Full Length ArticleSignificance of the prognostic nutritional index in patients with glioblastoma: A retrospective study

- PNI was an independent prognostic factor to predict survival of patients with GBM.
- PNI could predict the effectiveness of adjuvant treatment in patients with GBM.
- No association observed between NLR, PLR, and LMR and OS of GBM patients.

ObjectiveAccumulating evidence demonstrates that prognostic nutritional index(PNI) is linked to the clinical outcome of patients with malignant tumors, but few studies had investigated the clinical significance of PNI in glioblastoma multiforme(GBM). This study aimed to clarify the association between PNI and the clinical outcome of patients with GBM.MethodsThe clinical data of 84 patients with GBM were retrospectively analyzed. PNI was calculated from the following formula: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). X-tile software was used to determine the cut-off of PNI and other hematological parameters. GBM patients were dichotomized as two groups based on the PNI cut-off.ResultsThe optimal PNI cut-off level was 44.4. There were 14 patients with a PNI < 44.4 and 70 patients with a PNI ≥ 44.4. The results showed that PNI score was associated with gender, serum albumin, and hemoglobin level. Univariate analysis suggested that age, extent of resection, adjuvant treatment, platelet count and PNI score were predictors of overall survival in patients with GBM. The 1- and 2-survival rates of patients with a PNI < 44.4 were 28.60 and 0%, respectively, while the corresponding values for patients with a PNI ≥ 44.4 were 52.90 and 5.70%, respectively. Based on multivariate analysis, a PNI ≥ 44.4 (HR:0.479, 95% CI:0.235-0.975,p = 0.042) remained an independent prognostic indicator for a favorable outcome of patients with GBM. Furthermore, patients with a PNI ≥ 44.4 may have a better efficacy of adjuvant treatment than patients with a PNI < 44.4 (HR:0.259, 95% CI:0.096-0.700, p = 0.008).ConclusionA PNI > 44.4 was an independent prognostic parameter of overall survival in patients with GBM and the efficacy of adjuvant treatment. Interventions aimed at correcting the nutritional and immune status of patients with GBM may, therefore, promote the effectiveness of adjuvant treatment and improve the survival outcomes.