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Is the prognostic nutritional index a prognostic and predictive factor in metastatic non-small cell lung cancer patients treated with first-line chemotherapy?

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Abstract

Purpose

We aimed to assess the prognostic and predictive significance of pretreatment Onodera’s prognostic nutritional index (OPNI) in metastatic non-small cell lung cancer patients (NSCLC) treated with first-line chemotherapy.

Materials and methods

Patients with metastatic NSCLC who attended five different medical oncology clinics between December 2008 and January 2018 were retrospectively analyzed. The optimal cut-off point for OPNI was performed by a receiver operating characteristic (ROC) curve analysis. Patients were assigned to either the low OPNI group or high OPNI group.

Results

A total of 333 patients were included in the study. Significant differences between the low and high OPNI groups were found regarding the rates of response to chemotherapy, sex, and hemoglobin level (p < 0.05). The patients in high OPNI group had a longer overall survival (OS) (15.3 vs. 10.6 months, p < 0.001) and progression-free survival (PFS) (6.7 vs. 5.3 months, p < 0.001) compared to the patients in low OPNI group. A multivariate analysis using Cox regression model revealed that a high OPNI score was an independent prognostic factor of OS (HR = 1.535, p = 0.002) and PFS (HR = 1.336, p = 0.014), but failed to demonstrate a statistical significance of pretreatment OPNI scores in predicting treatment response (p = 0.56).

Conclusions

Pretreatment OPNI is an independent prognostic factor for OS and PFS in metastatic NSCLC patients treated with first-line chemotherapy. Thus, it may be used as easily calculated and low-cost prognostic tool in the routine clinical practice in this patient group.

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Funding

There was no financial support in this study.

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Authors and Affiliations

  1. Clinic of Medical Oncology, Edirne State Hospital, 22030, Edirne, Turkey

    Yakup Bozkaya

  2. Department of Medical Oncology, Trakya University Faculty of Medicine, Edirne, Turkey

    Osman Köstek

  3. Department of Medical Oncology, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey

    Abdullah Sakin

  4. Department of Medical Oncology, SBÜ Dr. Lütfi Kırdar Kartal Education and Research Hospital, İstanbul, Turkey

    Deniz Tataroğlu Özyükseler

  5. Department of Medical Oncology, Aksaray University Education and Research Hospital, Aksaray, Turkey

    Teoman Şakalar

  6. Department of Medical Oncology, SBÜ Bakırköy Dr. Sadi Konuk Education and Research Hospital, İstanbul, Turkey

    İbrahim Çil

Authors
  1. Yakup Bozkaya
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  2. Osman Köstek
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  3. Abdullah Sakin
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  4. Deniz Tataroğlu Özyükseler
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Correspondence to Yakup Bozkaya.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Bozkaya, Y., Köstek, O., Sakin, A. et al. Is the prognostic nutritional index a prognostic and predictive factor in metastatic non-small cell lung cancer patients treated with first-line chemotherapy?. Support Care Cancer 28, 2273–2282 (2020). https://doi.org/10.1007/s00520-019-05055-x

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  • DOI: https://doi.org/10.1007/s00520-019-05055-x

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