The final, formatted version of the article will be published soon.
ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 11 - 2024 |
doi: 10.3389/fnut.2024.1436063
This article is part of the Research Topic Nutrition and Metabolism in Cancer: Role in Prevention and Prognosis View all 11 articles
Prognostic value of three clinical nutrition scoring system (NRI, PNI and CONUT) in elderly patients with prostate cancer
Provisionally accepted- 1 Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
- 2 Sichuan Cancer Hospital, Chengdu, Sichuan Province, China
- 3 Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, China
BACKGROUND: Most of patients with prostate cancer (PCa) are elderly and have a long course of disease.Preoperative assessment of the patient's clinical nutritional status facilitates early intervention and improves patient prognosis.We assessed the nutritional status of PCa patients utilizing the Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) scoring systems. Survival comparisons between groups were conducted using Kaplan-Meier curve analysis and log-rank tests, while Cox proportional hazards regression analysis was employed to identify independent prognostic factors.Furthermore, we implemented bootstrap-based optimism correction methods to validate the scoring systems and applied decision curve analysis to evaluate the non-inferiority of these three clinical nutrition scoring systems relative to the conventional American Joint Committee on Cancer (AJCC) staging.In this study, malnutrition was diagnosed in 31.51% of the patients using the NRI, 13.02% using the PNI, and 88.28% using the CONUT score. After adjusting for confounders, normal nutritional status as defined by NRI and PNI emerged as an independent prognostic factor for prostate-specific antigen progression-free survival (PSA-PFS). However, nutritional status assessed by CONUT inaccurately predicted PSA-PFS. Normal nutritional status, as determined by all three scoring systems, was found to be an independent prognostic factor for progression-free survival (PFS). Following adjustments for optimistic estimates, the C-index for NRI in predicting both PSA-PFS and PFS remained the highest among the three scoring systems. The results of the DCA indicated that the C-index of all three scoring systems was higher than that of AJCC stage. CONCLUSIONS: NRI, PNI and CONUT are convenient and clinically applicable scoring systems. A clinical malnutrition intervention may improve the prognosis of prostate cancer patients.
Keywords: prostate cancer, Malnutrition, prognosis, NRI, PNI, CONUT
Received: 21 May 2024; Accepted: 10 Sep 2024.
Copyright: © 2024 Liu, Li, Lilin, Liu and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
RuiJi Liu, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.