343 EFFECTS OF PREOPERATIVE PNI (PROGNOSTIC NUTRITIONAL INDEX) AND POSTOPERATIVE INFLAMMATORY RESPONSE ON PROGNOSIS IN PATIENTS WITH ESOPHAGEAL CANCER

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Yoshinori Fujiwara ◽  
Masaharu Higashida ◽  
Hisako Kubota ◽  
Yuko Okamoto ◽  
Syumei Mineta ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Blood Loss ◽  
Inflammatory Response ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Inflammatory Responses ◽  
Cox Model ◽  
Prognostic Nutritional Index ◽  
Nutritional Index ◽  
Group 3

Abstract   The effects of preoperative nutritional status and postoperative inflammatory response on esophageal cancer patients on prognosis were unclear. In the present study, we evaluated the preoperative nutritional parameters and postoperative inflammatory responses and analyzed relationship between these parameters and cancer prognosis. Methods One hundred and eleven esophageal squamous cell carcinoma patients were analyzed with pathological TNM StageI-IV. Preoperative nutritional parameters: PNI (Prognostic Nutritional Index) was calculated from following formula:10 x Albumin(g/dl) +0.005 x peripheral lymphocyte counts (/mm3). Preoperative NLR (Neutrophil/Lymphocyte ratio) was defined as absolute neutrophil counts divided by the absolute lymphocyte counts. The highest CRP level was evaluated as postoperative inflammatory responses. Cut-off values of these continuous parameters were calculated by ROC, and univariate and multivariate analysis using Cox model for overall survival (OS) were examined in the parameters. Results Overall three or five years survivals were 60.9%, 56.28%, respectively. Cut-off value of PNI, CRP, NLR, Intraoperative blood loss were 44.8, 21.7 mg/dl,2.27,159 mL, respectively. High PNI group was significantly better survival than low group (3 years OS, 65.94 vs 45.82%, p < 0.05). No association between PNI and prognosis was noted for patients with pStageI, but the low PNI patients of pStageII-IV were extremely poor prognosis (p < 0.01). High CRP group was tendency to be worse survival than low group (3 years OS, 65.97 vs 38.82%, p = 0.062). The patients of low blood loss group was significantly better survival than high group (p < 0.05).NLR was not associated with OS. Cox model showed that pTNM, tumor location, and PNI were independent prognostic factors. Conclusion Preoperative nutritional status affected the prognosis of esophageal cancer patients. But, postoperative inflammatory response was not affected the prognosis of these patients. Preoperative nutritional interventions may improve the prognosis of patients with esophageal cancer.

scholarly journals Perioperative Predictive Markers for Recurrence of Esophageal Cancer after Esophagectomy

2021 ◽  
Vol 8 (2) ◽  
pp. 87-95
Author(s):  
Yoshinori Fujiwara ◽  
Masaharu Higashida ◽  
Hisako Kubota ◽  
Yuko Okamoto ◽  
Shumei Mineta ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factors ◽  
Blood Loss ◽  
Inflammatory Response ◽  
Inflammatory Responses ◽  
Prognostic Nutritional Index ◽  
Continuous Variables ◽  
Intraoperative Blood Loss ◽  
Respiratory Complications ◽  
Cutoff Values

Introduction: We studied whether perioperative nutritional, immunological factors or postoperative inflammatory responses predicted esophageal cancer (EC) progression and prognosis in patients who received esophagectomies. Methods: We evaluated preoperative prognostic nutritional index (PNI), BMI, neutrophil-to-lymphocyte ratio (NLR), intraoperative blood loss, postoperative C-reactive protein (CRP) max, recurrence-free survival (RFS), and overall survival (OS) in 111 patients with pStage I–IV squamous cell EC who received esophagectomies. Optimal cutoff values for each continuous parameter were determined by receiver operating characteristic curves and Youden indices. Univariate and multivariate Cox analyses were used to derive independent prognostic factors. Propensity score matching using inverse probability of treatment weighting was used in groups divided by Youden indices, as appropriate. Results: Cutoff values of continuous variables were NLR: 2.27, PNI: 44.2, blood loss: 159 mL, and CRPmax: 21.7 mg/dL. In multivariate analyses, PNI, CRPmax, and intraoperative blood loss were independent prognostic factors for OS and RFS. Among patients with stage II–IV disease, low PNI was associated with shorter RFS. Postoperative respiratory complications were associated with both higher CRP and shorter RFS. Discussion/Conclusions: Low preoperative PNI and high postoperative inflammatory response were associated with postoperative EC progression after esophagectomy. Preoperative nutritional interventions or suppression of postoperative inflammatory response, including respiratory complications, may improve patient prognosis.

