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- Title
Preoperative Prognostic Nutritional Index is a Significant Predictor of Survival with Bladder Cancer after Radical Cystectomy: a retrospective study.
- Authors
Ding Peng; Yan-qing Gong; Han Hao; Zhi-song He; Xue-song Li; Cui-jian Zhang; Li-qun Zhou; Peng, Ding; Gong, Yan-Qing; Hao, Han; He, Zhi-Song; Li, Xue-Song; Zhang, Cui-Jian; Zhou, Li-Qun
- Abstract
<bold>Background: </bold>To explore the prognostic significance of preoperative prognostic nutritional index (PNI) in bladder cancer after radical cystectomy and compare the prognostic ability of inflammation-based indices.<bold>Methods: </bold>We retrospectively analyzed data for 516 patients with bladder cancer who underwent radical cystectomy in our institution between 2006 to 2012. Clinicopathologic characteristics and inflammation-based indices (PNI, neutrophil/lymphocyte ratio [NLR], platelet/lymphocyte ratio [PLR], lymphocyte/monocyte ratio [LMR]) were evaluated by pre-treatment measurements. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method and compared by log-rank test. Multivariate analysis with a Cox proportional hazards model was used to confirm predictors identified on univariate analysis. The association between clinicopathological characteristics and PNI or NLR was tested.<bold>Results: </bold>Among the 516 patients, the median follow-up was 37 months (interquartile range 20 to 56). On multivariate analysis, PNI and NLR independently predicted OS (PNI: hazard ratio [HR] = 1.668, 95% CI: 1.147-2.425, P = 0.007; NLR: HR = 1.416, 95% CI:1.094-2.016, P = 0.0149) and PFS (PNI: HR = 1.680, 95% CI:1.092-2.005, P = 0.015; NLR: HR = 1.550, 95% CI:1.140-2.388, P = 0.008). Low PNI predicted worse OS for all pathological stages and PFS for T1 and T2 stages. Low PNI was associated with older age (>65 years), muscle-invasive bladder cancer, high American Society of Anesthesiologists grade and anemia.<bold>Conclusion: </bold>PNI and NLR were independent predictors of OS and PFS for patients with bladder cancer after radical cystectomy and PNI might be a novel reliable biomarker for bladder cancer.
- Subjects
BLADDER cancer; CYSTECTOMY; URINARY diversion; LYMPHOCYTES; MULTIVARIATE analysis; UNIVARIATE analysis; PROPORTIONAL hazards models; BLADDER tumors; NUTRITIONAL assessment; PROGNOSIS; RETROSPECTIVE studies; PREOPERATIVE period; KAPLAN-Meier estimator; DIAGNOSIS
- Publication
BMC Cancer, 2017, Vol 17, p1
- ISSN
1471-2407
- Publication type
Academic Journal
- DOI
10.1186/s12885-017-3372-8