Clinical impact of pretreatment prognostic nutritional index (PNI) in small cell lung cancer patients treated with platinum-based chemotherapy.

INTRODUCTION: Numbers of prognostic factors of small cell lung cancer (SCLC) have been demonstrated in previous studies. However, the identification of biomarkers with easy access, convenience, and low consumption is of great value in clinics.

OBJECTIVES: In order to find such a biomarker, a single institution study with 1156 SCLC patients was retrospectively conducted to assess the prognostic value of prognostic nutritional index (PNI) on SCLC patients treated with platinum-based chemotherapy.

METHODS: The optimal cut-off values were determined by a receiver operating characteristic (ROC) curve analysis. Univariate and multivariate analyses were used to assess their prognostic values for overall survival (OS).

RESULTS: On univariate analysis, age, smoking history, tumor stage, PNI, radiotherapy, and surgery were significantly associated with OS. Age, stage, PNI, radiotherapy, and surgery held statistical significance on multivariate analysis. High PNI was closely associated with younger age, limited disease, and radiotherapy. PNI was also demonstrated to be an independent prognostic factor in subgroups analysis, especially in patients with age ≤ 60, no smoking history, no family history of tumor, and no radiotherapy.

CONCLUSIONS: Age ≤ 60 years, limited disease, high PNI, radiotherapy, and surgery were independent positive prognostic factors of SCLC patients treated with chemotherapy. PNI was a good biomarker for the assessment of SCLC prognosis for its easy access, convenience to be calculated, and low consumption. Pretreatment PNI can better predict the prognosis of SCLC, especially in patients with age ≤ 60, no smoking history, no family history of tumor, and no radiotherapy.