Prognostic significance of the pretreatment prognostic nutritional index in patients with epithelial ovarian cancer.

// Naoko Komura 1 , Seiji Mabuchi 1 , Eriko Yokoi 1 , Kotaro Shimura 1 , Mahiru Kawano 1 , Yuri Matsumoto 1 and Tadashi Kimura 1 1 Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan Correspondence to: Seiji Mabuchi, email: smabuchi@gyne.med.osaka-u.ac.jp Keywords: ovarian cancer; prognostic nutritional index; clinical stage; survival; prognostic factor Received: July 23, 2018     Accepted: April 14, 2019     Published: June 04, 2019 ABSTRACT Objective We retrospectively investigated the prognostic significance of the pretreatment prognostic nutritional index (PNI) in patients with epithelial ovarian cancer (EOC) according to the clinical stage. Methods The baseline characteristics and clinical outcomes of 308 EOC patients were collected and retrospectively reviewed. PNI was defined as 10 × serum albumin (g/L) + 0.005 × lymphocyte count (per mm 3 ) in the peripheral blood. The cut-off value of PNI was defined by time-dependent receiver operating characteristics (ROC) analysis. Univariate or multivariate analysis was conducted to evaluate the association between pretreatment PNI, progression-free survival (PFS), and disease-specific survival (DSS) according to the clinical stage. Results The cut-off value of PNI was defined as 44.7 in early-stage patients and 42.9 in advanced-stage patient by ROC analysis, respectively. Although decreased PNI was not associated with short PFS or DSS in early-stage patients, it was significantly correlated with short PFS (p<0.0001) and DSS (p<0.0001) in advanced-stage patients. In multivariate analysis, decreased PNI was an independent prognostic predictor of recurrence and short survival in advanced-stage patients. Conclusion A decreased pretreatment PNI was an independent poor prognostic factor in patients with advanced EOC.