Clinical application value of prognostic nutritional index for predicting survival in patients with esophageal squamous cell carcinoma undergoing chemoradiotherapy (CRT) or radiotherapy.

Abstract

e24075 Background: The prognostic nutrition index (PNI) has been shown to have prognostic value in several common cancers. We explore its clinical application value in the prognosis of patients with esophageal squamous cell carcinoma (ESCC) undergoing radical chemoradiotherapy (CRT) or radiotherapy. Methods: Overall, 193 patients with ESCC who received radiotherapy with or without chemotherapy at Sichuan Cancer Hospital from March 20, 2012 to December 25, 2017 were retrospectively analyzed. Based on serum measurements before treatment, PNI at ESCC recurrence was calculated as albumin (g/L) + 5 × total lymphocyte count. Kaplan-Meier method and Cox proportional regression model were used to analyze the relationship between PNI and overall survival (OS). Results: The PNI of 193 ESCC patients was 49.01 ± 4.68. The optimal cutoff value of PNI was calculated to be 47.975. The patients were divided into a low PNI group (<47.975) and a high PNI group (≥47.975). The median OS for the entire group was 22.37 months. The median OS of patients in the high PNI group (PNI ≥ 47.975) and low PNI group (PNI <47.975) were 32.63 months and 15.4 months, respectively. The 3-year overall survival rates were 47.5% and 32.2%, and 5-year overall survival rates were 37.7% and 16.8%, respectively, and the differences were statistically significant (P = 0.001). Multivariate analysis showed that tumor length (P = 0.019), synchronous chemotherapy (P = 0.009), and PNI (P = 0.003) were independent prognostic factors affecting the prognosis of patients in ESCC treated with radical CRT or radiotherapy. Conclusions: The calculation of PNI value is simple, reliable and repeatable, which can improve the accuracy of patients' prognosis. And it needs to be further confirmed by the prospective study of large sample size. Keywords: Esophageal squamous cell carcinoma, chemoradiotherapy, prognostic nutritional index, prognosis.