Prognostic nutritional index before adjuvant chemotherapy predicts chemotherapy compliance and survival among patients with non-small-cell lung cancer

Figures & data

Table 1 Patient characteristics enrolled in this study (n=106)

	Number	%
Sex
Men	74	69.8
Women	32	30.2
Age, mean ± SD	66.9±8.7
Histology
Adenocarcinoma	72	67.9
Squamous cell carcinoma	20	18.9
Large-cell carcinoma	7	6.6
Adenosquamous carcinoma	3	2.8
Pleomorphic carcinoma	4	3.8
Tumor differentiation
Well	26	24.5
Moderate	37	34.9
Poor	43	40.6
Nodal status
N0	61	57.6
N1	22	20.7
N2	23	21.7
Pathological stage
IA	11	10.4
IB	37	35.0
IIA + IIB	29	27.3
IIIA	29	27.3
Chemotherapy regimen
PB agent	53	50.0
CBDCA + paclitaxel	29
CBDCA + gemcitabine	12
CDDP + vinorelbine	7
CBDCA + S-1	5
OT agent	53	50.0
UFT	39
S-1	14

Abbreviations: CDDP, cisplatin; CBDCA, carboplatin; UFT, tegafur-uracil; OT, oral tegafur; PB, platinum-based.

Table 2 Patient characteristics according to chemotherapy regimen

Characteristics	PB chemotherapy	Oral-FT chemotherapy	P-value
Patients, number	53	53
Age, mean ± SD	65.1±8.4	68.6±8.7	0.036
Sex			0.526
Male	39	35
Female	14	18
Histology			0.451
Adenocarcinoma	32	40
Squamous cell carcinoma	11	9
Large-cell carcinoma	6	1
Adenoaquamous carcinoma	2	1
Pleomorphic carcinoma	2	2
Tumor size (mean), mm	36.6	35.3	0.644
Pathological nodal status			0.001
pN0	19	42
pN1	16	6
pN2	18	5
Pathological stage			0.001
IA	0	11
IB	12	25
IIA + IIB	17	12
IIIA	24	5
PNI
Before surgery, mean ± SD	52.7±5.9	50.9±5.5	0.102
Before chemotherapy, mean ± SD	49.7±4.7	49.9±5.3	0.815

Abbreviations: PNI, prognostic nutritional index; PB, platinum-based; FT, tegafur.

Table 3 Treatment compliance according to PNI

Characteristics	PNI before chemotherapy
	<50	≥50	P-value
PB chemotherapy
Patients, number	29	24
Treatment compliance			0.999
4 cycle (complete)	27 (93.1%)	23 (95.8%)
≤3 cycle	2	1
Treatment discontinuation reason
Adverse effect	2	0
Recurrence	0	1
Oral-FT chemotherapy
Patients, number	25	28
Treatment compliance			0.010
Completea	9 (36.0%)	20 (71.4%)
Incomplete	16	8
Treatment discontinuation reason
Adverse effect	8	4
Recurrence	8	4

Notes:

a Complete; UFT: 2 years, S-1: 1 year.

Abbreviations: PNI, prognostic nutritional index; UFT, tegafur–uracil; PB, platinum-based; FT, tegafur.

Figure 1 Kaplan–Meier recurrence-free survival curve according to the prognostic nutritional index before adjuvant chemotherapy: log-rank P=0.001 (number of patients; PNI <50=54, PNI ≥50=52).

Abbreviation: PNI, prognostic nutritional index.

Table 4 Prognostic analysis of factors predicting recurrence-free survival in adjuvant chemotherapy: univariate and multivariate analysis in all cases

	Univariate			Multivariate
	HR	95% CI	P-value	HR	95% CI	P-value
Sex
Male/female	0.89	0.46–1.73	0.731	1.06	0.50–2.24	0.887
Age
>70/≤70	1.68	0.90–3.15	0.107	1.28	0.64–2.58	0.489
Tumor size (mm)
>30/≤30	0.83	0.44–1.57	0.561	0.92	0.45–1.90	0.828
Nodal metastasis
Positive/negative	5.27	2.59–10.72	<0.001	8.21	3.52–19.18	<0.001
Histological type
SQ/non-SQ	0.57	0.22–1.45	0.235	0.40	0.15–1.06	0.064
PNI before surgery
<50/≥50	1.19	0.63–2.26	0.590	1.96	0.87–4.44	0.107
PNI before chemotherapy
<50/≥50	3.38	1.67–6.81	0.001	3.00	1.40–6.41	0.005

Notes: P-values in bold indicate significance (P<0.05).

Abbreviations: SQ, squamous cell carcinoma; PNI, prognostic nutritional index; HR, hazard ratio; CI, confidence interval.

Figure 2 Kaplan–Meier recurrence-free survival curve according to the prognostic nutritional index before adjuvant chemotherapy.

Notes: (A) PB chemotherapy, and (B) oral-FT chemotherapy.
Abbreviations: PNI, prognostic nutritional index; PB, platinum-based; FT, tegafur.

Table 5 Prognostic analysis of factors predicting recurrence-free survival in adjuvant chemotherapy: multivariate analysis according to chemotherapy regimens

	PB chemotherapy			Oral-FT chemotherapy
	HR	95% CI	P-value	HR	95% CI	P-value
Nodal metastasis
Positive/negative	35.6	4.00–316.4	0.001	4.93	1.23–19.74	0.024
PNI before chemotherapy
<50/≥50	2.58	0.85–7.85	0.095	5.45	1.32–22.39	0.019

Notes: P-values in bold indicate significance (P<0.05).

Abbreviations: PNI, prognostic nutritional index; PB, platinum-based; HR, hazard ratio; CI, confidence interval; FT, tegafur.