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Prognostic nutritional index and its dynamics after curative treatment are independent prognostic factors on survival in non-metastatic nasopharyngeal carcinoma

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Abstract

Purpose

We aimed to identify the prognostic and predictive values of post-treatment prognostic nutritional index (PNI) and PNI dynamics in nasopharyngeal cancer patients (NPC) in this study.

Methods

One hundred seven non-metastatic NPC patients were included. PNI was calculated by using the following formula: [10 × serum albumin value (gr/dL)] + [0.005 × total lymphocyte count (per mm3)]. ROC analysis was used for determining prognostic PNI values and univariate and multivariate statistical analyses for prognostic characterization of PNI.

Results

The statistically significant cut-off values for pre- and post-treatment PNI were 50.65 and 44.75, respectively. Of the pre-treatment PNI analysis, PNI ≤ 50.65 group had shorter loco-regional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS). Furthermore, for post-treatment PNI analysis, PNI ≤ 44.75 group had shorter LRRFS and OS. In univariate analysis, only pre-treatment PNI was associated with LRRFS and DMFS, while pre- and post-treatment PNI were both associated with OS. In multivariate analysis, both PNI were independent prognostic markers for OS. In the combined analysis, pre- and post-treatment PNI, differences between the groups were statistically significant, and the PNI dynamics was an independent prognostic indicator for OS.

Conclusion

PNI is a useful, independent prognostic marker for non-metastatic NPC patients. It is used for either pre- or post-treatment patients. Furthermore, changes in pre-treatment PNI value after curative treatment is a significant indicator for OS.

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Data Availability

Information provided in the literature and personal experience.

Code availability

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Authors and Affiliations

  1. Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey

    Ahmet Küçükarda, Bülent Erdoğan, Ali Gökyer, İvo Gökmen, Erkan Özcan, Muhammet Bekir Hacıoğlu, Sernaz Uzunoğlu & İrfan Çiçin

  2. Trakya University School of Medicine, Edirne, Turkey

    Sezin Sayın

Authors
  1. Ahmet Küçükarda
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  2. Bülent Erdoğan
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  3. Ali Gökyer
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  4. Sezin Sayın
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  5. İvo Gökmen
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  6. Erkan Özcan
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  7. Muhammet Bekir Hacıoğlu
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  8. Sernaz Uzunoğlu
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  9. İrfan Çiçin
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Contributions

AK, AG, and SE: Writing—original draft. BE, MBH, and SU: Writing—review and editing. AK, AG, İG, and EK: Data curation and investigation. BE, MBH, SU, and İÇ: Supervision.

Corresponding author

Correspondence to Ahmet Küçükarda.

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Institutional Review Board approval was obtained. All procedures performed in studies involving 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.

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Küçükarda, A., Erdoğan, B., Gökyer, A. et al. Prognostic nutritional index and its dynamics after curative treatment are independent prognostic factors on survival in non-metastatic nasopharyngeal carcinoma. Support Care Cancer 30, 2131–2139 (2022). https://doi.org/10.1007/s00520-021-06627-6

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