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A promising prediction model for survival in gallbladder carcinoma patients: pretreatment prognostic nutrient index

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Tumor Biology

Abstract

The pretreatment nutritional and immunological status play indispensable roles in predicting the outcome of patients with various types of malignancies. The aim of the study was to investigate whether preoperative prognostic nutritional index (PNI), which simply accounts for nutritional and immunological status, was associated with overall survival (OS) in patients with gallbladder carcinoma (GBC). The retrospective study included a total of 315 GBC patients after surgery between 2002 and 2012. PNI was calculated according to the following formula: 10× serum albumin (g/dl) +0.005× total lymphocyte count (per mm3). A receiver operating characteristic (ROC) curve for survival prediction was plotted to verify the optimal cutoff value for LMR, which was set at 46.14. According the value, patients were categorized into two different groups, namely high-PNI group (n = 133) and low-PNI group (n = 182). The univariate and multivariate Cox regression models were used to identify the independent prognostic factors. The results showed that low pretreatment PNI value was significantly associated with elderly age, partial surgery procedure, and advanced tumor status such as tumor stage, node stage, and tumor-node-metastasis stage (P < 0.05). The low-PNI group had a worse OS compare with the high-PNI group (P < 0.05). Via univariate and multivariate analyses, pretreatment PNI was identified as an independent prognostic factor for OS [HR: 0.613; 95%CI: 0.448–0.838; P < 0.001]. Subgroup analyses further revealed that PNI was significantly associated with postoperative OS independent of tumor node metastasis stage and surgical procedure. In conclusion, pretreatment PNI might serve as an effective predictor to evaluate prognosis of GBC patients after surgery. Based on the findings, PNI, characterized with accessibility, objectivity and noninvasiveness, should be included in the routine assessment of GBC.

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Acknowledgment

The study was supported by the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University, China (No. XJTU1AF-CRF-2015-003).

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, No.277 West Yan-ta Road, Xi’an, Shaanxi Province, 710061, China

    Yan Deng, Qing Pang, Jian-Bin Bi, Xing Zhang, Yan-Yan Zhou, Run-Chen Miao, Wei Chen, Kai Qu & Chang Liu

  2. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Qinghai University, Xining, Qinghai Province, 810000, China

    Ling-qiang Zhang

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  1. Yan Deng
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Supported by the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University, China (No. XJTU1AF-CRF-2015-003).

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Deng, Y., Pang, Q., Bi, JB. et al. A promising prediction model for survival in gallbladder carcinoma patients: pretreatment prognostic nutrient index. Tumor Biol. 37, 15773–15781 (2016). https://doi.org/10.1007/s13277-016-5396-0

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