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.

Prognostic factors of concurrent chemo-radiotherapy in head and neck cancers

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16527-16527
Author(s):  
K. Thankappan ◽  
S. V. Rugmini ◽  
R. F. Cohen ◽  
B. Sunil ◽  
J. Samuel ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Head And Neck ◽  
Squamous Cell ◽  
Vascular Invasion ◽  
Significant Prognostic Factor ◽  
Advanced Stage ◽  
Positive Margins ◽  
Significant Difference

16527 Background: Concurrent chemo-radiotherapy either as primary or adjuvant treatment is now the standard of care in high- risk head and neck squamous cell carcinomas. This has improved survival rates and chances of organ preservation. Advanced stage, extra- capsular extension, perineural and lympho-vascular invasion and positive surgical margins were considered as poor prognostic factors with radiotherapy alone. Herein we report the significance of these clinical and pathological factors, with concurrent chemo-radiotherapy regimens. Methods:A retrospective analysis of 54 patients with squamous cell carcinoma of head and neck who underwent either primary (21,39 %) or adjuvant (33,61%) concurrent chemoradiation at Amrita Institute of Medical Sciences, Kochi, India, during January 2004 to May 2005 and followed up to Dec 2006. 6 (11%) patients had stage III and 48 (89 %) had stage IV disease. Prognostic significance of clinical and pathological factors was evaluated. Kaplan-Meir curves for survival analysis, log rank test for univariate and Cox proportional method for multivariate analysis were employed. Results: The median follow up was 22 months. Two-year overall (OS) and disease free survival (DFS) rates were 66 % and 52 % respectively. Univariate and multivariate analysis of T stage, nodal stage, radiotherapy interruptions, completion of chemotherapy, schedule of chemotherapy (week 1,4,7 vs weekly), perineural invasion, extra-capsular extension and positive margins showed no significant difference in OS and DFS. However both univariate (p = 0.019 for OS and p = 0.012 for DFS) and multivariate analysis (p = 0.029, HR 0.16,95 %CI - 0.03 to 0.8 for OS and p = 0.017,HR 0.188,95% CI - 0.04 to 0.74 for DFS) revealed lympho-vascular invasion as a significant prognostic factor. Conclusions: Advanced stage, extra capsular invasion and positive margins were conventionally thought to be poor prognostic markers in head and neck cancer. However in our series of patients treated with concurrent chemo radiation lymphovascular invasion was the only significant poor prognostic factor. Other factors were found to be not significant. No significant financial relationships to disclose.

scholarly journals Onodera’s prognostic nutritional index is a strong prognostic indicator for patients with hepatocellular carcinoma after initial hepatectomy, especially patients with preserved liver function

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Akihiro Tanemura ◽  
Shugo Mizuno ◽  
Aoi Hayasaki ◽  
Kazuyuki Gyoten ◽  
Takehiro Fujii ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Liver Function ◽  
Prognostic Nutritional Index ◽  
Independent Prognostic Factor ◽  
Related Factors ◽  
Impaired Liver Function ◽  
Nutritional Index ◽  
Initial Hepatectomy

Abstract Background Several inflammation-based scores are used to assess the surgical outcomes of hepatocellular carcinoma (HCC). The aim of the present study was to elucidate the prognostic value of the prognostic nutritional index (PNI) in HCC patients who underwent hepatectomy with special attention to preoperative liver functional reserve. Methods Preoperative demographic and tumor-related factors were analyzed in 189 patients with HCC undergoing initial hepatectomy from August 2005 to May 2016 to identify significant prognostic factors. Results Multivariate analysis for overall survival (OS) revealed that female sex (p = 0.005), tumor size (p < 0.001) and PNI (p = 0.001) were independent prognostic factors. Compared to the High PNI group (PNI ≥ 37, n = 172), the Low PNI group (PNI < 37, n = 17) had impaired liver function and significantly poorer OS (13% vs. 67% in 5-year OS, p = 0.001) and recurrence-free survival (RFS) (8 vs. 25 months in median PFS time, p = 0.002). In the subgroup of patients with a preserved liver function of LHL15 ≥ 0.9, PNI was also independent prognostic factor, and OS (21% vs. 70% in 5-year OS, p = 0.008) and RFS (8 vs. 28 months in median PFS time, p = 0.018) were significantly poorer in the Low PNI group than the High PNI group. Conclusions PNI was an independent prognostic factor for HCC patients who underwent hepatectomy. Patients with PNI lower than 37 were at high risk for early recurrence and poor patient survival, especially in the patients with preserved liver function of LHL ≥ 0.9.

