Prognostic Nutritional Index predicts adverse events of chemotherapy in patients with esophageal cancer

Date

19 Dec 2015

Session

Poster presentation 1

Presenters

Yoshifumi Matsumoto

Citation

Annals of Oncology (2015) 26 (suppl_9): 42-70. 10.1093/annonc/mdv523

Authors

Y. Matsumoto1, M. Moriyama2, Q. Zhou2, Y. Saijo2

Author affiliations

  • 1 Medical Oncology, Niigata University Medical and Dental Hospital, 9518510 - Niigata/JP
  • 2 Medical Oncology, Niigata University Medical and Dental Hospital, Niigata/JP
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Aim/Background

The prognostic nutritional index (PNI) is useful to predict postoperative outcome in various cancer patients. However, the prognostic significance of the post-chemotherapy PNI is unclarified. The aim of this study was to investigate whether the PNI is associated with adverse events (AEs) due to chemotherapy in patients with esophageal cancer.

Methods

The clinical data of 277 patients with esophageal cancer who underwent chemotherapy were evaluated. All patients were treated with fluorouracil, including chemoradiotherapy (CRT), chemotherapy combined with surgical treatment, and after endoscopic submucosal dissection (ESD). The PNI was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm3), and was measured within a week before the chemotherapy. Then we evaluated the impact of PNI on AEs of each treatment.

Results

In this study, the median pre-treatment PNI was 45.50 (28.90-60.95). The median PNI of CRT after ESD was highest, and then adjuvant chemotherapy, palliative chemotherapy, radical CRT, palliative CRT were followed. The patients with low PNI were more likely to complicate grade 3 or higher non-hematologic or hematologic AEs, but the significant difference was not observed. Then we examined each anticancer drug of the chemotherapy. A correlation was found in the case of cisplatin used between the PNI and grade 3 to 4 hematologic AEs (N:209 p = 0.01).

Conclusions

There was no significant correlation between the PNI and AEs due to chemotherapy. Thus, we should subscribe the chemotherapy without de-escalation for patients with esophageal cancer, regardless of the PNI.

While the cisplatin plus fluorouracil therapy, the PNI value can be useful predictor of hematologic adverse events.

Clinical trial identification

Disclosure

All authors have declared no conflicts of interest.

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