Prognostic nutrition index affects the prognosis of patients undergoing trimodality therapy for locally advanced non-sma
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ORIGINAL ARTICLE
Prognostic nutrition index affects the prognosis of patients undergoing trimodality therapy for locally advanced non‑small cell lung cancer Junichi Soh1,4 · Ken Suzawa1 · Kazuhiko Shien1 · Shinji Otani1 · Hiromasa Yamamoto1 · Mikio Okazaki1 · Seiichiro Sugimoto1 · Kuniaki Katsui2 · Masaomi Yamane1 · Katsuyuki Kiura3 · Susumu Kanazawa2 · Shinichi Toyooka1 Received: 3 March 2020 / Accepted: 22 May 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose Trimodality therapy, comprised of induction chemoradiotherapy (iCRT) followed by surgery, is a highly invasive treatment option for locally advanced non-small cell lung cancers (LA-NSCLCs; defined as a heterogenous disease). We conducted this study to investigate the prognostic nutritional index (PNI) of LA-NSCLC patients undergoing trimodality therapy, which has not been studied in detail before. Methods The subjects of this retrospective study were 127 patients who underwent trimodality therapy between 1999 and 2016. We measured the PNI at three points: before iCRT (pre-iCRT), before the operation, and after the operation. Results PNIs decreased significantly as treatment progressed. Patients with clinical T3/4 (cT3/4) disease had a significantly lower PNI than those with cT1/2 disease, but the extent of lymph-node metastasis did not affect the PNI at any point. Using the cut-off values of receiver-operating curve analyses, multivariable analyses revealed that a high PNI pre-iCRT correlated significantly with a better survival of LA-NSCLC patients, especially those with cT3/4 disease (hazard ratio 3.84; 95% confidential interval 1.34–12.5, P = 0.012). Conclusions Measuring the PNI before trimodality therapy is important for predicting the clinical outcome of patients with LA-NSCLC, with differing predictive ability according to the disease extent. Perioperative intensive nutritional intervention must be considered for patients who undergo trimodality therapy for LA-NSCLC. Keywords Nutrition · Induction chemoradiotherapy followed by surgery · Prognosis Meeting presentation: Presented in part at the 20th World Conference on Lung Cancer, Barcelona, SPAIN, September 7 to 10, 2019 (Final results) and at the 17th World Conference on Lung Cancer, Vienna, AUSTRIA, December 4 to 7, 2016 (Preliminary analyses). Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00595-020-02067-7) contains supplementary material, which is available to authorized users. * Junichi Soh [email protected] 1
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Departments of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2‑5‑1 Shikata‑cho, Kita‑ku, Okayama 700‑8558, Japan
Introduction Lung cancer is the leading cause of cancer-related death in the world [1]. The standard treatment for early stage nonsmall cell lung cancer (NSCLC) is surgery, whereas that recommended, by several reports, for locally advanced NSCLC 3
Department of Respiratory Medicine, Ok
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