scholarly journals Development and validation of a radiomics-based model to predict local progression-free survival after chemo-radiotherapy in patients with esophageal squamous cell cancer

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
He-San Luo ◽  
Ying-Ying Chen ◽  
Wei-Zhen Huang ◽  
Sheng-Xi Wu ◽  
Shao-Fu Huang ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Local Recurrence ◽  
Squamous Cell ◽  
Cox Regression ◽  
Validation Cohort ◽  
Cell Cancer ◽  
Clinical Factors ◽  
Free Survival ◽  
Training Cohort ◽  
Cox Regression Analysis

Abstract Purpose To develop a nomogram model for predicting local progress-free survival (LPFS) in esophageal squamous cell carcinoma (ESCC) patients treated with concurrent chemo-radiotherapy (CCRT). Methods We collected the clinical data of ESCC patients treated with CCRT in our hospital. Eligible patients were randomly divided into training cohort and validation cohort. The least absolute shrinkage and selection operator (LASSO) with COX regression was performed to select optimal radiomic features to calculate Rad-score for predicting LPFS in the training cohort. The univariate and multivariate analyses were performed to identify the predictive clinical factors for developing a nomogram model. The C-index was used to assess the performance of the predictive model and calibration curve was used to evaluate the accuracy. Results A total of 221 ESCC patients were included in our study, with 155 patients in training cohort and 66 patients in validation cohort. Seventeen radiomic features were selected by LASSO COX regression analysis to calculate Rad-score for predicting LPFS. The patients with a Rad-score ≥ 0.1411 had high risk of local recurrence, and those with a Rad-score < 0.1411 had low risk of local recurrence. Multivariate analysis showed that N stage, CR status and Rad-score were independent predictive factors for LPFS. A nomogram model was built based on the result of multivariate analysis. The C-index of the nomogram was 0.745 (95% CI 0.7700–0.790) in training cohort and 0.723(95% CI 0.654–0.791) in validation cohort. The 3-year LPFS rate predicted by the nomogram model was highly consistent with the actual 3-year LPFS rate both in the training cohort and the validation cohort. Conclusion We developed and validated a prediction model based on radiomic features and clinical factors, which can be used to predict LPFS of patients after CCRT. This model is conducive to identifying the patients with ESCC benefited more from CCRT.

scholarly journals Investigation of the Relationship Between Delta Inflammatory Markers and Prognosis in Head and Neck Squamous Cell Carcinoma

2021 ◽  
Author(s):  
Julian Khaymovich ◽  
Andrew Ko ◽  
Amanda Wong ◽  
Daniel Zhu ◽  
Christian Gigante ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Multivariate Analysis ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Inflammatory Markers ◽  
Hospital Setting ◽  
Neck Squamous Cell Carcinoma ◽  
Cancer Prognosis ◽  
Lymphocyte Ratio

Purpose: Inflammatory markers, such as Lymphocyte-to-Monocyte Ratio (LMR), Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR), have been shown to hold significant prognostic value in the context of head and neck cancer (HNC). Recently, delta inflammatory markers, the difference between pre and post- treatment inflammatory marker ratios, have been suggested as potentially significant values in predicting cancer prognosis. Our objective was to evaluate the prognostic utility of delta LMR, NLR, and PLR in head and neck squamous cell carcinoma (HNSCC). Methods: Retrospective cohort study in a tertiary academic hospital setting. Patients diagnosed with HNSCC in the oral cavity, larynx, and oropharynx treated with curative intent treatment were included. The variables collected were age, sex, BMI, alcohol/tobacco exposure, performance scores, ACE-27, tumor characteristics, adjuvant treatment, ECOG score, and lab values. Overall Survival (OS) and Event-Free Survival (EFS) were chosen as endpoints. OS was defined as time from date of treatment to date of last follow-up or death from any cause, and EFS was defined as the start of treatment to any progression, recurrence, or death from any cause. Univariate and multivariate analyses were performed on the primary endpoints. Results: A total of 89 patients were included from 2010 to 2017. In multivariate analysis, EFS was found to be significantly associated with an N stage of 3 (p=0.0005) and delta LMR > -1.48 (p=0.0241). No significant relationships were uncovered with OS in multivariate analysis. Conclusion: A higher delta LMR value (>-1.48) was associated with poorer EFS, but was not associated with OS.

