Abstract
Background
The systemic inflammatory response and nutritional status of the patients are related to postoperative results in malignant tumors. We examined the usefulness of the prognostic nutritional index (PNI) as a prognostic factor in patients with oral squamous cell carcinoma who underwent radical surgery.
Methods
From 2008 to 2019, 102 patients (73 males, 29 females, age, 65.6 ± 9.8 years) who visited our hospital and underwent surgical therapy were included in this study. The endpoint was the total survival period, and the evaluation items included the lymphocyte count and albumin levels in the peripheral blood obtained within 4 weeks preoperatively, as well as age, sex, alcohol consumption and smoking history, site of the tumor, pathological stage, and surgery status. The PNI was calculated using serum albumin levels and the peripheral blood lymphocyte count. The relationships between the PNI and patient characteristics were analyzed using Fisher's exact test. The Kaplan–Meier method was used to evaluate the survival rate. The survival periods were compared using the log-rank method. We evaluated the prognostic factors for the overall survival (OS) in a logistic regression model.
Results
The tumor sites included the maxilla (n = 12), buccal mucosa (n = 11), mandible (n = 17), floor of the mouth (n = 9), and tongue (n = 53). The number of patients with stage I, II, III, and IV oral cancers was 28 (27.5%), 34 (27.5%), 26 (33.3%), and 14 (13.7%), respectively. During the observation period, 21 patients died of head and neck cancer. The optimal cut-off PNI value was 42.9 (range: 38.8–49.4) according to the receiver operating characteristic analysis. The proportion of patients with a short OS was lower in those with PNI higher than 42.9, and the 5-year OS in patients with PNI higher and lower than the cut-off value was 62.3% and 86.0%, respectively (P = 0.0105).
Conclusions
The OS of patients with PNI ≤ 42.9 was lower than that of patients with PNI greater than 42.9. The PNI, which is a preoperative head-to-foot inflammatory marker, can help estimate the prognosis of oral cancer.
The prognostic impact of a combined carbonic anhydrase IX and Ki67 signature in oral squamous cell carcinoma