Prognosis Prediction for Postoperative Esophageal Cancer Patients Using Onodera's Prognostic Nutritional Index

2017 ◽  
Vol 69 (6) ◽  
pp. 849-854 ◽  
Author(s):  
Hideo Matsumoto ◽  
Yuko Okamoto ◽  
Akimasa Kawai ◽  
Daisuke Ueno ◽  
Hisako Kubota ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Prognostic Nutritional Index ◽  
Prognosis Prediction ◽  
Nutritional Index ◽  
Onodera’S Prognostic Nutritional Index

The clinical impact of the Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) score on breast cancer patients survival.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 1560-1560
Author(s):  
Nami Yamashita ◽  
Yuka Inoue ◽  
Kimihiro Tanaka ◽  
Hiroshi Saeki ◽  
Eiji Oki ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Prognostic Nutritional Index ◽  
Clinical Impact ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Nutritional Index ◽  
Conut Score

1560 Background: Recent reports show that the preoperative immunonutritional status correlate with the survival rate in cancer patients. The Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) score are used as screening tools for immunonutritional status and reported to be a predictor of postoperative recurrence in patients with various gastrointestinal cancers. However, the clinical importance of the PNI and CONUT in breast cancer has not been elucidated. The aim of this study is to investigate the clinical impact of preoperative PNI and CONUT on long-term survival of breast cancer patients. Methods: We retrospectively analyzed 653 consecutive stage I-III breast cancer patients who were treated from January 2002 to December 2013. The PNI score was calculated as 10 x serum albumin (g/dl) + 0.005 x total lymphocyte count (per mm3). The CONUT score is calculated from three parameters, serum albumin, cholesterol, and total lymphocytes count. The patients were divided into two groups according to the PNI and CONUT score. The uni- and multivariate Cox regression analyses were performed to evaluate the prognositic value of the PNI and CONUT in breast cancer. Results: The malnutritional status was observed in 170 (26%) and 131 (20%) patients as low-PNI and high-CONUT, respectively. The relapse-free survival (RFS) and overall survival (OS) rates were significantly lower in the low-PNI group (RFS: p < 0.0001, OS: p < 0.0001) and high-CONUT group (RFS: p = 0.0009, OS: p = 0.0018). In the multivariate analysis, low-PNI was independent prognostic factors for both RFS and OS (RFS: HR2.33, p = 0.032, OS: HR5.01, p = 0.0009). In the subset analysis, the low-PNI group showed poor prognosis especially in the postmenopausal, hormone receptor negative patients. The low-PNI also had poorer prognosis in post-recurrence survival. Conclusions: The preoperative PNI is a strong independent predictor of long-term survival among breast cancer patients.

