Skip to main content
SpringerLink
Log in

Maintenance of the nutritional prognostic index predicts survival in patients with unresectable metastatic colorectal cancer

  • Original Article – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Nutrition and immunity significantly affect the progression of cancer in cancer patients. Therefore, the evaluation of the nutritional and immune status would be useful as a prognostic factor and to determine the optimal treatment strategy for patients with unresectable metastatic colorectal cancer who are receiving chemotherapy. The aim of this retrospective study was to evaluate the prognostic significance of the nutritional and immune status in patients with unresectable metastatic colorectal cancer treated with chemotherapy.

Methods

We retrospectively reviewed 80 patients with colorectal cancer. A total of 22 patients had metachronous unresectable cancer, and 58 patients had synchronous unresectable cancer. All patients underwent combination chemotherapy with oxaliplatin or irinotecan plus 5-fluorouracil/leucovorin as first-line chemotherapy. We then examined the correlations between the Onodera’s prognostic nutritional index (OPNI) and the patients’ clinicopathological features. The OPNI was calculated as follows: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm3). According to the receiver operating characteristic (ROC) curve analysis, the cutoff value for OPNI was 44.5.

Results

Patients with a pretreatment OPNI of ≧44.5 demonstrated a longer OS than those with a pretreatment OPNI of <44.5. Moreover, we categorized these patients into four groups according to the combination of the pre- and post-treatment OPNI. The patients in the group with both OPNIs ≥44.5 exhibited a better prognosis compared to the other group (p = 0.001).

Conclusion

The OPNI is considered to be a useful marker for predicting the long-term outcome in patients who receive chemotherapy for unresectable metastatic colorectal cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Bauer J, Herrmann F (1991) Interleukin-6 in clinical medicine. Ann Hematol 62:203–210

    Article  CAS  PubMed  Google Scholar 

  • Ceze N, Thibault G, Goujon G, Viguier J, Watier H, Dorval E, Lecomte T (2011) Pre-treatment lymphopenia as a prognostic biomarker in colorectal cancer patients receiving chemotherapy. Cancer Chemother Pharmacol 13:1305–1313

    Article  Google Scholar 

  • Chojkier M (2005) Inhibition of albumin synthesis in chronic diseases. J Clin Gastroenterol 39:S143–S146

    Article  CAS  PubMed  Google Scholar 

  • Ciccolallo L, Capocaccia R, Coleman MP et al (2005) Survival differences between European and US patients with colorectal cancer: role of stage at diagnosis and surgery. Gut 54:268–273

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Dintinjana RD, Guina T, Krznarić Z, Radić M, Dintinjana M (2008) Effects of nutritional support in patients with colorectal cancer during chemotherapy. Coll Antropol 32:737–740

    PubMed  Google Scholar 

  • Dintinjana RD, Trivanovic D, Zelić M et al (2013) Nutritional support in patients with colorectal cancer during chemotherapy: does it work? Hepatogastroenterology 60:475–480

    PubMed  Google Scholar 

  • Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R et al (2009) New response evaluation criteria in solid tumours, revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247

    Article  CAS  PubMed  Google Scholar 

  • Fearon KCH, Falconer JS, Slater C (1998) Albumin synthesis rates are not decreased in hypoalbuminemic cachectic cancer patients with an ongoing acute-phase protein synthesis. Ann Surg 227:249–254

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Feng JF, Chen QX (2014) Significance of the prognostic nutritional index in patients with esophageal squamous cell carcinoma. Ther Clin Risk Manag 10:1–7

    PubMed Central  PubMed  Google Scholar 

  • Forones NM, Mandowsky SV, Lourenco LG (2001) Serum levels of interleukin-2 and tumor necrosis factor-alpha correlate to tumor progression in gastric cancer. Hepatogastroenterology 48:1199–1201

    CAS  PubMed  Google Scholar 

  • Gupta D, Lis CG (2010) Pretreatment serum albumin as a predictor of cancer survival : a systemic review of the epidemiological literature. Nutr J 9:69

    Article  PubMed Central  PubMed  Google Scholar 

  • Haggar FA, Boushey RP (2009) Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg 22:191–197

    Article  PubMed Central  PubMed  Google Scholar 

  • Hoffmann TK, Dworacki G, Tsukihiro T, Meidenbauer N, Gooding W, Johnson JT, Whiteside TL (2002) Spontaneous apoptosis of circulating T lymphocytes in patients with head and neck cancer and its clinical importance. Clin Cancer Res 8:2553–2562

    PubMed  Google Scholar 

  • Kanda M, Fujii T, Kodera Y, Nagai S, Takeda S, Nakao A (2011) Nutritional predictors of postoperative outcome in pancreatic cancer. Br J Surg 98:268–274

