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11.01.2017 | Clinical Study | Ausgabe 2/2017

Journal of Neuro-Oncology 2/2017

Low preoperative prognostic nutritional index predicts poor survival in patients with newly diagnosed high-grade gliomas

Zeitschrift:
Journal of Neuro-Oncology > Ausgabe 2/2017
Autoren:
Zhen-Qiang He, Chao Ke, Fuad Al-Nahari, Hao Duan, Cheng-Cheng Guo, Yang Wang, Xiang-Heng Zhang, Yin-Sheng Chen, Zhi-Gang Liu, Jian Wang, Zhong-Ping Chen, Xiao-Bing Jiang, Yong-Gao Mou
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s11060-016-2361-0) contains supplementary material, which is available to authorized users.

Abstract

Preoperative prognostic nutritional index (PNI) has been widely demonstrated to predict survival of patients with malignant tumors. Its utility in predicting outcomes in patients with high-grade gliomas (HGG) remains undefined. A retrospective study of 188 HGG patients was conducted. An optimal PNI cut-off value was applied to stratify patients into high PNI (≥52.55, n = 78) and low PNI (<52.55, n = 110) groups. Univariate and multivariate analysis was performed to identify prognostic factors associated with overall survival (OS) and progression free survival (PFS). The resulting prognostic models were externally validated using a demographic-matched cohort of 130 HGG patients. In the training set, PNI value was negatively correlated with age (p = 0.027) and tumor grade (p = 0.048). Both PFS (8.27 vs. 20.77 months, p < 0.001) and OS (13.57 vs. 33.23 months, p < 0.001) were significantly worse in the low PNI group. Strikingly, patients in high PNI group had a 52% decrease in the risk of tumor progression and 55% decrease of death relative to low PNI. Multivariate analysis further demonstrated PNI as an independent predictor for PFS (HR = 0.62, 95% CI 0.43–0.87) and OS (HR = 0.56, 95% CI 0.38–0.80). The PNI retained independent prognostic value in the validation set for both PFS (p = 0.013) and OS (p = 0.003). On subgroup analysis by tumor grade and treatment modalities, both PFS and OS were better for the patients with high PNI. The PNI is a potentially valuable preoperative marker for the survival of patients following HGG resection.

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Zusatzmaterial
Supplementary Fig. S1 Kaplan-Meier survival curves of HGG patients by IDH1 mutation status. Mutated IDH1 was significantly associated with better PFS (A) and OS (B). (TIF 424 KB)
11060_2016_2361_MOESM1_ESM.tif
Supplementary Fig. S2 Kaplan-Meier survival curves of all HGG patients. Patients in PNI-high group had significantly longer PFS and OS than patients in PNI-low group (Both p&#x003C;0.001). (TIF 392 KB)
11060_2016_2361_MOESM2_ESM.tif
Supplementary material 3 (DOCX 34 KB)
11060_2016_2361_MOESM3_ESM.docx
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