01.12.2017 | Research article | Ausgabe 1/2017 Open Access

Preoperative Prognostic Nutritional Index is a Significant Predictor of Survival with Bladder Cancer after Radical Cystectomy: a retrospective study
- Zeitschrift:
- BMC Cancer > Ausgabe 1/2017
Background
Methods
Statistical analysis
Results
Characteristics
|
Total
n = 516
|
---|---|
Age, years, median (IQR)
|
66 (35–91)
|
Female sex, n (%)
|
80 (15.5%)
|
Histology type, n (%)
|
|
UC
|
488 (94.6%)
|
NUC
|
28 (5.4%)
|
Pathological grade, n (%)
|
|
2
|
131 (25.4%)
|
3
|
385 (74.6%)
|
Smoking history
|
161 (31.2%)
|
Diabetes Mellitus
|
56 (10.9%)
|
Hypertension
|
149 (28.9%)
|
Heart disease
|
55 (10.7%)
|
Cerebrovascular disease
|
17 (3.3%)
|
pT stage, n (%)
|
|
1
|
162 (31.4%)
|
2
|
161 (31.2%)
|
3
|
105 (20.3%)
|
4
|
88 (17.1%)
|
pN status, n (%)
|
|
negative
|
81 (15.7%)
|
positive
|
435 (84.3%)
|
ASA grade, n (%)
|
|
1&2
|
436 (84.5%)
|
3&4
|
80 (15.5%)
|
Surgery style
|
|
open
|
409 (79.3%)
|
laparoscopic
|
107 (20.7%)
|
Postoperative complications
|
|
present
|
73 (8.3%)
|
absent
|
443 (91.7%)
|
Anemia
|
|
present
|
144 (27.9%)
|
absent
|
372 (72.1%)
|
Hypoalbuminemia
|
|
present
|
74 (14.3%)
|
absent
|
442 (85.7%)
|
NLR, median (IQR)
|
2.34 (1.74–3.49)
|
PLR, median (IQR)
|
133.8 (98.22–180.22)
|
LMR, median (IQR)
|
4.37 (3.30–5.72)
|
PNI, median (IQR)
|
47.8 (44.66–51.58)
|
Variable
|
Univariate
|
Multivariate
|
|
---|---|---|---|
P value
|
HR (95% CI)
|
P Value
|
|
Overall survival
|
|||
Age (>65 vs. ≤65)
|
<0.001
|
1.615 (1.116–2.337)
|
0.011
|
Gender (male vs. female)
|
0.264
|
||
Histology type (NUC vs. UC)
|
0.363
|
||
Pathological grade (3 vs. 2)
|
<0.001
|
||
pT (pT2 or greater vs. pT1)
|
<0.001
|
2.796 (1.700–4.598)
|
<0.001
|
pN status (positive vs. negative)
|
<0.001
|
1.682 (1.141–2.480)
|
0.009
|
Smoking history
|
0.937
|
||
Hypertension
|
0.480
|
||
Diabetes Mellitus
|
0.534
|
||
Heart disease
|
0.018
|
||
Cerebrovascular disease
|
0.032
|
||
ASA grade (3&4 vs. 1&2)
|
<0.001
|
1.641 (1.113–2.418)
|
0.012
|
Hypoalbuminemia
|
<0.001
|
||
Anemia
|
<0.001
|
||
Postoperative complications
|
0.003
|
1.607 (1.076–2.400)
|
0.020
|
PNI (low vs. high)
|
<0.001
|
1.668 (1.147–2.425)
|
0.007
|
PLR (high vs. low)
|
<0.001
|
||
NLR (high vs. low)
|
<0.001
|
1.416 (1.094–2.016)
|
0.014
|
LMR (low vs. high)
|
<0.001
|
||
Progression-free survival
|
|||
Age (>65 vs. ≤65)
|
<0.001
|
||
Gender (male vs. female)
|
0.304
|
||
Histology type (NUC vs. UC)
|
0.683
|
||
Pathological grade (3 vs. 2)
|
<0.001
|
||
pT (pT2 or greater vs. pT1)
|
<0.001
|
2.560 (1.677–3.906)
|
<0.001
|
pN status (positive vs. negative)
|
<0.001
|
1.871 (1.306–2.680)
|
0.001
|
Smoking history
|
0.952
|
||
Hypertension
|
0.604
|
||
Diabetes Mellitus
