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RESEARCH PRODUCT
Prognostic Nutritional Index as an independent prognostic factor in locoregionally advanced squamous cell head and neck cancer.
Maria MaroñasInes GonzálezG. BruixolaMiriam MorianaMiguel CiveraAndrés CervantesNeus BoschMiguel PastorFederica PapaccioAngelica PetrilloAina IranzoJavier Caballerosubject
0301 basic medicineOncologyCancer Researchmedicine.medical_specialtyMultivariate analysisDerived neutrophil-to-lymphocyte ratio; Head and neck squamous cell carcinoma; Inflammation-based prognostic scores; Neutrophil-to-lymphocyte ratio; Overall survival; Prognostic factors; Prognostic nutritional indexoverall survivalhead and neck squamous cell carcinomaderived neutrophil-to-lymphocyte ratio03 medical and health sciences0302 clinical medicineneutrophil-to-lymphocyte ratioInternal medicinemedicine1506Stage (cooking)Neutrophil to lymphocyte ratioOriginal ResearchUnivariate analysisbusiness.industryHead and neck cancerInduction chemotherapyprognostic factorsprognostic nutritional indexmedicine.diseaseHead and neck squamous-cell carcinomaClinical trial030104 developmental biologyOncology030220 oncology & carcinogenesisinflammation-based prognostic scoresbusinessdescription
Background: Locally advanced head and neck squamous cell carcinoma (LAHNSCC) is a heterogeneous disease in which better predictive and prognostic factors are needed. Apart from TNM stage, both systemic inflammation and poor nutritional status have a negative impact on survival. Methods: We retrospectively analysed two independent cohorts of a total of 145 patients with LAHNSCC treated with induction chemotherapy followed by concurrent chemoradiotherapy at two different academic institutions. Full clinical data, including the Prognostic Nutritional Index (PNI), neutrophil to lymphocyte ratio and derived neutrophil to lymphocyte ratio, were analysed in a training cohort of 50 patients. Receiver operating characteristic curve analysis was used to establish optimal cut-off. Univariate and multivariate analyses of prognostic factors for overall survival (OS) were performed. Independent predictors of OS identified in multivariate analysis were confirmed in a validation cohort of 95 patients. Results: In the univariate analysis, low PNI (PNI<45) (p=0.001), large primary tumour (T4) (p=0.044) and advanced lymph node disease (N2b-N3) (p=0.025) were significantly associated with poorer OS in the validation cohort. The independent prognostic factors in the multivariate analysis for OS identified in the training cohort were dRNL (p=0.030) and PNI (p=0.042). In the validation cohort, only the PNI remained as independent prognostic factor (p=0.007). Conclusions: PNI is a readily available, independent prognostic biomarker for OS in LAHNSCC. Adding PNI to tumour staging could improve individual risk stratification of patients with LAHNSCC in future clinical trials.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-07-19 | ESMO open |