objectives</h4>It has been reported that there is an association between the nutritional condition and the prognosis of cancer. Here, we evaluated the relation between the prognostic nutritional index (PNI) and colorectal cancer (CRC).<h4>Methods</h4>A total of 184 patients with CRC who underwent curative surgery from October 2011 to December 2012 at the Osaka University Hospital were investigated. According to the median PNI value of our data set, patients were classified into a high-PNI (≥ ...[more]

PMID: 31583325

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Project description:To evaluate the prognostic significance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and prognostic nutritional index (PNI) and other clinicopathological factors in patients undergoing curative resection of colon cancer.183 patients with histologically proven colorectal cancer who had undergone potentially curative resection between 2010 and 2016 at Ankara Numune Training and Research Hospital were retrospectively analyzed and clinicopathological characteristics included age, sex, tumor type, grade, size and localization, the number of metastatic and total number of lymph nodes removed, vascular and perineural invasion of the tumor, TNM stages, tumor marker levels (CEA, CA19-9, AFP, CA-125, CA15-3), complete blood counts, albumin levels, overall survival (months), NLR, PLR, LMR and PNI ratios were retrospectively reviewed and analyzed from the electronic database. The primary outcome measure was overall survival.Regarding overall survival, on univariate analysis the following variables were significantly associated with poor outcome following resection: T-stage (P = 0.037), lymph node invasion (P = 0.037), cancer stage (P = 0.034), CEA (P = 0.042), CA19-9 (P = 0.004), and PNI (P = 0.001). To evaluate the independent prognostic value, multivariate Cox proportional hazard analysis to control for other prognostic factors was used. Using cancer-specific death as an end point for NLR, PLR, LMR, PNI and CA19-9 the optimal cut off values were calculated by ROC analysis. Regarding overall survival, on multivariate analysis high CA19-9 (HR = 1.001, 95%CI: 1.00-1.002, P = 0.012) and low PNI (HR = 0.938, 95%CI: 0.891-0.987, P = 0.014) were the only variables independently associated with shortened overall survival. Patients with a PNI < 35 had a median OS of 52.25 mo. In contrast, patients with an PNI > 35 had a median OS of 66 mo. Patients with a CA 19-9 < 17 had a median OS of 66 mo and in patients with a CA19-9 > 17 had a median OS of 53.76 mo.This study shows that decrease in the PNI and increase in CA 19-9 is associated with poor survival in patients with resectable colon cancer.

Dataset Information

Development of Novel Prognostic Prediction Models including the Prognostic Nutritional Index for Patients with Colorectal Cancer after Curative Resection.

Publications

Development of Novel Prognostic Prediction Models including the Prognostic Nutritional Index for Patients with Colorectal Cancer after Curative Resection.

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