Prognostic nutritional index (PNI) Medical Presentation

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Prognostic Nutritional Index Predicts Prognosis In Patients with Metastatic Nasopharyngeal Carcinoma La Ode Jumadil Jaya Sentosa Pembimbing : Dr.dr. Nova A.L. Pieter, SpT.H.T.K.L(K), FICS Wei Gan-Bao, Lu Yao Yong, Chen Qing-Sheng, Zhang Kun-Qiang. Dove Press Journal : Onco Targets and Therapy Sep 28th 2016 1
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ABSTRACT ABSTRACT 2
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ABSTRACT Objective This study aimed to investigate the prognostic value of Onodera’s prognostic nutritional index (PNI) in patients with metastatic nasopharyngeal carcinoma (NPC). 3
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ABSTRACT Methods A total of 187 patients with metastatic NPC treated with cisplatin-based chemotherapy were retrospectively reviewed. The PNI was calculated using the following formula: serum albumin level (gram per liter) +0.005× peripheral lymphocyte count (per cubic millimeter). A receiver operating characteristics curve for overall survival (OS) with the highest Youden index was determined to calculate the best cutoff value of PNI. The relationship between PNI and clinicopathological parameters was compared with the χ test. Survival analysis was applied to evaluate the predictive value of PNI. 4
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ABSTRACT Results Results: The median PNI in this study was 49.0 (ranging from 32.2 to 78.4). The best cutoff value of PNI for OS was 51.0 according to the receiver operating characteristics analysis. The median OS time was 13.0 months. The multivariate analysis indicated that the complete response (hazard ratio 0.681, 95% confidence interval 0.574–0.902; P=0.013) and PNI (hazard ratio 1.732, 95% confidence interval 1.216–2.892; P=0.005) were independent prognostic factors for OS in patients with metastatic NPC 5
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ABSTRACT Conclusion This study revealed that PNI is a simple and effective predictor for overall survival in patients with metastatic NPC. 6
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INTRODUCTION INTRODUCTION 7
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INTRODUCTION Nasopharyngeal Carcinoma High Incidence Rate Failure of Treatment in Far Metastasis Need Identify High-Risk Patients ↓ 8
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Lymposit & Albumin Survival in several types of malignancies 9 PNI AIM To investigate the PNI value in patients with metastatic nasopharyngeal carcinoma
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SUBJECTS AND METHODS SUBJECTS AND METHODS 10
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Ethics Statement Ethics Committee of People’s Hospital of Gaozhou, Guangdong, People’s Republic of China. Principles of the Declaration of Helsinki. Informed concent 11
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Patient Characteristics January 2003 - June 2013, 187 patients People’s Hospital of Gaozhou Metastatic NPC Treated with first-line cisplatin-based chemotherapy Stage IVC 12
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Subjects 13
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Subjects 14
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Material Whole Blood : WBC Lym Neu Hb PLT Albumin Total Bilirubin ALP 15 PNI (Albumin) + (0,005 x peripheral lymphocyte count)
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Material Serum Epstein-Barr Virus : VCA/IgA EA/IgA 16
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Chemotherapy 17 97 patients (51.9%) PF regimen Cisplatin, 25 mg/m IV on Days 1–3 every 3 weeks 5-fluororacil, 500 mg/m IV on Days 1–5 every 3 weeks 56 patients (29.9%) TP regimen Cisplatin, 25 mg/m2 IV on Days 1–3 every 3 weeks Paclitaxel, 175 mg/m IV over 3 hr with std premedic on day 1 every 3 wk 34 patients (18.2%) received other regimens. The median number of cycles of chemotherapy was 4 (ranging from 2 to 12
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Follow Up 3 months during the first 2 years 6 months thereafter for up to 5 years or until death Physical examination, blood test, and imaging studies of the relevant region. The response of treatment was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST 1.0) The end of follow-up was November 2015 18
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Statistical Analysis SPSS 21.0 software 19
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RESULTS RESULTS 20
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Grafik 1. Proportion of consentations of serum magnesium from population 21
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22
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24
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25 20 % 8 %
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26
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27 VCA
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29 PNI
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31 EA
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DISCUSSION DISCUSSION 33
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DISCUSSION 34
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DISCUSSION 35
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DISCUSSION 36
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STRENGTH STRENGTH 37
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STRENGTH The first study to explore the prognostic value of PNI in metastatic NPC patients. 38
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LIMITATION LIMITATION 39
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LIMITATION Retrospective nature Relatively small number of metastatic NPC patients in a single institution. PNI was only assessed at a single time point before the treatment. 40
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CONCLUSION CONCLUSION 41
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CONCLUSION This study revealed that PNI is a simple and effective predictor for OS in patients with metastatic NPC 42
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CONCLUSION TERIMA KASIH 43