Association of the prognostic nutrition index with overall survival time of the patients with brain metastases of lung adenocarcinoma

doi:10.3760/cma.j.issn.1673-422X.2018.06.005

Abstract

Abstract: Objective To explore the effect of prognostic nutrition index (PNI) on the overall survival time of patients with brain metastases of lung adenocarcinoma. Methods A retrospective analysis was performed on the clinic data of 274 patients who were admitted to our hospital and confirmed with brain metastases of lung adenocarcinoma from May 2013 to May 2016. The prognosic factors for brain metastases such as PNI, gender, age, smoking history, epidermal growth factor receptor (EGFR) mutation status, Karnofsky performance status (KPS) score, the number of brain lesions, treatment of brain lesions, extracranial metastases and the status of primary disease were analyzed. The receiver operating characteristic (ROC) curve was drawn to determine the optimal cutoff value of PNI, and the patients were divided into high PNI group and low PNI group. The univariate and multivariate prognostic analyses were performed by the Logrank test and the Cox proportional hazards model. Results The patients were divided into high PNI (＞50.45) group (n=72) and low PNI (≤50.45) group (n=202). The median overall survival (OS) was 11.20 months in all patients with brain metastases, and the median OS of the low PNI group and high PNI group were 10.13 months and 15.17 months respectively. The univariate analysis results showed that gender (χ2=5.459, P=0.019), age (χ2=3.986, P=0.046), smoking or not (χ2=6.878, P=0.009), EGFR mutation status (χ2=20.484, P＜0.001), KPS score (χ2=126.573, P＜0.001), extracranial metastases or not (χ2=4.403, P=0.036), treatment on the brain lesions (χ2=40.444, P＜0.001) and PNI (χ2=7.972,P=0.005) were related to the prognosis. The Cox multivariate analysis results showed that age (HR=1.580, 95%CI: 1.1042.295, P=0.012), EGFR mutation status (HR=0.549, 95%CI: 0.4080.738, P＜0.001), KPS score (HR=0.077, 95%CI: 0.0450.134, P＜0.001), treatment on brain metastases (HR=0.882, 95%CI: 0.7890.987, P=0.029) and PNI (HR=0.614, 95%CI: 0.4370.861, P=0.005) were related to the prognosis. Conclusion PNI is an independent prognostic predictor of brain metastases in patients with lung adenocarcinoma, and the highPNI is correlated to the long OS of patients with brain metastases of lung adenocarcinoma, which has certain clinical practical value.

Key words: Carcinoma, non-small-cell lung, Neoplasm metastasis, brain, Nutrition assessment, Prognosis

Xue Ruiqi, Li Hongwei, Zhang Xiaqin, Song Xin, Peng Hua, Zhou Wei, Zhang Changcheng. Association of the prognostic nutrition index with overall survival time of the patients with brain metastases of lung adenocarcinoma[J]. Journal of International Oncology, 2018, 45(6): 341-346.

