Clinical significance of the preoperative prognostic nutritional index in patients with resectable non-small cell lung cancer: a multicenter study.

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-01-16 DOI:10.1007/s00595-024-02987-8

Mamoru Takahashi, Akihiro Aoyama, Masatsugu Hamaji, Takashi Sozu, Masashi Kobayashi, Tatsuo Nakagawa, Masashi Ishikawa, Ryo Miyahara, Cheng-Long Huang, Takuji Fujinaga, Hiroaki Sakai, Hiromichi Katakura, Makoto Sonobe, Norihito Okumura, Hidenao Kayawake, Toshi Menju, Ei Miyamoto, Ryo Miyata, Harutaro Okada, Tomoya Kono, Ryota Sumitomo, Naoki Date, Takehisa Fukada, Akira Matsumoto, Yasuto Sakaguchi, Hiroshi Date

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引用次数: 0

Abstract

Purpose: To validate the clinical impacts of the prognostic nutritional index (PNI), an immune-nutritional blood marker, in patients with resectable non-small cell lung cancer (NSCLC) using multicenter cohort data.

Methods: The subjects of this retrospective multicenter study, involving 11 hospitals, were patients who underwent curative lung resection for pathological stage IA-IIIA NSCLC. We analyzed the relationship between the preoperative PNI and postoperative outcomes. Patients were divided into a high PNI group and a low PNI group (cutoff: 45). We also performed exact matching and three propensity score-based methods to validate the results.

Results: Among the total 2,770 patients, 2,272 (82.0%) had a high PNI (>45) and 498 (18.0%) had a low PNI (≤45). A low preoperative PNI was a predictor of increased overall postoperative complications (relative risk 1.49; 95% confidence interval (CI) 1.31-1.69) and an independent adverse prognostic factor for overall survival (hazard ratio 1.77; 95% CI 1.45-2.17) and recurrence-free survival (1.34; 95% CI 1.14-1.59). All the methods we used (whole cohort, exact matching, and three propensity score methods) showed consistent results.

Conclusions: The findings of this multicenter study suggest that immune-nutritional assessment using the PNI will provide useful prognostic information for patients with resectable NSCLC.

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可切除非小细胞肺癌患者术前预后营养指数的临床意义：一项多中心研究。

目的：利用多中心队列数据验证可切除非小细胞肺癌（NSCLC）患者的预后营养指数（PNI）（一种免疫营养血液标志物）的临床影响。方法：本回顾性多中心研究涉及11家医院，为病理期IA-IIIA期NSCLC行根治性肺切除术的患者。我们分析了术前PNI与术后预后的关系。将患者分为高PNI组和低PNI组（截止值：45）。我们还进行了精确匹配和三种基于倾向评分的方法来验证结果。结果：2770例患者中，高PNI 2272例（82.0%），低PNI 498例（18.0%），PNI≤45。术前低PNI是术后并发症增加的预测因子(相对危险度1.49；95%可信区间（CI） 1.31-1.69)和总体生存的独立不良预后因素(风险比1.77；95% CI 1.45-2.17)和无复发生存率(1.34；95% ci 1.14-1.59)。我们使用的所有方法（全队列、精确匹配和三种倾向评分方法）都显示出一致的结果。结论：这项多中心研究的结果表明，使用PNI进行免疫营养评估将为可切除的非小细胞肺癌患者提供有用的预后信息。

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.