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. 2018 Dec 17:18:207.
doi: 10.1186/s12935-018-0708-7. eCollection 2018.

Pre-treatment prognostic nutritional index may serve as a potential biomarker in urinary cancers: a systematic review and meta-analysis

Feng Qi #  1 , Xiang Zhou #  1 , Yi Wang #  1 , Yamin Wang  1 , Yichun Wang  1 , Qijie Zhang  1 , Rong Cong  1 , Jie Yang  1 , Ninghong Song  1
Affiliations

Pre-treatment prognostic nutritional index may serve as a potential biomarker in urinary cancers: a systematic review and meta-analysis

Feng Qi et al. Cancer Cell Int. .

Abstract

Background: To investigate the potential prognostic role of pre-treatment prognostic nutritional index (PNI) in urinary cancers.

Methods: Relevant articles were searched comprehensively from PubMed, Embase and Web of Science, up to November 2018. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted to evaluate their associations.

Result: A total of 12 related articles including 6561 patients were ultimately enrolled. Our results indicated that a relatively lower level of pre-treatment PNI was associated with decreased OS, CSS/DSS and DFS/RFS/PFS (pooled HR = 1.68, 95% CI 1.45-1.95; pooled HR = 1.57, 95% CI 1.33-1.86; pooled HR = 1.75, 95% CI 1.53-1.99, respectively). Subsequent stratified analysis by cancer type for OS showed that PNI could also be a predictor no matter in renal cell cancer (RCC) or bladder cancer (BC) (pooled HR = 1.65, 95% CI 1.37-1.97 and pooled HR = 1.67, 95% CI 1.20-2.33). Similar results could be found in DFS/RFS/PFS (RCC: HR = 1.81, 95% CI 1.54-2.13 and BC: HR = 1.68, 95% CI 1.32-2.12) and in CSS/DSS (RCC: HR = 1.50, 95% CI 1.23-1.82 and upper tract urothelial carcinoma: HR = 1.61, 95% CI 1.13-2.28). As for the treatment subgroup, a relatively lower level of PNI could also be a positive predictor for OS (surgery: HR = 1.64, 95% CI 1.40-1.93; target therapy: HR = 1.88, 95% CI 1.34-2.63) and DFS/RFS/PFS (surgery: HR = 1.69, 95% CI 1.47-1.95; target therapy: HR = 2.14, 95% CI 1.50-3.05).

Conclusion: The outcomes of us shed light on that elevated pre-treatment PNI was positively associated with OS, CSS/DSS and DFS/RFS/PFS, indicating that it could be an independent prognostic factor in urinary cancers.

Keywords: Meta-analysis; PNI; Prognostic nutritional index; Urinary cancer.

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Figures

Fig. 1
Fig. 1
Flow diagram of literature search and selection process
Fig. 2
Fig. 2
Forrest plots of OS associated with PNI in urinary cancers. a The overall group; b the subgroup analysis of cancer type; c the subgroup analysis of treatment type
Fig. 3
Fig. 3
Forrest plots of DFS/RFS/PFS associated with PNI in urinary cancers. a The overall group; b the subgroup analysis of cancer type; c the subgroup analysis of treatment type
Fig. 4
Fig. 4
Forrest plots of CSS/DSS associated with PNI in urinary cancers. a The overall group; b the subgroup analysis of cancer type
Fig. 5
Fig. 5
Sensitivity analysis of each included study. a OS for individual studies; b DFS/RFS/PFS for individual studies; c CSS/DSS for individual studies
Fig. 6
Fig. 6
Begg’s funnel plots of the publication bias. a OS for individual studies; b DFS/RFS/PFS for individual studies; c CSS/DSS for individual studies
See this image and copyright information in PMC

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