Impact of prognostic nutritional index on long-term outcomes in patients with breast cancer.

Tomomi Mohri,Kenji Takeuchi,Tsunehiko Shigemori,Yasuhiko Mohri,Yoshiyuki Itoh,Toshio Kato

doi:10.1186/s12957-016-0920-7

Tomomi Mohri, Kenji Takeuchi + Show 4 more

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https://doi.org/10.1186/s12957-016-0920-7

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Abstract

BackgroundPrognostic nutritional index has been shown to be a prognostic marker for various solid tumors. However, few studies have investigated the impact of the prognostic nutritional index on survival of patients with breast cancer. The aim of this study was to investigate the impact of the prognostic nutritional index on the long-term outcomes in patients with breast cancer.MethodsThis study reviewed the medical records of 212 patients with breast cancer who underwent mastectomy. The prognostic nutritional index was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm3). Receiver operating characteristic curve analysis was performed to determine the cutoff value of the prognostic nutritional index. The survival curves were calculated by the Kaplan–Meier method. Differences between the curves were analyzed by the log-rank test. Multivariate Cox proportional hazard model was used to evaluate the prognostic significance of prognostic nutritional index in patients with breast cancer.ResultsThe mean prognostic nutritional index just before the operation was 51.9, and the median follow-up after surgery was 47.7 months. The optimal cutoff value of the prognostic nutritional index for predicting the overall survival was 52.8 from the receiver operating characteristic curve analysis. The 5-year overall survival rate was 98.3 % in the prognostic nutritional index >52.8 and 92.0 % in the prognostic nutritional index <52.8 (P = 0.013). In the multivariate analysis, a low prognostic nutritional index was an independent predictor for poor overall survival (HR, 5.88; 95 % CI, 1.13–108.01; P = 0.033).ConclusionsThe prognostic nutritional index is a simple and useful marker for predicting the long-term outcomes of breast cancer patients, independent of the tumor stage.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-016-0920-7) contains supplementary material, which is available to authorized users.

Highlights

Prognostic nutritional index has been shown to be a prognostic marker for various solid tumors
The mean prognostic nutritional index (PNI) in patients aged >65 years was significantly lower than that in patients aged ≦65 years (P < 0.001; Table 1)
Our present study demonstrated that the PNI can predict the long-term outcomes of breast cancer patients, independent of the conventional TNM classification

Summary

Introduction

Prognostic nutritional index has been shown to be a prognostic marker for various solid tumors. Few studies have investigated the impact of the prognostic nutritional index on survival of patients with breast cancer. The aim of this study was to investigate the impact of the prognostic nutritional index on the long-term outcomes in patients with breast cancer. Despite recent improvements in early detection, progress in surgical techniques, Serum albumin is one of the most commonly used markers for assessing nutritional status. The levels of serum albumin fall sharply because malnutrition and systematic inflammatory response to tumors both suppress albumin synthesis [3]. The prevalence of malnutrition among breast cancer patients reported by

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