scholarly journals Prediction Efficacy of Prognostic Nutritional Index and Albumin–Bilirubin Grade in Patients With Intrahepatic Cholangiocarcinoma After Radical Resection: A Multi-Institutional Analysis of 535 Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Qi Li ◽  
Chen Chen ◽  
Jian Zhang ◽  
Hong Wu ◽  
Yinghe Qiu ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Intrahepatic Cholangiocarcinoma ◽  
Predictive Ability ◽  
Prognostic Nutritional Index ◽  
Radical Resection ◽  
Time Dependent ◽  
Cancer Antigen ◽  
Nutritional Index ◽  
Tertiary Hospitals

BackgroundThe preoperative nutritional status and the immunological status have been reported to be independent prognostic factors of patients with intrahepatic cholangiocarcinoma (ICC). This study aimed to investigate whether prognostic nutritional index (PNI) + albumin–bilirubin (ALBI) could be a better predictor than PNI and ALBI alone in patients with ICC after radical resection.MethodsThe prognostic prediction evaluation of the PNI, ALBI, and the PNI+ALBI grade was performed in 373 patients with ICC who underwent radical resection between 2010 and 2018 at six Chinese tertiary hospitals, and external validation was conducted in 162 patients at four other Chinese tertiary hospitals. Overall survival (OS) and relapse-free survival (RFS) were estimated using the Kaplan–Meier method. Multivariate analysis was conducted to identify independent prognostic factors. A time-dependent receiver operating characteristic (ROC) curve and a nomogram prediction model were further constructed to assess the predictive ability of PNI, ALBI, and the PNI+ALBI grade. The C-index and a calibration plot were used to assess the performance of the nomogram models.ResultsUnivariate analysis showed that PNI, ALBI, and the PNI+ALBI grade were prognostic factors for the OS and RFS of patients with ICC after radical resection in the training and testing sets (p &lt; 0.001). Multivariate analysis showed that the PNI+ALBI grade was an independent risk factor for OS and RFS in the training and testing sets (p &lt; 0.001). Analysis of the relationship between the PNI+ALBI grade and clinicopathological characteristics showed that the PNI+ALBI grade correlated with obstructive jaundice, alpha-fetoprotein (AFP), cancer antigen 19-9 (CA19-9), cancer antigen 125 (CA125), PNI, ALBI, Child–Pugh grade, type of resection, tumor size, major vascular invasion, microvascular invasion, T stage, and N stage (p &lt; 0.05). The time-dependent ROC curves showed that the PNI+ALBI grade had better prognostic predictive ability than the PNI, ALBI, and the Child–Pugh grade in the training and testing sets.ConclusionPreoperative PNI+ALBI grade is an effective and practical predictor for the OS and RFS of patients with ICC after radical resection.

scholarly journals Proteomics Analysis Identified ASNS as a Novel Biomarker for Predicting Recurrence of Skull Base Chordoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Yutao Shen ◽  
Mingxuan Li ◽  
Yujia Xiong ◽  
Songbai Gui ◽  
Jiwei Bai ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Skull Base ◽  
Validation Cohort ◽  
High Expression ◽  
Migration And Invasion ◽  
Training Cohort ◽  
Cox Regression Analysis ◽  
Potential Biomarker ◽  
Skull Base Chordoma

