Abstract
BackgroundTo analyze the prognostic value of preoperative prognostic nutritional index (PNI) in predicting the survival outcome of hypopharyngeal squamous cell carcinoma (HPSCC) patients receiving radical surgery.MethodsFrom March 2006 to August 2016, 123 eligible HPSCC patients were reviewed. The preoperative PNI was calculated as serum albumin (g/dL) × 10 + total lymphocyte count (mm−3) × 0.005. These biomarkers were measured within 2 weeks prior to surgery. The impact of preoperative PNI on overall survival (OS), progression-free survival (PFS), locoregional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) were analyzed using Kaplan–Meier method and Cox proportional hazards model.ResultsMedian value of 52.0 for the PNI was selected as the cutoff point. PNI value was then classified into two groups: high PNI (> 52.0) versus low PNI (≤ 52.0). Multivariate analysis showed that high preoperative PNI was an independent prognostic factor for better OS (P = 0.000), PFS (P = 0.001), LRFS (P = 0.005) and DMFS (P = 0.016).ConclusionsHigh PNI predicts superior survival in HPSCC patients treated with radical surgery. As easily accessible biomarkers, preoperative PNI together with the conventional TNM staging system can be utilized to enhance the accuracy in predicting survival and determining therapy strategies in these patients.
Highlights
To analyze the prognostic value of preoperative prognostic nutritional index (PNI) in predicting the survival outcome of hypopharyngeal squamous cell carcinoma (HPSCC) patients receiving radical surgery
As for progression-free survival (PFS), primary tumor at posterior wall/postcricoid (HR 2.328, 95% confidence interval (CI) 1.224–4.426; P = 0.010), advanced pathological tumor (pT) (HR 1.842, 95% CI 1.115–3.042; P = 0.017), high lymph node density (LND) (HR 1.971, 95% CI 1.201–3.237; P = 0.007) and low PNI (HR 2.401, 95% CI 1.419–4.061; P = 0.001) remained significantly associated with inferior survival
Our study presented that the preoperative PNI was an effective factor in predicting outcomes for HPSCC patients with radical surgery, in terms of overall survival (OS), locoregional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS) and PFS
Summary
To analyze the prognostic value of preoperative prognostic nutritional index (PNI) in predicting the survival outcome of hypopharyngeal squamous cell carcinoma (HPSCC) patients receiving radical surgery. Hypopharyngeal squamous cell carcinoma (HPSCC) is an aggressive tumor with poor prognosis in head and neck squamous cell carcinomas (HNSCC). The clinicopathologic characteristics further give rise to poor outcomes on account of extensive submucosal spread, early lymphatic invasion, widely systemic dissemination and high. It was originally designed to evaluate preoperative nutritional conditions and surgical complications in patients with gastrointestinal malignancies [5]. The significance of the PNI as a prognostic predictor has been uncovered in various malignancies [6,7,8], as well as in HNSCC [9,10,11].
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