References

［1］ Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002［J］. CA Cancer J Clin, 2005, 55(2): 74-108. ［2］ Nayak L, Lee EQ, Wen PY. Epidemiology of brain metastases［J］. Curr Oncol Rep, 2012, 14(1): 48-54. DOI: 10.1007/s11912-011-0203-y. ［3］ Pastore CA, Orlandi SP, Gonzalez MC. The inflammatorynutritional index; assessing nutritional status and prognosis in gastrointestinal and lung cancer patients［J］. Nutr Hosp, 2014, 29(3): 629-634. DOI: 10.3305/nh.2014.29.3.7195. ［4］ Nozoe T, Kimura Y, Ishida M, et al. Correlation of preoperative nutritional condition with postoperative complications in surgical treatment for oesophageal carcinoma［J］. Eur J Surg Oncol, 2002, 28(4): 396-400. ［5］ Kanda M, Fujii T, Kodera Y, et al. Nutritional predictors of postoperative outcome in pancreatic cancer［J］. Br J Surg, 2011, 98(2): 268-274. DOI: 10.1002/bjs.7305. ［6］ Sagawa M, Yoshimatsu K, Yokomizo H, et al. Onodera′s prognostic nutritional index (PNI) and the modified Glasgow Prognostic Score (mGPS) in colorectal cancer surgery［J］. Gan to Kagaku Ryoho, 2014, 41(10): 1273-1275. ［7］ Jiang N, Deng JY, Ding XW, et al. Prognostic nutritional index predicts postoperative complications and longterm outcomes of gastric cancer［J］. World J Gastroenterol, 2014, 20(30): 10537-10544. DOI: 10.3748/wjg.v20.i30.10537. ［8］ Hofbauer SL, Pantuck AJ, de Martino M, et al. The preoperative prognostic nutritional index is an independent predictor of survival in patients with renal cell carcinoma［J］. Urol Oncol, 2015, 33(2): e1-7. DOI: 10.1016/j.urolonc.2014.08.005. ［9］ Barreto Penié J, Cuban Group for the Study of Hospital Malnutrition. State of malnutrition in Cuban hospitals［J］. Nutrition, 2005, 21(4): 487-497. DOI: 10.1016/j.nut.2004.08.019. ［10］ Lin PH, Aronson W, Freedland SJ. Nutrition, dietary interventions and prostate cancer: the latest evidence［J］. BMC Med, 2015, 13: 3. DOI: 10.1186/s12916-014-0234-y. ［11］ Hong S, Zhou T, Fang W, et al. The prognostic nutritional index (PNI) predicts overall survival of smallcell lung cancer patients［J］. Tumour Biol, 2015, 36(5): 33893397. DOI: 10.1007/s13277-014-2973-y. ［12］ Pinato DJ, North BV, Sharma R. A novel, externally validated inflammationbased prognostic algorithm in hepatocellular carcinoma: the prognostic nutritional index (PNI)［J］. Br J Cancer, 2012, 106(8): 1439-1445. DOI: 10.1038/bjc.2012.92. ［13］ Sagawa M, Katsube T, Konno S, et al. The significance of Onodera′s prognostic nutritional index for the treatment of gastrointestinal cancer［J］. Gan to Kagaku Ryoho, 2008, 35(12): 2253-2255. ［14］ Hsu CL, Chen JH, Chen KY, et al. Advanced nonsmall cell lung cancer in the elderly: the impact of age and comorbidities on treatment modalities and patient prognosis［J］. J Geriatr Oncol, 2015, 6(1): 38-45. DOI: 10.1016/j.jgo.2014.09.178. ［15］ Meoni G, Cecere FL, Lucherini E, et al. Medical treatment of advanced nonsmall cell lung cancer in elderly patients: a review of the role of chemotherapy and targeted agents［J］. J Geriatr Oncol, 2013, 4(3): 282-290. DOI: 10.1016/j.jgo.2013.04.005. ［16］ Shimizu K, Okita R, Saisho S, et al. Preoperative neutrophil/lymphocyte ratio and prognostic nutritional index predict survival in patients with nonsmall cell lung cancer［J］. World J Surg Oncol, 2015, 13: 291. DOI: 10.1186/s12957-015-0710-7. ［17］ Qiu C, Qu X, Shen H, Zheng C, et al. Evaluation of prognostic nutritional index in patients undergoing radical surgery with nonsmall cell lung cancer［J］. Nutr Cancer, 2015, 67(5): 741-747. DOI: 10.1080/01635581.2015.1032430. ［18］ Mori S, Usami N, Fukumoto K, et al. The significance of the prognostic nutritional index in patients with completely resected nonsmall cell lung cancer［J］. PLoS One, 2015, 10(9): e0136897. DOI: 10.1371/journal.pone.0136897. ［19］ Eichler AF, Kahle KT, Wang DL, et al. EGFR mutation status and survival after diagnosis of brain metastasis in nonsmall cell lung cancer［J］. Neuro Oncol, 2010, 12(11): 1193-1199. DOI: 10.1093/neuonc/noq076.

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