Prognostic Significance of Pretreatment Prognostic Nutritional Index (PNI) in Patients with Nasopharyngeal Carcinoma: A Meta-Analysis

Previous studies have investigated the pretreatment prognostic nutritional index (PNI) as a prognostic factor in patients with nasopharyngeal carcinoma (NPC); however, the results remained inconsistent. We aimed to assess the prognostic value of PNI in patients with NPC through conducting meta-analy...

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Published in:Nutrition and cancer 2021, Vol.73 (9), p.1657-1667
Main Authors: Gao, Qiu-Ling, Shi, Jian-Guo, Huang, Yu-Dong
Format: Article
Language:English
Subjects:
Cancer
Confidence intervals
Meta-analysis
Metastases
Nasopharyngeal carcinoma
Nutrition assessment
Patients
Pretreatment
Subgroups
Survival
Throat cancer
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Shi, Jian-Guo
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description Previous studies have investigated the pretreatment prognostic nutritional index (PNI) as a prognostic factor in patients with nasopharyngeal carcinoma (NPC); however, the results remained inconsistent. We aimed to assess the prognostic value of PNI in patients with NPC through conducting meta-analysis. Methods: Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for low PNI of overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), loco-regional recurrence-free survival (LRFS), and cancer-specific survival (CSS). Results: Totally, eight studies involving 4299 patients were included in this meta-analysis. A low pretreatment PNI was associated with poor OS (HR = 1.86, 95% CI = 1.55-2.33, P 
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We aimed to assess the prognostic value of PNI in patients with NPC through conducting meta-analysis. Methods: Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for low PNI of overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), loco-regional recurrence-free survival (LRFS), and cancer-specific survival (CSS). Results: Totally, eight studies involving 4299 patients were included in this meta-analysis. A low pretreatment PNI was associated with poor OS (HR = 1.86, 95% CI = 1.55-2.33, P &lt; 0.001), DMFS (HR = 2.03, 95% CI = 1.69-2.44, P &lt; 0.001), PFS (HR = 1.57, 95% CI = 1.31-1.90, P &lt; 0.001), and CSS (HR = 2.29, 95% CI = 1.54-3.42, P &lt; 0.001). The subgroup analysis showed that low PNI remained a significant factor for poor OS, DMFS, and PFS irrespective of treatment, country, and cutoff value of PNI. In addition, low PNI was correlated to female gender (OR = 1.35, 95% CI = 1.12-1.62, P = 0.002), older age (OR = 1.75, 95% CI = 1.17-2.62, P = 0.007), and T3-T4 stage (OR = 1.27, 95% CI = 1.06-1.53, P = 0.011). Conclusions: A low PNI was associated with poor survival outcomes in patients with NPC. Moreover, PNI could serve as an index to help guide clinical management for older patients.</description><identifier>ISSN: 0163-5581</identifier><identifier>EISSN: 1532-7914</identifier><identifier>DOI: 10.1080/01635581.2020.1810715</identifier><identifier>PMID: 32924631</identifier><language>eng</language><publisher>United States: Taylor &amp; Francis</publisher><subject>Cancer ; Confidence intervals ; Meta-analysis ; Metastases ; Nasopharyngeal carcinoma ; Nutrition assessment ; Patients ; Pretreatment ; Subgroups ; Survival ; Throat cancer</subject><ispartof>Nutrition and cancer, 2021, Vol.73 (9), p.1657-1667</ispartof><rights>2020 Taylor &amp; Francis Group, LLC 2020</rights><rights>2020 Taylor &amp; Francis Group, LLC</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c394t-873d3d0e26e38b5d96555e2b76aa738a31d442ad8d4218f23d428d8238201f33</citedby><cites>FETCH-LOGICAL-c394t-873d3d0e26e38b5d96555e2b76aa738a31d442ad8d4218f23d428d8238201f33</cites><orcidid>0000-0001-8788-7799</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32924631$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gao, Qiu-Ling</creatorcontrib><creatorcontrib>Shi, Jian-Guo</creatorcontrib><creatorcontrib>Huang, Yu-Dong</creatorcontrib><title>Prognostic Significance of Pretreatment Prognostic Nutritional Index (PNI) in Patients with Nasopharyngeal Carcinoma: A Meta-Analysis</title><title>Nutrition and cancer</title><addtitle>Nutr Cancer</addtitle><description>Previous studies have investigated the pretreatment prognostic nutritional index (PNI) as a prognostic factor in patients with nasopharyngeal carcinoma (NPC); however, the results remained inconsistent. We aimed to assess the prognostic value of PNI in patients with NPC through conducting meta-analysis. Methods: Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for low PNI of overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), loco-regional recurrence-free survival (LRFS), and cancer-specific survival (CSS). Results: Totally, eight studies involving 4299 patients were included in this meta-analysis. A low pretreatment PNI was associated with poor OS (HR = 1.86, 95% CI = 1.55-2.33, P &lt; 0.001), DMFS (HR = 2.03, 95% CI = 1.69-2.44, P &lt; 0.001), PFS (HR = 1.57, 95% CI = 1.31-1.90, P &lt; 0.001), and CSS (HR = 2.29, 95% CI = 1.54-3.42, P &lt; 0.001). The subgroup analysis showed that low PNI remained a significant factor for poor OS, DMFS, and PFS irrespective of treatment, country, and cutoff value of PNI. In addition, low PNI was correlated to female gender (OR = 1.35, 95% CI = 1.12-1.62, P = 0.002), older age (OR = 1.75, 95% CI = 1.17-2.62, P = 0.007), and T3-T4 stage (OR = 1.27, 95% CI = 1.06-1.53, P = 0.011). Conclusions: A low PNI was associated with poor survival outcomes in patients with NPC. Moreover, PNI could serve as an index to help guide clinical management for older patients.