Prognostic nutritional index predicts outcomes of malignant pleural mesothelioma

J Cancer Res Clin Oncol. 2013 Dec;139(12):2117-23. doi: 10.1007/s00432-013-1523-0. Epub 2013 Oct 23.


Purpose: Nutritional status has been associated with long-time outcomes in cancer patients. We investigated whether the prognostic nutritional index (PNI), an indicator of nutritional status, affects overall survival in patients with malignant pleural mesothelioma (MPM).

Methods: We enrolled 121 patients with histologically confirmed MPM, who had successfully undergone biopsy by medical thoracoscopy in this study. Demographic, clinical and laboratory data were collected retrospectively. The PNI was calculated as 10× serum albumin value (g/dl) + 0.005 × total lymphocyte count (per mm(3)) in peripheral blood. Univariate and multivariate analyses were used to identify prognostic factors.

Results: Mean pretreatment PNI was 44.6. PNI was significantly associated with age (P = 0.031), smoking habits (P = 0.039) and weight loss (P = 0.029). Survival analysis showed PNI to be an independent prognostic factor in MPM. Patients with lower PNIs (PNI < 44.6) had greater risk of death than those with higher PNIs (PNI ≥ 44.6; hazard ratio: 2.290; 95 % confidence interval: 1.415-3.706; P = 0.001). These analyses were adjusted for patient age, gender, smoking habits, dyspnea, chest pain, weight loss, primary site of tumor, histology, platinum-based systemic chemotherapy, hospital and stage.

Conclusions: Pretreatment PNI is a novel independent prognostic factor in MPM.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Lung Neoplasms / mortality*
  • Male
  • Mesothelioma / mortality*
  • Mesothelioma, Malignant
  • Middle Aged
  • Nutrition Assessment*
  • Pleural Neoplasms / mortality*
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Young Adult