Prognostic value of perioperative changes in the prognostic nutritional index in patients with surgically resected non-small cell lung cancer.

Autor: Hayasaka K; Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan.; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8575, Japan., Notsuda H; Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan. hirotsugu.notsuda.c4@tohoku.ac.jp.; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8575, Japan. hirotsugu.notsuda.c4@tohoku.ac.jp., Onodera K; Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan.; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8575, Japan., Watanabe T; Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan.; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8575, Japan., Watanabe Y; Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan.; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8575, Japan., Suzuki T; Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan.; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8575, Japan., Hirama T; Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan.; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8575, Japan., Oishi H; Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan.; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8575, Japan., Niikawa H; Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan.; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8575, Japan., Okada Y; Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan.; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8575, Japan.
Jazyk: angličtina
Zdroj: Surgery today [Surg Today] 2024 Sep; Vol. 54 (9), pp. 1031-1040. Date of Electronic Publication: 2024 May 03.
DOI: 10.1007/s00595-024-02847-5
Abstrakt: Purpose: This single-institution retrospective cohort study was conducted to assess the prognostic significance of perioperative changes in the prognostic nutritional index (PNI) in patients who underwent surgery for non-small cell lung cancer (NSCLC).
Methods: Clinicopathological data were collected from 441 patients who underwent lobectomy for NSCLC between 2010 and 2016.The PNI ratio (postoperative PNI/preoperative PNI) was used as an indicator of perioperative PNI changes. Prognostic differences were investigated based on PNI ratios.
Results: The optimal cut-off value of the PNI ratio for overall survival (OS) was set at 0.88 using a receiver operating characteristic curve. The PNI ratio was inversely related to a high smoking index, interstitial lung disease, and postoperative pulmonary complications. The 5-year OS rates for the high vs. low PNI ratio groups were 88.2% vs. 68.5%, respectively (hazard ratio [HR]: 3.04, 95% confidence interval [CI]: 1.90-4.86). Multivariable analysis revealed that a low PNI ratio was significantly associated with poor prognosis (HR: 2.94, 95% CI: 1.77-4.87). The PNI ratio was a more sensitive indicator than postoperative PNI status alone for identifying patients at high risk of mortality, particularly those with non-lung cancer causes.
Conclusion: The perioperative PNI change is a significant prognostic factor for patients with NSCLC.
(© 2024. The Author(s).)
Databáze: MEDLINE
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