BackgroundThe prognostic factors of skull base chordoma associated with outcomes of patients after surgery remain inadequately identified. This study was designed to identify a novel prognostic factor for patients with skull base chordoma.MethodUsing a proteomic technique, the tumor biomarkers that were upregulated in the rapid-recurrence group of chordoma were screened and then narrowed down by bioinformatic analysis. Finally one potential biomarker was chosen for validation by immunohistochemistry using tissue microarray (TMA). A total of 187 patients included in TMA were randomly divided into two cohorts, the training cohort included 93 patients and the validation cohort included 94 patients. Kaplan-Meier survival analysis was used to assess the patients’ survival. Univariable and multivariable Cox regression analysis were used to identify prognostic factors predicting recurrence-free survival (RFS). CCK-8 assay, clonal formation assay and transwell assay were used to test the effect of asparagine synthetase (ASNS) on the proliferation, migration and invasion in chordoma cell lines.ResultsAmong 146 upregulated proteins, ASNS was chosen as a potential prognostic biomarker after bioinformatics analysis. The H-scores of ASNS ranged from 106.27 to 239.58 in TMA. High expression of ASNS was correlated with shorter RFS in both the training cohort (p = 0.0093) and validation cohort (p &lt; 0.001). Knockdown of ASNS by small interfering RNA (siRNA) inhibited the growth, colony formation, migration and invasion of chordoma cells in vitro.ConclusionThis study indicates that high expression of ASNS is correlated with poor prognosis of patients with skull base chordoma. ASNS may be a useful prognostic factor for patients with skull base chordoma.

scholarly journals Onodera’s prognostic nutritional index is a strong prognostic indicator for patients with hepatocellular carcinoma after initial hepatectomy, especially patients with preserved liver function

2020 ◽  
Author(s):  
Akihiro Tanemura ◽  
Shugo Mizuno ◽  
Aoi Hayasaki ◽  
Kazuyuki Gyoten ◽  
Takehiro Fujii ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Liver Function ◽  
Survival Time ◽  
Median Survival ◽  
Median Survival Time ◽  
Prognostic Nutritional Index ◽  
Nutritional Index ◽  
Initial Hepatectomy

Abstract Background Several inflammation-based scores are used to assess the surgical outcomes of hepatocellular carcinoma (HCC). The aim of the present study was to elucidate the prognostic value of the prognostic nutritional index (PNI) in HCC patients who underwent hepatectomy with special attention to preoperative liver functional reserve.Methods Preoperative demographic and tumor-related factors were analyzed in 189 patients with HCC undergoing initial hepatectomy from August 2005 to May 2016 to identify significant prognostic factors.Results Multivariate analysis for overall survival (OS) revealed that female gender (p=0.005), tumor size (p<0.001) and PNI (p=0.001) were independent prognostic factors. Compared to the High PNI group (PNI ≥37, n=172), the Low PNI group (PNI <37, n=17) had impaired liver function and significantly poorer OS (13% vs. 67% in 5-year survival, p=0.001) and recurrence-free survival (RFS) (8 vs. 25 months in median survival time, p=0.002). In the subgroup of patients with a preserved liver function of LHL15 ≥0.9, PNI was also independent prognostic factor, and OS (21% vs. 70% in 5-year survival, p=0.008) and RFS (8 vs. 28 months in median survival time, p=0.018) were significantly poorer in the Low PNI group than the High PNI group.Conclusions PNI was an independent prognostic factor for HCC patients who underwent hepatectomy. Patients with PNI lower than 37 were at high risk for early recurrence and poor patient survival, especially in the patients with preserved liver function of LHL ≥0.9.

The prognostic nutritional index as a predictor of long-term outcome in patients with resected esophageal squamous cell carcinoma

2020 ◽  
Author(s):  
Tsunehiko Maruyama ◽  
Mitsugi Shimoda ◽  
Akihiro Sako ◽  
Hiroyuki Hakoda ◽  
Kazumitsu Ueda ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Prognostic Nutritional Index ◽  
Long Term Outcome ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Nutritional Index

Abstract Background Preoperative nutritional and inflammation indexes have been shown to be associated with postoperative complications and the prognosis of patients with a malignant tumor. We evaluated several clinicopathological prognostic factors in patients with resected esophageal squamous cell carcinoma (ESCC). Methods Seventy-eight patients who underwent curative resection for ESCC were included in this retrospective study. The associations of body mass index (BMI), the prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and protein-albumin ratio (CAR) with various clinicopathological factors were evaluated. Results In multivariate analyses, only low PNI (<46.8) independently and significantly predicted overall survival (OS) (P=0.002). Conclusions The PNI is a simple, useful marker for predicting the long-term prognosis of patients with ESCC after esophagectomy. The PNI should be included in the routine assessment of patients with ESCC.

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