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Effectiveness of prognostic nutritional index in predicting overall survival and evaluating immunotherapy response in anaplastic thyroid carcinoma

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Abstract

Background

The prognostic value of nutritional status in anaplastic thyroid carcinoma (ATC) remains unclear. The Prognostic Nutritional Index (PNI) is a reliable indicator of overall nutritional and immune status, and it has emerged as a significant prognostic factor in various malignancies. This study aimed to explore the utility of PNI in ATC.

Methods

We systematically reviewed ATC patients in our institute from January 2000 to June 2023 and categorized them into high and low PNI groups based on the median PNI value. Kaplan–Meier analysis and Cox regression were employed to assess the impact of PNI on overall survival, while ROC curve analysis evaluated the predictive value of PNI. Mimics software was used for three-dimensional reconstruction of pre- and post-immunotherapy tumor volumes, enabling the assessment of treatment response.

Results

A total of 77 ATC patients were included in this study. Low baseline PNI was associated with significantly shorter overall survival (1-year survival rate: 5.26% vs 30.77%; median survival time: 5.30 months vs 8.87 months). The 1-year, 2-year, and 3-year AUC values for PNI were 0.82, 0.79, and 0.77, respectively. In the multivariate analysis, both PNI and tumor size emerged as independent prognostic factors for patient overall survival. Among ATC patients receiving 2–3 cycles of immunotherapy, an increase in post-treatment PNI levels was positively correlated with a reduction in tumor volume.

Conclusion

PNI is an independent predictor of overall survival and holds the potential to serve as a valuable indicator for assessing and predicting immunotherapy efficacy in ATC patients.

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Acknowledgements

We would like to thank the Information Department of Sun Yat-sen University Cancer Center for providing us with help in reviewing patient clinical data.

Funding

This study was supported by the National Natural Science Foundation of China (Nos. 82072981, 82272649, 82303881), Guangdong Basic and Applied Basic Research Foundation (Nos. 2023A1515010450, 2023A1515012903, 2022A1515110033), and Open Project Fund of the Sixth Affiliated Hospital of Guangzhou Medical University (No. 202011-201).

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Author notes

  1. These authors contributed equally: Yongchao Yu, Kang Ning, Xinyu Liu, Guangfeng Luo

Authors and Affiliations

  1. State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China

    Yongchao Yu, Kang Ning, Guangfeng Luo, Zan Jiao, Tong Wu, Zhongyuan Yang, Mingjie Jiang, Weichao Chen & Ankui Yang

  2. Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China

    Yongchao Yu, Kang Ning, Guangfeng Luo, Zan Jiao, Tong Wu, Zhongyuan Yang, Mingjie Jiang, Weichao Chen & Ankui Yang

  3. Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China

    Xinyu Liu & Yarong Liang

  4. Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

    Lexuan Hong

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  1. Yongchao Yu
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Contributions

Yongchao Yu: Conceptualization, Methodology, Writing—original draft, Visualization. Kang Ning: Visualization, Software, Formal analysis. Guangfeng Luo: Methodology, Formal analysis. Lexuan Hong: Software, Validation. Yarong Liang: Validation. Xinyu Liu: Validation. Zan Jiao: Resources. Tong Wu: Resources. Zhongyuan Yang: Investigation. Mingjie Jiang: Writing—review & editing, Validation. Weichao Chen: Writing—review & editing, Validation. Ankui Yang: Supervision, Writing—review & editing.

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Correspondence to Mingjie Jiang, Weichao Chen or Ankui Yang.

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Yu, Y., Ning, K., Liu, X. et al. Effectiveness of prognostic nutritional index in predicting overall survival and evaluating immunotherapy response in anaplastic thyroid carcinoma. Endocrine (2024). https://doi.org/10.1007/s12020-024-03826-z

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