MP38-15 PROGNOSTIC NUTRITIONAL INDEX (PNI) AS A PREDICTIVE FACTOR FOR UPSTAGING IN CYSTECTOMY PATIENTS

Abstract

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I (MP38)1 Sep 2021MP38-15 PROGNOSTIC NUTRITIONAL INDEX (PNI) AS A PREDICTIVE FACTOR FOR UPSTAGING IN CYSTECTOMY PATIENTS Emily Manning, Amr Mahran, Megan Prunty, Kirtishri Mishra, Sarah Markt, Lee Ponsky, Adam Calaway, and Laura Bukavina Emily ManningEmily Manning More articles by this author , Amr MahranAmr Mahran More articles by this author , Megan PruntyMegan Prunty More articles by this author , Kirtishri MishraKirtishri Mishra More articles by this author , Sarah MarktSarah Markt More articles by this author , Lee PonskyLee Ponsky More articles by this author , Adam CalawayAdam Calaway More articles by this author , and Laura BukavinaLaura Bukavina More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002053.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Our current study aims to determine the correlation between controlling nutritional status (CONUT) and prognostic nutritional index (PNI) and long term outcomes in bladder cancer patients. METHODS: A total of 302 bladder cancer patients who received a cystectomy from University Hospitals Cleveland Medical Center between 2007-2019 were evaluated. CONUT score was obtained based on total cholesterol, albumin, and lymphocyte count. PNI was calculated by utilizing the following formula: 10 × the serum albumin value (g/dl) + 0.005 × the total lymphocyte count in peripheral blood (per mm3). Using inclusion/exclusion criteria, a total of 179 patients were included. We utilized Kaplan-Meier survival analyses to determine the correlation between CONUT and PNI and survival. PNI and CONUT association with upstaging was performed via multivariable regression analysis after adjusting for age, gender, chemotherapy status (y/n), smoking, Charlson Comorbidity Index. RESULTS: Patients with a PNI >50 (no evidence of malnourishment) had an Odds-Ratio (OR) of 0.416 (95% CI: 0.196-0.884, p=0.023) for upstaging of disease compared to patients with PNI <50, suggesting a protective effect against upstaging. When adjusted for age (OR= 1.026.95% CI: 0.989-1.064, p=0.165), gender (OR= 0.566. 95% CI: 0.256-1.251, p=0.160), chemotherapy (OR=1.732. 95% CI: 0.497-6.038, p=0.389), current smoking (OR= 1.390. 95% CI: 0.546-3.541, p=0.490), former smoking (OR= 0.822. 95% CI: 0.372-1.816, p=0.627), and Charlson Comorbidity Score (OR= 1.078. 95% CI: 0.872-1.334, p=0.487), none were significant for upstaging. Our results revealed that PNI and CONUT score did not correlate with overall mortality, but there was a strong trend seen in overall survival in the PNI group, with patients PNI >50(no evidence of malnourishment) showing a decreased incidence of mortality. CONCLUSIONS: Our results indicate that PNI is a useful prognostic tool for predicting upstaging of disease among bladder cancer patients as well as the potential to predict overall mortality. While we were able to show the prognostic value of nutritional assessment with PNI, this was not demonstrated in the CONUT group. We hypothesize this is likely due to a small sample size. Future studies are planned to expand the cohort through multi-institutional collaboration. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e700-e700 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emily Manning More articles by this author Amr Mahran More articles by this author Megan Prunty More articles by this author Kirtishri Mishra More articles by this author Sarah Markt More articles by this author Lee Ponsky More articles by this author Adam Calaway More articles by this author Laura Bukavina More articles by this author Expand All Advertisement Loading ...