Prognostic significance of prognostic nutritional index and systemic immune‐inflammation index in patients after curative breast cancer resection: a retrospective cohort study

Background Nutritional status and inflammation are closely associated with poor outcome in malignant tumors. However, the prognostic impact of postoperative in these variables on breast cancer (BC) remains inconclusive. We aimed to determine whether prognostic nutritional index (PNI), systemic immun...

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Published in:BMC cancer 2022-11, Vol.22 (1), p.1-1128, Article 1128
Main Authors: Xu, Tai, Zhang, Si-Ming, Wu, He-Ming, Wen, Xiao-Min, Qiu, Dong-Qin, Yang, Yu-Yang, Wang, Li-Zhen, Zhu, Wen-Biao, He, Li-Shan, Li, Jian-Juan
Format: Article
Language:English
Subjects:
Blood platelets
Body mass index
Breast cancer
Cancer patients
Cancer therapies
Care and treatment
Chemotherapy
Cohort analysis
Endocrine therapy
Evaluation
Family medical history
Food and nutrition
Hospitals
Inflammation
Laboratories
Leukocytes (neutrophilic)
Lumpectomy
Lymphocytes
Mastectomy
Metastasis
Methods
Neutrophils
Neutrophil–lymphocyte ratio
Nutritional status
Patient outcomes
Patients
Platelet-lymphocyte ratio
Prognosis
Prognostic nutritional index
Radiation therapy
Serum albumin
Surgery
Surgical outcomes
Systemic immune-inflammation index
Tumors
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Summary:Background Nutritional status and inflammation are closely associated with poor outcome in malignant tumors. However, the prognostic impact of postoperative in these variables on breast cancer (BC) remains inconclusive. We aimed to determine whether prognostic nutritional index (PNI), systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) affect two long-term outcomes among patients after curative resection of BC. Methods We retrospectively reviewed 508 patients with BC treated with curative surgery between February 5, 2013 and May 26, 2020. All patients were divided into 3 groups based on tertiles (T1-T3) of PNI, SII, NLR, and PLR. The effects of four indexes on disease-free survival (DFS) and overall survival (OS) have been evaluated using Cox proportional hazards models and Kaplan-Meier method. Results Compared with PNI-lowest cases, patients with highest PNI showed significantly longer DFS (multivariate adjusted hazard ratio [HR] = 0.37, 95% confident interval [CI] 0.19-0.70, P for trend = 0.002), whereas higher PLR seemed to be marginally associated with poorer DFS (P for trend = 0.086 and 0.074, respectively). Subgroup analyses indicate the potential modification effects of family history of BC and radiotherapy on the prognosis value of PNI to DFS in BC patients (P for interaction = 0.004 and 0.025, respectively). In addition, the levels of three inflammatory indices, namely SII, NLR, and PLR might be positively related with increased age at diagnosis (all P for trend < 0.001). Conclusions A high PNI was associated with better DFS, supporting its roles as prognostic parameters for patients with BC. The nutritional status and systemic immune may exert great effects on patient prognosis. Further studies are warrant to explore the prognosis value of PLR. Keywords: Breast cancer, Prognostic nutritional index, Systemic immune-inflammation index, Neutrophil-lymphocyte ratio, Platelet-lymphocyte ratio
ISSN:1471-2407
1471-2407
DOI:10.1186/s12885-022-10218-x