|
0.681
|
||
Heart disease
|
0.012
|
||
Cerebrovascular disease
|
0.033
|
||
ASA grade (3&4 vs. 1&2)
|
<0.001
|
1.561 (1.086–2.243)
|
0.016
|
Hypoalbuminemia
|
<0.001
|
||
Anemia
|
<0.001
|
||
Postoperative complications
|
0.004
|
||
PNI (low vs. high)
|
<0.001
|
1.680 (1.092–2.005)
|
0.011
|
PLR (high vs. low)
|
<0.001
|
||
NLR (high vs. low)
|
<0.001
|
1.550 (1.140–2.388)
|
0.008
|
LMR (low vs. high)
|
<0.001
|
Variable
|
N
|
PNI
|
P value
|
NLR
|
P value
|
---|---|---|---|---|---|
Gender
|
0.068
|
0.406
|
|||
male
|
436
|
48.05 (44.95–51.75)
|
2.39 (1.77–3.47)
|
||
female
|
80
|
46.90 (43.87–50.05)
|
2.21 (1.59–3.97)
|
||
Age, years
|
<0.001
|
<0.001
|
|||
> 65
|
278
|
46.92 (43.33–49.68)
|
2.61 (1.95–3.91)
|
||
≤ 65
|
238
|
49.62 (46.25–53.22)
|
2.15 (1.68–2.92)
|
||
Histology type
|
0.396
|
0.667
|
|||
UC
|
488
|
47.80 (44.65–51.55)
|
2.33 (1.76–3.49)
|
||
NUC
|
28
|
48.95 (46.15–53.05)
|
2.67 (1.66–3.54)
|
||
Pathological grade
|
0.086
|
0.048
|
|||
2
|
131
|
48.65 (45.25–52)
|
2.24 (1.70–2.90)
|
||
3
|
385
|
47.65 (44.52–51.15)
|
2.43 (1.76–3.73)
|
||
T stage
|
<0.001
|
<0.001
|
|||
pT2 or greater
|
354
|
47.35 (44.05–50.65)
|
2.52 (1.90–3.93)
|
||
pT1
|
162
|
49.00 (46.20–52.97)
|
2.06 (1.63–2.68)
|
||
N status
|
0.250
|
0.041
|
|||
negative
|
435
|
48.00 (44.90–51.65)
|
2.29 (1.71–3.42)
|
||
positive
|
81
|
47.10 (43.87–51.02)
|
2.50 (1.99–3.96)
|
||
Smoking
|
0.109
|
0.524
|
|||
no
|
355
|
47.55 (44.40–51.57)
|
2.39 (1.72–3.64)
|
||
yes
|
161
|
48.70 (45.42–51.60)
|
2.33 (1.81–3.17)
|
||
Diabetes Mellitus
|
0.948
|
0.179
|
|||
no
|
460
|
47.8 (44.75–51.60)
|
2.32 (1.73–3.44)
|
||
yes
|
56
|
48 (44.50–51.28)
|
2.72 (1.81–3.99)
|
||
Hypertension
|
0.862
|
0.067
|
|||
no
|
367
|
47.80 (44.75–51.65)
|
2.27 (1.71–3.19)
|
||
yes
|
149
|
48.02 (44.57–51.15)
|
2.50 (1.82–3.75)
|
||
Heart disease
|
0.177
|
0.516
|
|||
no
|
461
|
47.97 (44.90–51.65)
|
2.31 (1.73–3.53)
|
||
yes
|
55
|
47.22 (43.70–50.56)
|
2.48 (1.78–3.09)
|
||
Cerebrovascular disease
|
0.277
|
0.045
|
|||
no
|
499
|
47.95 (44.71–51.6)
|
2.32 (1.72–3.44)
|
||
yes
|
17
|
47.10 (42.77–49.10)
|
2.69 (2.22–4.04)
|
||
Surgery style
|
0.278
|
0.806
|
|||
open
|
409
|
47.95 (44.9051.75)
|
2.37 (1.73–3.65)
|
||
laparoscopic
|
107
|
47.60 (44.2051.25)
|
2.28 (1.80–3.20)
|
||
Postoperative complications
|
0.129
|
0.730
|
|||
no
|
443
|
48.00 (45.05–51.55)
|
2.33 (1.76–3.47)
|
||
yes
|
73
|
46.35 (43.75–51.78)
|
2.37 (1.59–3.61)
|
||
ASA grade
|
<0.001
|
0.031
|
|||
1&2
|
436
|
48.05 (45.25–51.90)
|
2.30 (1.725–3.21)
|
||
3&4
|
80
|
46.00 (42.50–49.37)
|
2.53 (2.05–3.99)
|
||
Anemia
|
<0.001
|
<0.001
|
|||
no
|
372
|
49.07 (46.502.93)
|
2.23 (1.69–2.96)
|
||
yes
|
144
|
44.55 (40.90–47.38)
|
3.01 (2.00–4.42)
|