Significance of Prognostic Nutritional Index in post-surgical outcomes after surgical management in gastric cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15535-e15535
Author(s):  
Marytere Herrera ◽  
Nora Sobrevilla-Moreno ◽  
IVAN LYRA-GONZALEZ ◽  
German Calderillo ◽  
Consuelo Diaz ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Nutritional Status ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Locally Advanced ◽  
Prognostic Nutritional Index ◽  
Locally Advanced Gastric Cancer ◽  
Nutritional Index ◽  
Gastric Cancer Patients

e15535 Background: Preoperative nutritional status in gastric cancer patients is not only correlated with postoperative complications, also, prognostic nutritional index or Onodera´s nutritional index (PNI) may relate with overall survival (OS) after gastrectomy. There is no available data of preoperative nutritional status in Mexican population. We decide to explore these variables and analyze its impact in outcomes reported in our population. Methods: This is a retrospective included a total of 91 patients patients with locally advanced gastric cancer confirmed by laparoscopy treated in the National Cancer Institute in México between January 2010 and June 2016. The PNI level was determined according the following formula: 10 x serum albumin (g/dl) + 0.005 x total lymphocyte count (per mm3). The optimal cutoff value of PNI in our population was set at 38.7 according the median, we stratified patients in high (PNI > 38.7) or low (PNI < 38.7) nutritional status, clinicopathologic features were compared. Results: We analyzed 91 patients, the mean patients age was 58, 61.5% were man, the 51.6% went to total gastrectomy with D2 dissection, 56% were pathologic stage III and 61.5% of the patients received adjuvant chemotherapy. The patients with high nutritional status had a OS of 46 months vs patients with low nutritional status with 25 months (p = 0.009). Patients with body mass index (BMI) > 23 had a OS of 41 months vs patients with BMI < 23 with 19 months of OS (p = 0.001), finally the patients with albumin > 3.75 had a 39 months of OS vs 23 months with albumin < 3.75 (p = 0.011) Conclusions: The low PNI group had worse OS than the high PNI group (46 months vs 25 months, p = 0.009). Preoperative is a simple and useful marker to predict overall survival in patients with locally advanced gastric cancer

FA08.04: RELATIONSHIP BETWEEN PROGNOSTIC NUTRITIONAL INDEX AND PERITUMORAL IMMUNE SYSTEM DYNAMICS IN ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 17-17
Author(s):  
Kazuo Okadome ◽  
Yoshifumi Baba ◽  
Taisuke Yagi ◽  
Yuki Kiyozumi ◽  
Kuroda Daisuke ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Immune System ◽  
Prognostic Factor ◽  
Nutritional Status ◽  
Prognostic Nutritional Index ◽  
Immune Competence ◽  
High Group ◽  
Cancer Specific Survival ◽  
Nutritional Index

Abstract Background There have been reported that nutritional status and tumor-infiltrating lymphocytes (TILs) are prognostic factor for esophageal cancer. Prognostic Nutritional Index (PNI) is one of the most widely used indicators for nutritional status and also shows systemic immune competence. Because TILs is related to peritumoral immune system, there may be relation between PNI and TILs. Methods Using a database of 300 curatively resected esophageal cancer from April 2005 to Jun 2013, we evaluated the relationship between PNI and TILs. PNI was calculated using serum albumin and total lymphocyte count. TILs were histologically estimated using postoperative samples. Studying the expression of CD8 and Foxp3 by immunohistochemical staining, we tried to reveal which subsets of lymphocyte were relevant to PNI. Results PNI high group (N = 198) experienced better overall survival (P < 0.001) and cancer specific survival (P < 0.001) compared with PNI low group (N = 102). PNI was significantly related to the TILs status (P < 0.01). CD8 positive lymphocyte was also significantly related to the PNI (P = 0.013) but Foxp3 wasn’t (P = 0.62). CD8 positive lymphocyte high group (N = 224) was significantly better in overall survival (P = 0.028) and cancer specific survival (P = 0.012) than low group (N = 76). There was no significant difference between Foxp3 high group (N = 225) and Foxp3 low group (N = 75) about overall survival (P = 0.87) and cancer specific survival (P = 0.90). Conclusion PNI was predictive prognostic marker for esophageal cancer and had relation to TILs status. It means systemic immune competence maybe affects peritumoral immune system. Among subsets of lymphocyte, CD8 positive lymphocyte had relation to PNI and was prognostic factor. In this study, Foxp3 didn’t have any relation to PNI and prognosis. Disclosure All authors have declared no conflicts of interest.

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