</description><subject>Cancer</subject><subject>Confidence intervals</subject><subject>Meta-analysis</subject><subject>Metastases</subject><subject>Nasopharyngeal carcinoma</subject><subject>Nutrition assessment</subject><subject>Patients</subject><subject>Pretreatment</subject><subject>Subgroups</subject><subject>Survival</subject><subject>Throat cancer</subject><issn>0163-5581</issn><issn>1532-7914</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kc1uEzEURi0EoiHwCCBLbMpiin_GMx5WjSKgkdoQie6tm7EndTVjB9ujkgfgvfEoaYVYdHUl63yffX0Qek_JBSWSfCa04kJIesEIy0eSkpqKF2hGBWdF3dDyJZpNTDFBZ-hNjPeEZIbL1-iMs4aVFacz9GcT_M75mGyLf9qds51twbUG-w5vgknBQBqMS_gfbj2mYJP1Dnq8ctr8xueb9eoTtg5vINlMR_xg0x1eQ_T7OwgHtzOZXUJorfMDfMELfGMSFItccYg2vkWvOuijeXeac3T77evt8qq4_vF9tVxcFy1vylTImmuuiWGV4XIrdFMJIQzb1hVAzSVwqsuSgZa6ZFR2jOcptWRcMkI7zufo_Fi7D_7XaGJSg42t6Xtwxo9RsZyWJS3zt83Rx__Qez-G_NxMiYpVFambqVAcqTb4GIPp1D7YIS-sKFGTJvWoSU2a1ElTzn04tY_bwein1KOXDFweAes6HwZ48KHXKsGh96ELWZCNij9_x1_gqaDw</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Gao, Qiu-Ling</creator><creator>Shi, Jian-Guo</creator><creator>Huang, Yu-Dong</creator><general>Taylor &amp; Francis</general><general>Taylor &amp; Francis Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8788-7799</orcidid></search><sort><creationdate>2021</creationdate><title>Prognostic Significance of Pretreatment Prognostic Nutritional Index (PNI) in Patients with Nasopharyngeal Carcinoma: A Meta-Analysis</title><author>Gao, Qiu-Ling ; Shi, Jian-Guo ; Huang, Yu-Dong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c394t-873d3d0e26e38b5d96555e2b76aa738a31d442ad8d4218f23d428d8238201f33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cancer</topic><topic>Confidence intervals</topic><topic>Meta-analysis</topic><topic>Metastases</topic><topic>Nasopharyngeal carcinoma</topic><topic>Nutrition assessment</topic><topic>Patients</topic><topic>Pretreatment</topic><topic>Subgroups</topic><topic>Survival</topic><topic>Throat cancer</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gao, Qiu-Ling</creatorcontrib><creatorcontrib>Shi, Jian-Guo</creatorcontrib><creatorcontrib>Huang, Yu-Dong</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Nutrition and cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gao, Qiu-Ling</au><au>Shi, Jian-Guo</au><au>Huang, Yu-Dong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Significance of Pretreatment Prognostic Nutritional Index (PNI) in Patients with Nasopharyngeal Carcinoma: A Meta-Analysis</atitle><jtitle>Nutrition and cancer</jtitle><addtitle>Nutr Cancer</addtitle><date>2021</date><risdate>2021</risdate><volume>73</volume><issue>9</issue><spage>1657</spage><epage>1667</epage><pages>1657-1667</pages><issn>0163-5581</issn><eissn>1532-7914</eissn><abstract>Previous studies have investigated the pretreatment prognostic nutritional index (PNI) as a prognostic factor in patients with nasopharyngeal carcinoma (NPC); however, the results remained inconsistent. We aimed to assess the prognostic value of PNI in patients with NPC through conducting meta-analysis. Methods: Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for low PNI of overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), loco-regional recurrence-free survival (LRFS), and cancer-specific survival (CSS). Results: Totally, eight studies involving 4299 patients were included in this meta-analysis. A low pretreatment PNI was associated with poor OS (HR = 1.86, 95% CI = 1.55-2.33, P &lt; 0.001), DMFS (HR = 2.03, 95% CI = 1.69-2.44, P &lt; 0.001), PFS (HR = 1.57, 95% CI = 1.31-1.90, P &lt; 0.001), and CSS (HR = 2.29, 95% CI = 1.54-3.42, P &lt; 0.001). The subgroup analysis showed that low PNI remained a significant factor for poor OS, DMFS, and PFS irrespective of treatment, country, and cutoff value of PNI. In addition, low PNI was correlated to female gender (OR = 1.35, 95% CI = 1.12-1.62, P = 0.002), older age (OR = 1.75, 95% CI = 1.17-2.62, P = 0.007), and T3-T4 stage (OR = 1.27, 95% CI = 1.06-1.53, P = 0.011). Conclusions: A low PNI was associated with poor survival outcomes in patients with NPC. Moreover, PNI could serve as an index to help guide clinical management for older patients.</abstract><cop>United States</cop><pub>Taylor &amp; Francis</pub><pmid>32924631</pmid><doi>10.1080/01635581.2020.1810715</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-8788-7799</orcidid></addata></record>
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subjects Cancer
Confidence intervals
Meta-analysis
Metastases
Nasopharyngeal carcinoma
Nutrition assessment
Patients
Pretreatment
Subgroups
Survival
Throat cancer
title Prognostic Significance of Pretreatment Prognostic Nutritional Index (PNI) in Patients with Nasopharyngeal Carcinoma: A Meta-Analysis
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