Impact of prognostic nutritional index on survival in recurrent glioblastoma

Ozkan Alan; Tugba Akın Telli; Tugba Basoğlu; Rukiye Arikan; Nazim Can Demircan; Ozlem Ercelep; Mustafa Sakar; Suheyla Bozkurt; Beste Melek Atasoy; Faysal Dane; Mustafa İbrahim Ziyal; Perran Fulden Yumuk

doi:10.1016/j.neucir.2020.11.005

Impact of prognostic nutritional index on survival in recurrent glioblastoma

Neurocirugia (Astur : Engl Ed). 2021 Jan 13:S1130-1473(20)30136-6. doi: 10.1016/j.neucir.2020.11.005. Online ahead of print.

[Article in English, Spanish]

Affiliations

¹ Department of Internal Medicine Division of Medical Oncology, Marmara University School of Medicine, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey. Electronic address: ozkan.alan@hotmail.com.
² Department of Internal Medicine Division of Medical Oncology, Marmara University School of Medicine, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey.
³ Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey.
⁴ Department of Pathology, Marmara University School of Medicine, Istanbul, Turkey.
⁵ Department of Radiation Oncology, Marmara University School of Medicine, Istanbul, Turkey.

PMID: 33454185
DOI: 10.1016/j.neucir.2020.11.005

Abstract

Background: Primary brain tumors are relatively rare malignancy, with high-grade gliomas (glioblastoma multiforme and anaplastic gliomas) are the most common types. We aimed to evaluate the prognostic value of Prognostic Nutritional Index (PNI), which is calculated by lymphocyte count and albumin, in recurrent glioblastoma patients treated with systemic treatment.

Methods: Data of 64 patients with recurrent glioblastoma who received systemic treatment and followed in our clinic between 2012 and 2018 was retrospectively collected and analyzed. PNI was calculated as: [(10×serum albumin (g/dL))+(0.005×total lymphocyte count)]. Patients were categorized according to the median PNI value. We investigated the prognostic role of PNI groups, and survival outcomes.

Results: Median value of PNI was 45.7, and median follow-up duration was 9 months (1-68 months). Median overall survival (OS) was 7.9 months (95%CI: 5.5-10.4). Median OS was significantly longer in patients with PNI>45.7 compared to patients with PNI≤45.7 (13.9 months (95%CI: 10.5-17.4), and 4.6 months (95%CI: 2.5-6.8), p<0.001, respectively). In multivariate analysis, PNI was found to be an independent prognostic factor for OS [HR:0.41 (95%CI:0.22-0.74), p=0.03)].

Conclusion: In our study, the PNI was found to be an independent prognostic biomarker in patients with recurrent glioblastoma, but further prospective trials are necessary to validate its prognostic role.

Keywords: Glioblastoma; Inflammatory-based indices; Overall survival; Prognostic Nutritional Index; Prognostic nutritional index; Supervivencia global; Systemic treatment; Tratamiento sistémico; Índices de inflamación.