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Purpose <p>To validate the clinical impacts of the prognostic nutritional index (PNI), an immune-nutritional blood marker, in patients with resectable non-small cell lung cancer (NSCLC) using multicenter cohort data.</p> Methods <p>The subjects of this retrospective multicenter study, involving 11 hospitals, were patients who underwent curative lung resection for pathological stage IA-IIIA NSCLC. We analyzed the relationship between the preoperative PNI and postoperative outcomes. Patients were divided into a high PNI group and a low PNI group (cutoff: 45). We also performed exact matching and three propensity score-based methods to validate the results.</p> Results <p>Among the total 2,770 patients, 2,272 (82.0%) had a high PNI (&gt;45) and 498 (18.0%) had a low PNI (≤45). A low preoperative PNI was a predictor of increased overall postoperative complications (relative risk 1.49; 95% confidence interval (CI) 1.31–1.69) and an independent adverse prognostic factor for overall survival (hazard ratio 1.77; 95% CI 1.45–2.17) and recurrence-free survival (1.34; 95% CI 1.14–1.59). All the methods we used (whole cohort, exact matching, and three propensity score methods) showed consistent results.</p> Conclusions <p>The findings of this multicenter study suggest that immune-nutritional assessment using the PNI will provide useful prognostic information for patients with resectable NSCLC.</p>

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Clinical significance of the preoperative prognostic nutritional index in patients with resectable non-small cell lung cancer: a multicenter study

  • 期刊论文

  • 发表日期：

    2025年1月16日

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  • Mamoru Takahashi,
  • Akihiro Aoyama,
  • Masatsugu Hamaji,
  • Takashi Sozu,
  • Masashi Kobayashi,
  • Tatsuo Nakagawa,
  • Masashi Ishikawa,
  • Ryo Miyahara,
  • Cheng-long Huang,
  • Takuji Fujinaga,
  • Hiroaki Sakai,
  • Hiromichi Katakura,
  • Makoto Sonobe,
  • Norihito Okumura,
  • Hidenao Kayawake,
  • Toshi Menju,
  • Ei Miyamoto,
  • Ryo Miyata,
  • Harutaro Okada,
  • Tomoya Kono,
  • Ryota Sumitomo,
  • Naoki Date,
  • Takehisa Fukada,
  • Akira Matsumoto,
  • Yasuto Sakaguchi,
  • Hiroshi Date

摘要

Purpose

To validate the clinical impacts of the prognostic nutritional index (PNI), an immune-nutritional blood marker, in patients with resectable non-small cell lung cancer (NSCLC) using multicenter cohort data.

Methods

The subjects of this retrospective multicenter study, involving 11 hospitals, were patients who underwent curative lung resection for pathological stage IA-IIIA NSCLC. We analyzed the relationship between the preoperative PNI and postoperative outcomes. Patients were divided into a high PNI group and a low PNI group (cutoff: 45). We also performed exact matching and three propensity score-based methods to validate the results.

Results

Among the total 2,770 patients, 2,272 (82.0%) had a high PNI (>45) and 498 (18.0%) had a low PNI (≤45). A low preoperative PNI was a predictor of increased overall postoperative complications (relative risk 1.49; 95% confidence interval (CI) 1.31–1.69) and an independent adverse prognostic factor for overall survival (hazard ratio 1.77; 95% CI 1.45–2.17) and recurrence-free survival (1.34; 95% CI 1.14–1.59). All the methods we used (whole cohort, exact matching, and three propensity score methods) showed consistent results.

Conclusions

The findings of this multicenter study suggest that immune-nutritional assessment using the PNI will provide useful prognostic information for patients with resectable NSCLC.