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.

scholarly journals Survival impact of perioperative changes in prognostic nutritional index levels after esophagectomy

Esophagus ◽  
2021 ◽  
Author(s):  
Ryoma Haneda ◽  
Yoshihiro Hiramatsu ◽  
Sanshiro Kawata ◽  
Junko Honke ◽  
Wataru Soneda ◽  
...  
Keyword(s):  
Overall Survival ◽  
Confidence Interval ◽  
Nutritional Status ◽  
Multivariable Analysis ◽  
Prognostic Nutritional Index ◽  
Hazard Ratio ◽  
High Group ◽  
Nutritional Index ◽  
Significant Difference ◽  
The Impact

Abstract Background The correlation between perioperative changes in nutritional status during esophagectomy and prognosis remains unclear. This study aimed to evaluate the impact of changes in prognostic nutritional index levels during the perioperative period on esophageal cancer patient survivals. Methods From January 2009 to May 2019, 158 patients with esophageal squamous cell carcinoma were enrolled. From the time-dependent ROC analysis, the cutoff values of preoperative and postoperative prognostic nutritional index levels were 46.9 and 40.9. Patients were divided into preoperative-high group (Group H) and preoperative-low group (Group L). Then, patients in Group L were divided into preoperative-low and postoperative-high group (Group L–H) and preoperative-low and postoperative-low group (Group L–L). Long-term outcomes and prognostic factors were evaluated. Results Patients in Group L had significantly worse overall survival than those in Group H (p = 0.001). Patients in Group L–L had significantly worse overall survival than those in Group L–H (p = 0.023). However, there was no significant difference in overall survival between Groups H and L–H (p = 0.224). In multivariable analysis, advanced pathological stage (hazard ratio 10.947, 95% confidence interval 2.590–46.268, p = 0.001) and Group L–L (hazard ratio 2.171, 95% confidence interval 1.249–3.775, p = 0.006) were independent predictors of poor overall survival. Conclusions Patients in Group L–H had a good prognosis, similar to those in Group H. This result indicated that increasing the postoperative prognostic nutritional index level sufficiently using various intensive perioperative support methods could improve prognosis after esophagectomy in patients with poor preoperative nutritional status.

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 &lt; 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 &lt; 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 &lt; 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.

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

scholarly journals Immunonutritive Scoring in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: Prognostic Nutritional Index or Controlling Nutritional Status Score?

2021 ◽  
Vol 11 ◽  
Author(s):  
Lukas Müller ◽  
Felix Hahn ◽  
Aline Mähringer-Kunz ◽  
Fabian Stoehr ◽  
Simon J. Gairing ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multivariate Analysis ◽  
Prognostic Factor ◽  
Nutritional Status ◽  
Transarterial Chemoembolization ◽  
Predictive Ability ◽  
Prognostic Nutritional Index ◽  
Independent Prognostic Factor ◽  
Nutritional Index ◽  
Conut Score

ObjectivesThe Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) score are immunonutritive scoring systems with proven predictive ability in various cancer entities, including hepatocellular carcinoma (HCC). We performed the first evaluation of the CONUT score for patients undergoing transarterial chemoembolization (TACE) and compared CONUT and PNI in the ability to predict median overall survival (OS).MethodsBetween 2010 and 2020, we retrospectively identified 237 treatment-naïve patients with HCC who underwent initial TACE at our institution. Both scores include the albumin level and total lymphocyte count. The CONUT additionally includes the cholesterol level. Both scores were compared in univariate and multivariate regression analyses taking into account established risk factors. In a second step, a subgroup analysis was performed on BCLC stage B patients, for whom TACE is the recommended first-line treatment.ResultsA high CONUT score and low PNI were associated with impaired median OS (8.7 vs. 22.3 months, p&lt;0.001 and 6.8 vs. 20.1 months, p&lt;0.001, respectively). In multivariate analysis, only the PNI remained an independent prognostic predictor (p=0.003), whereas the CONUT score lost its predictive ability (p=0.201). In the subgroup of recommended TACE candidates, both CONUT and PNI were able to stratify patients according to their median OS (6.6 vs. 17.9 months, p&lt;0.001 and 10.3 vs. 22.0 months, p&lt;0.001, respectively). Again, in the multivariate analysis, only the PNI remained an independent prognostic factor (p=0.012).ConclusionBoth scores were able to stratify patients according to their median OS, but only the PNI remained an independent prognostic factor. Therefore, PNI should be preferred when evaluating the nutritional status of patients undergoing TACE.

scholarly journals Prognostic Nutritional Index as an independent prognostic factor in locoregionally advanced squamous cell head and neck cancer

ESMO Open ◽  
2018 ◽  
Vol 3 (6) ◽  
pp. e000425 ◽  
Author(s):  
Gema Bruixola ◽  
Javier Caballero ◽  
Federica Papaccio ◽  
Angelica Petrillo ◽  
Aina Iranzo ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Head And Neck ◽  
Squamous Cell ◽  
Validation Cohort ◽  
Prognostic Nutritional Index ◽  
Training Cohort ◽  
Lymphocyte Ratio ◽  
Nutritional Index

BackgroundLocally advanced head and neck squamous cell carcinoma (LAHNSCC) is a heterogeneous disease in which better predictive and prognostic factors are needed. Apart from TNM stage, both systemic inflammation and poor nutritional status have a negative impact on survival.MethodsWe retrospectively analysed two independent cohorts of a total of 145 patients with LAHNSCC treated with induction chemotherapy followed by concurrent chemoradiotherapy at two different academic institutions. Full clinical data, including the Prognostic Nutritional Index (PNI), neutrophil to lymphocyte ratio and derived neutrophil to lymphocyte ratio, were analysed in a training cohort of 50 patients. Receiver operating characteristic curve analysis was used to establish optimal cut-off. Univariate and multivariate analyses of prognostic factors for overall survival (OS) were performed. Independent predictors of OS identified in multivariate analysis were confirmed in a validation cohort of 95 patients.ResultsIn the univariate analysis, low PNI (PNI<45) (p=0.001), large primary tumour (T4) (p=0.044) and advanced lymph node disease (N2b-N3) (p=0.025) were significantly associated with poorer OS in the validation cohort. The independent prognostic factors in the multivariate analysis for OS identified in the training cohort were dRNL (p=0.030) and PNI (p=0.042). In the validation cohort, only the PNI remained as independent prognostic factor (p=0.007).ConclusionsPNI is a readily available, independent prognostic biomarker for OS in LAHNSCC. Adding PNI to tumour staging could improve individual risk stratification of patients with LAHNSCC in future clinical trials.

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