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Significance of the prognostic nutritional index in patients with esophageal squamous cell carcinoma

Authors Feng JF, Chen QX

Received 18 October 2013

Accepted for publication 13 November 2013

Published 16 December 2013 Volume 2014:10 Pages 1—7

DOI https://doi.org/10.2147/TCRM.S56159

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Ji-Feng Feng, Qi-Xun Chen

Department of Thoracic Surgery, Zhejiang Cancer Hospital, Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, People's Republic of China

Background: The prognostic nutritional index (PNI) is related to the prognosis in many cancers; however, its role in esophageal cancer is still controversial. Further, controversy exists concerning the optimal cut-off points for PNI to predict survival. The aim of this study was to determine the prognostic value of PNI and propose the optimal cut-off points for PNI in predicting cancer-specific survival (CSS) in esophageal squamous cell carcinoma (ESCC).
Methods: This retrospective study included 375 patients who underwent esophagectomy for ESCC. The PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). With the help of the fit line on the scatter plot, we classified the patients into three categories according to the PNI, ie, >52, 42–52, and <42.
Results: Our study showed that PNI was associated with tumor length (P=0.007), T grade (P=0.001), and N staging (P<0.001). The 5-year CSS in patients with PNI <42, 42–52, and >52 were 11.0%, 39.1%, and 55.2%, respectively (P<0.001). Multivariate analysis showed that PNI was a significant predictor of CSS (42–52 versus >52, P=0.011; <42 versus PNI >52, P<0.001).
Conclusion: PNI is a predictive factor for long-term survival in ESCC. The survival rate of ESCC can be discriminated between three groups, ie, PNI ,42, 42–52, and .52.

Keywords: esophageal squamous cell carcinoma, prognostic nutritional index, prognostic factor, survival

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