Use of the Prognostic Nutritional Index to predict clinical outcomes of patients with terminal stage cancer
10.2512/jspm.8.199
- VernacularTitle:がん終末期予後予測因子としてのPrognostic Nutritional Indexの有用性に関する検討
- Author:
Yoichi Nakamura
;
Jiro Nagao
;
Yoshihisa Saida
;
Manabu Watanabe
;
Yasushi Okamoto
;
Koji Asai
;
Toshiyuki Enomoto
;
Takaharu Kiribayashi
;
Shinya Kusachi
- Publication Type:Journal Article
- Keywords:
cancer;
palliative care;
survival prediction prognosis;
Prognostic Nutritional Index
- From:Palliative Care Research
2013;8(2):199-202
- CountryJapan
- Language:Japanese
-
Abstract:
Introduction: The importance of estimating the prognosis of advanced cancer patients is well known, but clinicians do not estimate survival time accurately. Since there is a need for an objective index to estimate survival time, the utility of the Prognostic Nutritional Index (PNI), which depends only on objective factors, was evaluated. Methods: The PNI was calculated using the following formula, PNI=10×serum albumin value (g/dL)+0.005×lymphocyte count in peripheral blood, at 3 months, 2 months, 1 month, 3 weeks, 2 weeks, 1 week, and within 3 days before death in 278 cancer patients (166 men, 112 women; age range, 33-99 years; mean age, 69.8 years) who died in a hospital surgical unit. Results: Sites of primary diseases included lung, breast, esophagus, stomach, colorectum, liver, biliary tract, and pancreas. The PNI values showed a gradual decrease over time. Changes in the PNI values were lower in non-gastrointestinal cancer patients than in gastrointestinal cancer patients. The mean PNI value was significantly higher in patients who lived >3 weeks (38.8) than in those who died within 3 weeks (32.4). When the PNI cut-off point was set at 35, and it was assumed that the life expectancy was within 3 weeks in cases with PNI <35, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 74.8%, 62.2%, 68.1%, and 69.6%, respectively. Discussion: The PNI appears to be a useful and simple parameter to predict clinical outcomes of patients with terminal stage cancer. Particularly, the PNI is considered feasible for gastrointestinal cancer patients.
