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Poster display session

4450 - Prognostic nutritional index (PNI) is an independent prognostic factor in locoregionally advanced squamous cell head and neck cancer (LAHNSCC)

Date

10 Sep 2017

Session

Poster display session

Presenters

Gema Bruixola

Citation

Annals of Oncology (2017) 28 (suppl_5): v372-v394. 10.1093/annonc/mdx374

Authors

G. Bruixola1, J. Caballero2, F. Papaccio3, A. Petrillo3, M. Pastor2, A. Cervantes1

Author affiliations

  • 1 Medical Oncology, Biomedical Research institute INCLIVA - University of Valencia, 46010 - Valencia/ES
  • 2 Medical Oncology, Hospital Universitari i Politècnic La Fe, 46026 - Valencia/ES
  • 3 Oncology, Università degli Studi della Campania Luigi Vanvitelli, 80131 - Napoli/IT
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Abstract 4450

Background

There is increasing evidence that the presence of an ongoing systemic inflammation response and the nutritional status are a stage-independent predictor of poor outcome in cancer patients. This study aims to investigate association of the Prognostic Nutritional Index (PNI), a proposed marker of cancer-related inflammation and nutritional status, with survival in LAHNSCC patients (pts).

Methods

We included 137 LAHNSCC pts treated with induction chemotherapy (ICT) followed by concurrent chemoradiotherapy (CCRT) at Hospital La Fe (HFV) (n = 50) and Hospital Clínico (HCV) (n = 87) between 2011-2016; they were used as a training (HFV) and validation (HCV) set respectively. Demographic and clinical data were collected. All nutritional factors were measured within 5 days before ICT. PNI was calculated as: 10× serum albumin concentration (g/dL) + 0.005× lymphocyte count (number/mm2) in peripheral blood (Nozoe et al, 2010). Receiver operating characteristic (ROC) curve was used to determine the optimal cutoff for PNI in the HFV set. Cox regression models were used to investigate the association of PNI with OS.Table:

1091P The Prognostic Nutritional Index (PNI): definition

ScoreDefinitionMeaning
0 pointsPNI ≥ cutoff = PNI-high groupNormal nutritional status – Low risk
1 pointPNI < cutoff = PNI-low groupModerate severe nutritional impairment - High Risk

Results

At baseline, HFV pts were younger with a median age of 54.5 (41-59 years) vs 60.6(43-77 years) and with less advanced stage (stage III 18.8 vs 20.5%; stage IVA: 78.1 vs 62.1%; stage IVB:3.1 vs 17.2%). The optimal cutoff established in the HFV set was 45. According to this cutoff, 10 pts (20%) in HFV set had a low PNI. In HFV set, OS at 12-months follow-up (FU) was 75% in PNI-high group vs 37.5% in PNI-low group (P = 0.032) with a Hazard ratio of (HR) of 2.84 (95%CI 1.04-7.78) in the multivariate analysis. In the HCV set, a low PNI was found in 23 (26.4%) out of 87 pts. OS at 12-months FU was 95% in PNI-high group and 45% in PNI-low group (p = 0.007) with a HR of 3.9 (95% CI 1.45-10.98) in the multivariate analysis.

Conclusions

PNI is a valuable prognostic marker in LAHNSCC associated with survival in pts treated with ICT followed by CCRT. PNI could be useful for stratification in future clinical trials.

Clinical trial identification

None

Legal entity responsible for the study

Gema Bruixola

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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