Correlation of prognostic nutritional index and related indicators with prognosis of postoperative patients with glioma

Objective  To discuss the correlation of prognostic nutritional index (PNI) and related indicators with prognosis of postoperative patients with glioma.

Methods  A total of 151 patients with glioma were retrospectively selected as study objects, and relevant clinical data were collected and the follow-up was conducted. Receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of different indicators in predicting prognosis. Kaplan-Meier method was used to draw the survival curve, and Log-rank test and Cox regression were used to analyze the influencing factors of prognosis.

Results  Of the 151 patients, the median follow-up duration was 13 months, and the average survival period was 21.9 months. The death rate during the follow-up period was 66.89%(101 cases). The best cutoff values of albumin (ALB), prealbumin (PA), lymphocyte (LYM), PNI, body mass index (BMI) and C-reactive protein (CRP) in predicting the prognosis of patients were 36.45 g/L, 206.0 mg/L and 1.85× 10⁹/L, 46.9, 21.45 kg/m² and 8.55 mg/L, respectively, with areas under the curve of 0.885, 0.683, 0.867, 0.955, 0.635 and 0.646, respectively. Univariate analysis showed that World Health Organization (WHO) tumor grading for central nervous system (short for WHO grading), operation mode, preoperative Karnofsky Performance Status (KPS) score, ALB, PA, LYM, BMI, CRP and PNI were the influencing factors of prognosis in glioma patients (P < 0.05). COX multivariate analysis showed that PNI ≥ 46.9, preoperative KPS score ≥60 and WHO grade Ⅱ and Ⅲ (compared with grade Ⅳ) are the protective factors for the prognosis of patients with glioma(HR=0.925, 0.964, 0.122 and 0.577 respectively, P < 0.05). The one-year survival rates of patients with grade Ⅱ, Ⅲ and Ⅳ of WHO were 85.37%, 50.75 and 16.28% respectively, and the one-year survival rates of patients with PNI < 46.9 and ≥46.9 were 34.38% and 87.27% respectively. The one-year survival rates of patients with preoperative KPS score < 60 and ≥60 were 30.23% and 62.96%, respectively.

Conclusion  The clinical prognosis of glioma is poor. PNI, preoperative KPS score and WHO grade are related to the clinical outcome of patients with glioma.