Prognostic Significance of Pretreatment Prognostic Nutritional Index (PNI) in Patients with Nasopharyngeal Carcinoma: A Meta-Analysis

Abstract

Objective

Previous studies have investigated the pretreatment prognostic nutritional index (PNI) as a prognostic factor in patients with nasopharyngeal carcinoma (NPC); however, the results remained inconsistent. We aimed to assess the prognostic value of PNI in patients with NPC through conducting meta-analysis. Methods: Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for low PNI of overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), loco-regional recurrence-free survival (LRFS), and cancer-specific survival (CSS). Results: Totally, eight studies involving 4299 patients were included in this meta-analysis. A low pretreatment PNI was associated with poor OS (HR = 1.86, 95% CI = 1.55–2.33, P < 0.001), DMFS (HR = 2.03, 95% CI = 1.69–2.44, P < 0.001), PFS (HR = 1.57, 95% CI = 1.31–1.90, P < 0.001), and CSS (HR = 2.29, 95% CI = 1.54–3.42, P < 0.001). The subgroup analysis showed that low PNI remained a significant factor for poor OS, DMFS, and PFS irrespective of treatment, country, and cutoff value of PNI. In addition, low PNI was correlated to female gender (OR = 1.35, 95% CI = 1.12–1.62, P = 0.002), older age (OR = 1.75, 95% CI = 1.17–2.62, P = 0.007), and T3–T4 stage (OR = 1.27, 95% CI = 1.06–1.53, P = 0.011). Conclusions: A low PNI was associated with poor survival outcomes in patients with NPC. Moreover, PNI could serve as an index to help guide clinical management for older patients.

Disclosure Statement

The authors declare that they have no competing interests.

Authors’ Contributions

QLG collected and analyzed the data, wrote the paper; JGS and YDH collected and analyzed the data; YDH revised the whole paper. All authors reviewed the final paper. All authors read and approved the final manuscript.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ethics Approval and Consent to Participate

No ethical approval or informed consent statement was required for this article.