    Article  CAS  PubMed  Google Scholar 

  • Kayama T, Wakao F, Sobue T, Katanoda K, Tsukuma H, Mikami H, Kitai A (2011) Cancer statistics in Japan, 2011. Foundation for Promotion of Cancer Research, Tokyo

    Google Scholar 

  • Klek S, Szybinski P, Szczepanek K (2014) Perioperative immunonutrition in surgical cancer patients: a summary of a decade of research. World J Surg 38:803–812

    Article  PubMed Central  PubMed  Google Scholar 

  • Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer J (2008) Long-term outcome of laparoscopic surgery for colorectal cancer: a Cochrane systematic review of randomised controlled trials. Cancer Treat Rev 34:498–504

    Article  PubMed  Google Scholar 

  • Maeda K, Shibutani M, Otani H et al (2014) Low Nutritional Prognostic Index correlates with poor survival in patients with stage IV colorectal cancer following palliative resection of the primary tumor. World J Surg 38:1217–1222

    Article  PubMed  Google Scholar 

  • Mehrkhani F, Nasiri S, Donboli K, Meysamie A, Hedayat A (2009) Prognostic factors in survival of colorectal cancer patients after surgery. Color Dis 11:157–161

    Article  CAS  Google Scholar 

  • Meyerhardt JA, Mayer RJ (2005) Systemic therapy for colorectal cancer. N Engl J Med 3:476–487

    Article  Google Scholar 

  • Nozoe T, Ninomiya M, Maeda T, Matsukuma A, Nakashima H, Ezaki T (2010) Prognostic nutritional index: a tool to predict the biological aggressiveness of gastric carcinoma. Surg Today 40:440–443

    Article  PubMed  Google Scholar 

  • Nozoe T, Kohno M, Iguchi T, Mori E, Maeda T, Matsukuma A, Ezaki T (2012) The prognostic nutritional index can be a prognostic indicator in colorectal carcinoma. Surg Today 42:532–535

    Article  PubMed  Google Scholar 

  • Oñate-Ocaña LF, Aiello-Crocifoglio V, Gallardo-Rincón D et al (2007) Serum albumin as a significant prognostic factor for patients with gastric carcinoma. Ann Surg Oncol 14:381–389

    Article  PubMed  Google Scholar 

  • Onodera T, Goseki N, Kosaki G (1984) Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi 85:1001–1005

    CAS  PubMed  Google Scholar 

  • Rosenberg SA (2001) Progress in human tumour immunology and immunotherapy. Nature 411:380–384

    Article  CAS  PubMed  Google Scholar 

  • Ross PJ, Ashley S, Norton A et al (2004) Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers? Br J Cancer 90:1905–1911

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Rothschild MA, Oratz M, Schreiber SS (1988) Serum albumin. Hepatology 8:385–401

    Article  CAS  PubMed  Google Scholar 

  • Smyth MJ, Dunn GP, Schreiber RD (2006) Cancer immunosurveillance and immunoediting: the roles of immunity in suppressing tumor development and shaping tumor immunogenicity. Adv Immunol 90:1–50

    Article  CAS  PubMed  Google Scholar 

  • Sobin L, Gospodarowicz M, Wittekind C (2009) TNM classification of malignant tumors, 7th edn. Wiley, International Union Against Cancer, New York, pp 73–77

  • Zhang S, Gao F, Luo J, Yang J (2010) Prognostic factors in survival of colorectal cancer patients with synchronous liver metastasis. Color Dis 12:754–761

    Article  CAS  Google Scholar 

  • Zlobec I, Bihl MP, Schwarb H, Terracciano L, Lugli A (2010) Clinicopathological and protein characterization of BRAF- and K-RAS-mutated colorectal cancer and implications for prognosis. Int J Cancer 15:367–380

    Google Scholar 

Download references

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka, Japan

    Tetsuro Ikeya, Masatsune Shibutani, Kiyoshi Maeda, Kenji Sugano, Hisashi Nagahara, Hiroshi Ohtani & Kosei Hirakawa

Authors
  1. Tetsuro Ikeya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masatsune Shibutani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kiyoshi Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kenji Sugano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hisashi Nagahara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiroshi Ohtani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kosei Hirakawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masatsune Shibutani.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ikeya, T., Shibutani, M., Maeda, K. et al. Maintenance of the nutritional prognostic index predicts survival in patients with unresectable metastatic colorectal cancer. J Cancer Res Clin Oncol 141, 307–313 (2015). https://doi.org/10.1007/s00432-014-1799-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00432-014-1799-8

Keywords

Search

Navigation