The authors prospectively assessed the independent association between weight loss and deterioration in quality of life (QOL) in patients treated by radiotherapy for head and neck cancer. In 533 head and neck cancer patients treated by curative radiotherapy, changes in weight and QOL were assessed between baseline (before radiotherapy) and follow-up (12 wk after the start of radiotherapy). Patients were categorized into 4 weight loss categories: 0%, 0.1%-5.0%, 5.1%-10.0%, and >10% weight loss. The association between weight loss and change in QOL was analyzed by linear regression analysis, adjusted for sociodemographic and tumor-related characteristics, and additionally for disease specific symptoms and tube feeding. Thirty percent of patients lost 0.1%-5.0% weight, 26% lost 5.1%-10.0% weight, and 24% lost >10% weight. Adjusted regression analyses showed a significant association between weight loss and deterioration of global QOL, physical functioning, social functioning, social eating, and social contact. After additional adjustment for disease-specific symptoms and tube feeding, weight loss (>10%) remained significantly associated with global QOL, social eating, and social contact (P < 0.05). More than 10% weight loss during and directly after radiotherapy has a significant impact on social eating, social contact, and QOL in head and neck cancer patients.

More than 10% weight loss in head and neck cancer patients during radiotherapy is independently associated with deterioration in quality of life

Clinical Significance of Prognostic Nutritional Index After Surgical Treatment in Lung Cancer

Pretreatment prognostic nutritional index as a prognostic factor in lung cancer: Review and meta-analysis.

The immunological status, consisting of “inflammation status” and “nutritional condition,” is important for the survival of patients with various cancers, including non-small cell lung cancer (NSCLC). The neutrophil/lymphocyte ratio (NLR) reflects the inflammation status, and the prognostic nutritional index (PNI) reflects the immunological nutritional condition. In the present study, the correlation between the NLR and the PNI as well as the consistency and magnitude of the prognostic impact of the NLR and the PNI were investigated. We conducted a retrospective review of data from 334 patients who had undergone a curative resection for NSCLC. The NLR and the PNI were calculated, which was routinely performed before surgery. The correlations between the NLR and the PNI and survival were then evaluated. A clear inverse correlation was observed between the NLR and the PNI. The NLR was associated with sex, smoking history, the CEA level, tumor size, and vascular invasion. The PNI was associated with sex, age, smoking history, tumor size, histological type, tumor differentiation, and vascular invasion. Patients with NLR ≥2.5 had a significantly poorer survival outcome, and patients with PNI <50 had a significantly poorer survival outcome. A multivariate analysis demonstrated that age, nodal metastasis, tumor differentiation, NLR, and PNI were independent predictors of disease-free and overall survival. Our study demonstrated a significant inverse correlation between the NLR and the PNI, and a high NLR and a low PNI were significantly associated with a poor survival among patients who had undergone a complete resection for NSCLC.

https://link.springer.com/content/pdf/10.1186%2Fs12957-015-0710-7.pdf

Preoperative neutrophil/lymphocyte ratio and prognostic nutritional index predict survival in patients with non-small cell lung cancer

Clinical significance of preoperative serum albumin level for prognosis in surgically resected patients with non-small cell lung cancer: Comparative study of normal lung, emphysema, and pulmonary fibrosis

The prognostic nutritional index (PNI) has been reported to be a prognostic indicator in some malignant tumors. However, its prognostic value in nonsmall cell lung cancer (NSCLC) has not been fully investigated. A retrospective review of 1416 patients with NSCLC who underwent radical surgery between January 2006 and December 2011 was conducted. To obtain optimal cutoff levels of PNI, running log-rank statistics was applied. Survival was calculated by the Kaplan-Meier method. The prognostic significance of PNI, together with various clinicopathological factors, was evaluated by multivariate analysis. The optimal cutoff point for PNI was 52. The 1-, 3-, and 5-yr survival rates in patients with PNI of less than 52 were 80.0%, 61.3%, and 50.4%, respectively, and were significantly more unfavorable than those in patients with PNI 52 or higher (84.7%, 71.5%, and 60.3%, respectively, P < 0.001). Multivariate analysis suggested that gender (P = 0.026), age (P < 0.001), PNI (P = 0.005), differentiation (P = 0.024), pathology T category (P = 0.003), and pathology N category (P < 0.001) were revealed to be independent prognostic factors. Our results indicate that PNI is an independent predictor of survival for patients undergoing radical surgery with NSCLC.

Evaluation of Prognostic Nutritional Index in Patients Undergoing Radical Surgery with Nonsmall Cell Lung Cancer.

The objective of this explorative study was to measure weight loss during radiotherapy and to select predictive factors for early identification of malnourished patients. One hundred and fifty-nine consecutive initial diagnosed nasopharyngeal carcinoma patients attending the Oncology Center at Qilu Hospital of Shandong University, China participated. Patients' weights were measured at the baseline visit and at the end of radiotherapy. The baseline characteristics were recorded. A stepwise linear regression analysis was performed to find association between baseline characteristics and malnutrition. At baseline, 56% of the patients already had a 5% weight loss during the last 3 mo; after the treatment, the median weight loss was 6.9 kg (range, 2.1-12.6 kg). After the multivariate linear regression analyses, the following factors turned out to be independent prognostic factors for significant weight loss: global quality of life, body mass index, N stage, insomnia, radiation techniques, Karnofsky performance status, concurrent chemotherapy, and fatigue. The authors conclude that severe weight loss during radiotherapy for nasopharyngeal carcinoma is common. A combination of clinical factors may lead to malnutrition for nasopharyngeal carcinoma during radiotherapy.

Weight loss during radiotherapy for nasopharyngeal carcinoma: a prospective study from northern China.

Sublobectomy versus lobectomy for stage I non-small cell lung cancer in the elderly.

The aim of this study was to examine β-arrestin1 expression in patients with lung adenocarcinoma (ADC) and explore the relationship of β-arrestin1 protein with clinicopathologic factors, vascular endothelial growth factor (VEGF) and prognosis. A total of 105 surgically resected lung adenocarcinoma patients were recruited for the study. The expression of β-arrestin1 and VEGF were determined by immunohistochemistry (IHC). The score measuring the β-arrestin1 and VEGF were calculated by combining the percentage of positive cells and the intensity of staining. Kaplan-Meier method and multivariable Cox proportional hazards regression analyses were used to examine the relationship between β-arrestin1 and survival. The results demonstrated that a notably higher level of β-arrestin1 expression was found in lung ADC tissues. We also found that an elevated nuclear Β-arrestin1 correlates with higher intratumoral VEGF (P = 0.007). β-arrestin 1 over-expression indicated a poor 5-year overall survival (P = 0.016), and the Cox regression model confirmed that β-arrestin1 over-expression were independent prognostic factor for tumor progression (P = 0.027) and unfavorable overall survival (P = 0.015). We conclude that β-arrestin1 had a high expression in ADC and β-arrestin1 may be a promising biomarker to identify individuals with poor prognosis for patients with ADC.

β-arrestin1 over-expression is associated with an unfavorable prognosis in lung adenocarcinomas and correlated with vascular endothelial growth factor.

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Evaluation of Prognostic Nutritional Index in Patients Undergoing Radical Surgery with Nonsmall Cell Lung Cancer.

Weight loss during radiotherapy for nasopharyngeal carcinoma: a prospective study from northern China.

Sublobectomy versus lobectomy for stage I non-small cell lung cancer in the elderly.

β-arrestin1 over-expression is associated with an unfavorable prognosis in lung adenocarcinomas and correlated with vascular endothelial growth factor.