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Nutrition and Cancer Volume 74, 2022 - Issue 8
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Articles

Clinicopathological and Prognostic Significance of Preoperative Prognostic Nutritional Index in Patients with Upper Urinary Tract Urothelial Carcinoma

Jianyong Liua Department of Urology, Beijing Hospital, Beijing, People’s Republic of China;b National Center of Gerontology, Beijing, People’s Republic of China;c Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;d Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;e Beijing Hospital Continence Center, Beijing, People’s Republic of ChinaView further author information
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Pengjie Wua Department of Urology, Beijing Hospital, Beijing, People’s Republic of China;b National Center of Gerontology, Beijing, People’s Republic of China;c Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;e Beijing Hospital Continence Center, Beijing, People’s Republic of ChinaView further author information
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Shicong Laia Department of Urology, Beijing Hospital, Beijing, People’s Republic of China;b National Center of Gerontology, Beijing, People’s Republic of China;c Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;d Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaView further author information
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Xinda Songa Department of Urology, Beijing Hospital, Beijing, People’s Republic of China;b National Center of Gerontology, Beijing, People’s Republic of China;c Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;d Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaView further author information
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Miao Wanga Department of Urology, Beijing Hospital, Beijing, People’s Republic of China;b National Center of Gerontology, Beijing, People’s Republic of China;c Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;d Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;e Beijing Hospital Continence Center, Beijing, People’s Republic of ChinaView further author information
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Xuan Wanga Department of Urology, Beijing Hospital, Beijing, People’s Republic of China;b National Center of Gerontology, Beijing, People’s Republic of China;c Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;e Beijing Hospital Continence Center, Beijing, People’s Republic of ChinaView further author information
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Shengjie Liua Department of Urology, Beijing Hospital, Beijing, People’s Republic of China;b National Center of Gerontology, Beijing, People’s Republic of China;c Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;e Beijing Hospital Continence Center, Beijing, People’s Republic of ChinaView further author information
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Huimin Houa Department of Urology, Beijing Hospital, Beijing, People’s Republic of China;b National Center of Gerontology, Beijing, People’s Republic of China;c Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;e Beijing Hospital Continence Center, Beijing, People’s Republic of ChinaView further author information
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Yaoguang Zhanga Department of Urology, Beijing Hospital, Beijing, People’s Republic of China;b National Center of Gerontology, Beijing, People’s Republic of China;c Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;d Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;e Beijing Hospital Continence Center, Beijing, People’s Republic of ChinaCorrespondence[email protected]
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Jianye Wanga Department of Urology, Beijing Hospital, Beijing, People’s Republic of China;b National Center of Gerontology, Beijing, People’s Republic of China;c Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;d Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;e Beijing Hospital Continence Center, Beijing, People’s Republic of ChinaCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0003-4667-9365View further author information
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Pages 2964-2974 | Received 20 Nov 2020, Accepted 16 Feb 2022, Published online: 17 Mar 2022
 
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Abstract

Purpose:

To investigate the prognostic value of preoperative prognostic nutritional index (PNI) to predict oncological outcome and intravesical recurrence (IVR) in upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU).

Method:

This study involved the clinical data of 255 patients with UTUC who had undergone RNU from 2004 to 2019 at our institution. Patients were grouped according to an optimal value of preoperative PNI. Kaplan–Meier analyses and Cox proportional hazards models were used to analyze the associations of preoperative PNI with progression-free survival (PFS), cancer-specific survival (CSS), overall survival (OS), and IVR.

Result:

Patients with low PNI were more likely to be older, have higher tumor stage, higher eGFR, and multifocal lesions. No significant association was found between PNI and CSS, IVR. In subgroup analysis according to the risk stratification, low PNI was associated with worse PFS, CSS, and OS for patients with higher risk. Multivariate analyses showed that elevated PNI was an independent prognostic indicator for PFS (P = 0.014) and OS (P = 0.048).

Conclusion:

A low PNI is an independent predictor of PFS and OS in patients with UTUC after RNU. By subgroup analysis, the prognostic value of PNI was limited to patients with higher risk. PNI may become a useful biomarker to predict oncological outcomes in patients with UTUC after RNU.

Acknowledgment

The authors thank Xieraili Tiemuerniyazi, Ph.D., from the Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College for assistance with the statistical analysis.

Ethical Approval

This was a retrospective study and clinical data were de-identified before analysis; therefore, ethical approval was not required. Our study follows the principles of the Declaration of Helsinki.

Availability of Data and Material

All data generated or analyzed during this study are included in this published article.

Disclosure Statement

The authors declare that they have no competing interests.

Additional information

Funding

The study was funded by National Natural Science Foundation of China (grant number: 81900700); Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (grant number: 2018-I2M-1-002); National Key R&D Program of China (grant number: 2018YFC2002202), and Beijing Hospital Topics (grant number: BJ-2015-098).

Notes on contributors

Jianyong Liu

Jianyong Liu: Project development, Data collection, Data analysis, Manuscript writing; Pengjie Wu: Project development, Data collection, Data analysis, Manuscript writing; Shicong Lai: Data collection, Data analysis, Manuscript editing; Xinda Song: Data collection, Manuscript writing; Miao Wang: Data collection, Manuscript writing; Xuan Wang: Data analysis, Manuscript editing; Shengjie Liu: Data analysis, Manuscript editing; Huimin Hou: Data analysis, Manuscript editing; Yaoguang Zhang: Project development, Data analysis, Manuscript editing; Jianye Wang: Project development, Data analysis, Manuscript editing.

