Preoperative prognostic nutritional index predicts prognosis of patients with oral cavity cancer

Oral Dis. 2022 Oct;28(7):1816-1830. doi: 10.1111/odi.13840. Epub 2021 Apr 23.

Abstract

Objective: To investigate whether prognostic nutritional index (PNI) predicts patient survival outcomes in oral cavity squamous cell carcinoma (OSCC).

Materials and methods: The data of a total of 360 patients subjected to primary surgery for OSCC were retrospectively analysed. Patients were categorised into high-PNI (≥51.75) and low-PNI (<51.75) groups based on the PNI cut-off value attained from receiver operating characteristic analyses (p < .001), and the intergroup differences in clinicopathological features were determined. The Kaplan-Meier method and Cox proportional hazard model were employed to determine the survival prediction ability of the PNI, and a nomogram based on the PNI was established for individualised survival prediction.

Results: A low PNI was noted to exhibit a significant association with shorter overall survival (OS) and disease-free survival (DFS) (both p < .001). Multivariate Cox analyses showed that a lower PNI independently indicated shorter OS and DFS (hazard ratio [HR] = 2.187; p = .001 and HR = 1.459; p = .023, respectively). The concordance index and calibration plots of the PNI-based nomogram revealed the high discriminative ability for OS.

Conclusions: Preoperative PNI is a valuable biomarker for predicting OSCC prognosis, and the proposed PNI-based nomogram can provide individualised prognostic prediction.

Keywords: disease-free survival; nomogram; oral cavity squamous cell carcinoma; overall survival; prognostic nutritional index.

MeSH terms

  • Carcinoma, Squamous Cell* / surgery
  • Humans
  • Mouth Neoplasms* / surgery
  • Nutrition Assessment
  • Prognosis
  • Retrospective Studies