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Prognostic nutritional index predicts prognosis and efficacy of first-line chemotherapy for metastatic pancreatic cancer |
Yang Lei, Su Jing, Wang Wenbo, Zhou Fuxiang |
Department of Radiation and Medical Oncology Zhongnan Hospital Wuhan University / Hubei Key Laboratory of Tumor Biological
Behaviors/ Hubei Cancer Clinical Study Center Wuhan 430071 Hubei China |
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Abstract Objective We aim to investigate the clinical value of prognostic nutritional index PNI in evaluating the prognosis of
patients with metastatic pancreatic cancer. Method Clinical data and follow-up data of 83 patients with metastatic pancreatic cancer
undergoing first-line chemotherapy from April 2017 to February 2022 in Zhongnan Hospital of Wuhan University were retrospectively
collected and analyzed. PNI value was calculated and the optimal cut-off point of PNI was determined using the receiver operation
characteristics ROC curve. Cox univariate and multivariate regression analysis and Kaplan-Meier curve were performed to evaluate
the prognostic value of PNI for metastatic pancreatic cancer patients. Result According to the ROC curve analysis the optimal cut-off
point of PNI was 43. 10. PNI was significantly correlated with objective response rate ORR progression free survival PFS and
overall survival OS of patients with metastatic pancreatic cancer receiving first-line chemotherapy. The median PFS and median OS
were 4. 61 95%CI = 3. 92-5. 30 and 9. 05 95%CI = 8. 20-9. 89 months respectively. The ORR in low PNI group and high PNI
group was 5. 9% and 32. 7% respectively P<0. 05 . The median progression free survival time mPFS of patients in low PNI group
and high PNI group were 2. 96 months 95%CI = 2. 53-3. 47 and 5. 67 months 95%CI = 4. 43-6. 21 respectively. There was a
significant difference between the two groups P<0. 01 . Meanwhile the median overall survival time mOS of patients in the low
PNI group and the high PNI group was 5. 92 months 95% CI = 5. 30 - 6. 55 and 11. 84 months 95% CI = 9. 10 - 14. 59
respectively. There was also a significant difference between the two groups P<0. 01 . Multivariate Cox regression analysis showed
that PNI HR = 0. 123 95% CI = 0. 061- 0. 248 P< 0. 01 was an independent prognostic factor of OS in patients with metastatic
pancreatic cancer. Conclusion PNI can be used as a prognostic factor for patients with metastatic pancreatic cancer.
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Received: 15 September 2022
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