Pengjie Wu

Jianyong Liu: Project development, Data collection, Data analysis, Manuscript writing; Pengjie Wu: Project development, Data collection, Data analysis, Manuscript writing; Shicong Lai: Data collection, Data analysis, Manuscript editing; Xinda Song: Data collection, Manuscript writing; Miao Wang: Data collection, Manuscript writing; Xuan Wang: Data analysis, Manuscript editing; Shengjie Liu: Data analysis, Manuscript editing; Huimin Hou: Data analysis, Manuscript editing; Yaoguang Zhang: Project development, Data analysis, Manuscript editing; Jianye Wang: Project development, Data analysis, Manuscript editing.

Shicong Lai

Jianyong Liu: Project development, Data collection, Data analysis, Manuscript writing; Pengjie Wu: Project development, Data collection, Data analysis, Manuscript writing; Shicong Lai: Data collection, Data analysis, Manuscript editing; Xinda Song: Data collection, Manuscript writing; Miao Wang: Data collection, Manuscript writing; Xuan Wang: Data analysis, Manuscript editing; Shengjie Liu: Data analysis, Manuscript editing; Huimin Hou: Data analysis, Manuscript editing; Yaoguang Zhang: Project development, Data analysis, Manuscript editing; Jianye Wang: Project development, Data analysis, Manuscript editing.

Xinda Song

Jianyong Liu: Project development, Data collection, Data analysis, Manuscript writing; Pengjie Wu: Project development, Data collection, Data analysis, Manuscript writing; Shicong Lai: Data collection, Data analysis, Manuscript editing; Xinda Song: Data collection, Manuscript writing; Miao Wang: Data collection, Manuscript writing; Xuan Wang: Data analysis, Manuscript editing; Shengjie Liu: Data analysis, Manuscript editing; Huimin Hou: Data analysis, Manuscript editing; Yaoguang Zhang: Project development, Data analysis, Manuscript editing; Jianye Wang: Project development, Data analysis, Manuscript editing.

Miao Wang

Jianyong Liu: Project development, Data collection, Data analysis, Manuscript writing; Pengjie Wu: Project development, Data collection, Data analysis, Manuscript writing; Shicong Lai: Data collection, Data analysis, Manuscript editing; Xinda Song: Data collection, Manuscript writing; Miao Wang: Data collection, Manuscript writing; Xuan Wang: Data analysis, Manuscript editing; Shengjie Liu: Data analysis, Manuscript editing; Huimin Hou: Data analysis, Manuscript editing; Yaoguang Zhang: Project development, Data analysis, Manuscript editing; Jianye Wang: Project development, Data analysis, Manuscript editing.

Xuan Wang

Jianyong Liu: Project development, Data collection, Data analysis, Manuscript writing; Pengjie Wu: Project development, Data collection, Data analysis, Manuscript writing; Shicong Lai: Data collection, Data analysis, Manuscript editing; Xinda Song: Data collection, Manuscript writing; Miao Wang: Data collection, Manuscript writing; Xuan Wang: Data analysis, Manuscript editing; Shengjie Liu: Data analysis, Manuscript editing; Huimin Hou: Data analysis, Manuscript editing; Yaoguang Zhang: Project development, Data analysis, Manuscript editing; Jianye Wang: Project development, Data analysis, Manuscript editing.

Shengjie Liu

Jianyong Liu: Project development, Data collection, Data analysis, Manuscript writing; Pengjie Wu: Project development, Data collection, Data analysis, Manuscript writing; Shicong Lai: Data collection, Data analysis, Manuscript editing; Xinda Song: Data collection, Manuscript writing; Miao Wang: Data collection, Manuscript writing; Xuan Wang: Data analysis, Manuscript editing; Shengjie Liu: Data analysis, Manuscript editing; Huimin Hou: Data analysis, Manuscript editing; Yaoguang Zhang: Project development, Data analysis, Manuscript editing; Jianye Wang: Project development, Data analysis, Manuscript editing.

Huimin Hou

Jianyong Liu: Project development, Data collection, Data analysis, Manuscript writing; Pengjie Wu: Project development, Data collection, Data analysis, Manuscript writing; Shicong Lai: Data collection, Data analysis, Manuscript editing; Xinda Song: Data collection, Manuscript writing; Miao Wang: Data collection, Manuscript writing; Xuan Wang: Data analysis, Manuscript editing; Shengjie Liu: Data analysis, Manuscript editing; Huimin Hou: Data analysis, Manuscript editing; Yaoguang Zhang: Project development, Data analysis, Manuscript editing; Jianye Wang: Project development, Data analysis, Manuscript editing.

Yaoguang Zhang

Jianyong Liu: Project development, Data collection, Data analysis, Manuscript writing; Pengjie Wu: Project development, Data collection, Data analysis, Manuscript writing; Shicong Lai: Data collection, Data analysis, Manuscript editing; Xinda Song: Data collection, Manuscript writing; Miao Wang: Data collection, Manuscript writing; Xuan Wang: Data analysis, Manuscript editing; Shengjie Liu: Data analysis, Manuscript editing; Huimin Hou: Data analysis, Manuscript editing; Yaoguang Zhang: Project development, Data analysis, Manuscript editing; Jianye Wang: Project development, Data analysis, Manuscript editing.

Jianye Wang

Jianyong Liu: Project development, Data collection, Data analysis, Manuscript writing; Pengjie Wu: Project development, Data collection, Data analysis, Manuscript writing; Shicong Lai: Data collection, Data analysis, Manuscript editing; Xinda Song: Data collection, Manuscript writing; Miao Wang: Data collection, Manuscript writing; Xuan Wang: Data analysis, Manuscript editing; Shengjie Liu: Data analysis, Manuscript editing; Huimin Hou: Data analysis, Manuscript editing; Yaoguang Zhang: Project development, Data analysis, Manuscript editing; Jianye Wang: Project development, Data analysis, Manuscript editing.

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