Association of prognostic nutritional index with prognostic outcomes in patients with glioma: a meta-analysis and systematic review

Frontiers in Oncology

Oncology

Wan-Jung Cheng¹  I-Wen Chen¹  Chien-Hung Lin²  Cheuk-Kwan Sun³  Ting-Hui Liu⁴  Po-Yu Huang⁵  Yang-Pei Chang⁶  Jheng-Yan Wu⁷  Kuo-Chuan Hung⁸ 

[1] Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan;Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan;Department of Emergency Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan;School of Medicine for International, College of Medicine, I-Shou University, Kaohsiung, Taiwan;Department of General Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan;Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan;Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan;School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan;Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan;

关键词: glioma;    prognostic nutritional index;    overall survival;    progression-free survival;    prognosis;    nutrition;   

DOI  :  10.3389/fonc.2023.1188292

 received in 2023-03-17, accepted in 2023-07-04,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe potential link between Prognostic Nutritional Index (PNI) and prognosis in patients with glioma remains uncertain. This meta-analysis was conducted to assess the clinical value of PNI in glioma patients by integrating all available evidence to enhance statistical power.MethodA systematic search of databases including Medline, EMBASE, Google Scholar, and Cochrane Library was conducted from inception to January 8, 2023 to retrieve all pertinent peer-reviewed articles. The primary outcome of the study was to examine the association between a high PNI value and overall survival, while secondary outcome included the relationship between a high PNI and progression-free survival.ResultsIn this meta-analysis, we included 13 retrospective studies published from 2016 to 2022, which analyzed a total of 2,712 patients. Across all studies, surgery was the primary treatment modality, with or without chemotherapy and radiotherapy as adjunct therapies. A high PNI was linked to improved overall survival (Hazard Ratio (HR) = 0.61, 95% CI: 0.52 to 0.72, p < 0.00001, I2 = 25%), and this finding remained consistent even after conducting sensitivity analysis. Subgroup analyses based on ethnicity (Asian vs. non-Asian), sample size (<200 vs. >200), and source of hazard ratio (univariate vs. multivariate) yielded consistent outcomes. Furthermore, patients with a high PNI had better progression-free survival than those with a low PNI (HR=0.71, 95% CI: 0.58 to 0.88, p=0.001, I2 = 0%).ConclusionOur meta-analysis suggested that a high PNI was associated with better overall survival and progression-free survival in patients with glioma. These findings may have important implications in the treatment of patients with glioma. Additional studies on a larger scale are necessary to investigate if integrating the index into the treatment protocol leads to improved clinical outcomes in individuals with glioma.Systematic review registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42023389951].

【 授权许可】

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Copyright © 2023 Hung, Sun, Chang, Wu, Huang, Liu, Lin, Cheng and Chen