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

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2024-09-01 Epub Date: 2024-05-03 DOI:10.1007/s00595-024-02847-5

Kazuki Hayasaka, Hirotsugu Notsuda, Ken Onodera, Tatsuaki Watanabe, Yui Watanabe, Takaya Suzuki, Takashi Hirama, Hisashi Oishi, Hiromichi Niikawa, Yoshinori Okada

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Abstract

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.

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手术切除非小细胞肺癌患者围手术期营养指数变化的预后价值。

目的：本项单机构回顾性队列研究旨在评估非小细胞肺癌（NSCLC）手术患者围手术期营养指数（PNI）变化的预后意义：PNI比值（术后PNI/术前PNI）被用作围手术期PNI变化的指标。根据PNI比值研究了预后差异：结果：根据接收器操作特征曲线，总生存率（OS）的 PNI 比值的最佳临界值定为 0.88。PNI比值与高吸烟指数、间质性肺病和术后肺部并发症成反比。高 PNI 比率组和低 PNI 比率组的 5 年 OS 率分别为 88.2% 和 68.5%（危险比 [HR]：3.04，95% 置信区间 [CI]：1.90-4.86）。多变量分析显示，PNI 比值低与预后不良显著相关（HR：2.94，95% 置信区间：1.77-4.87）。在识别高死亡风险患者，尤其是非肺癌病因患者方面，PNI 比值是比单纯术后 PNI 状态更敏感的指标：结论：围手术期PNI变化是NSCLC患者的一个重要预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.