Saito Keiju, Kawabata Yusuke, Kato Ikuma, Shinoda Satoru, Hayashida Kenta, Fujita Shintaro, Yoshida Tomotaka, Choe Hyonmin, Takeyama Masanobu, Inaba Yutaka
Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan.
Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan.
J Orthop Sci. 2025 May;30(3):535-541. doi: 10.1016/j.jos.2024.08.005. Epub 2024 Sep 18.
It is known that preoperative Prognostic Nutritional Index (PNI) is useful in predicting prognosis in gastrointestinal diseases and that preoperative improvement of nutritional status improves prognosis. However, there have been few large-scale reports examining the prognostic value of PNI in soft tissue sarcomas. Therefore, the aim of this study is to investigate whether the PNI can be useful for predicting overall survival in soft tissue sarcoma.
Between January 2006 and March 2022 at our hospital, 111 patients with pathologically diagnosed soft tissue sarcoma were included, retrospectively. Several nutritional or inflammatory biomarkers such as PNI were calculated from the pretreatment blood sample results. The patients were classified into two groups (low and high groups) based on the median value of each parameter. Overall survival was analyzed by the Kaplan‒Meier method and log-rank test. Univariate and multivariate analyses using the Cox proportional hazards model were used to investigate prognostic factors for overall survival.
The median overall survival was 24.3 months (mean 37.3 months), and the high PNI group had a significantly longer overall survival than the low PNI group (p < 0.0001). PNI was the most significant univariate factor for overall survival among other nutritional and inflammatory parameters (HR: 5.64, 95% CI: 2.26-14.12, p = 0.0002). The multivariate proportional hazards model was built using variables with prognostic potential as suggested by previous analysis with respect to patient characteristics and PNI. As potential confounding factors, we included PNI, stage, age, and tumor location. PNI was also an independent prognostic factor in multivariate analysis (HR: 7.02, CI: 2.52-19.40, p = 0.0002).
PNI is a useful prognostic factor among various parameters for overall survival in patients with soft tissue sarcoma.
已知术前预后营养指数（PNI）有助于预测胃肠道疾病的预后，且术前营养状况的改善可改善预后。然而，关于PNI在软组织肉瘤中的预后价值，大规模报告较少。因此，本研究旨在探讨PNI是否有助于预测软组织肉瘤的总生存期。
回顾性纳入2006年1月至2022年3月在我院病理诊断为软组织肉瘤的111例患者。根据预处理血样结果计算PNI等几种营养或炎症生物标志物。根据各参数的中位数将患者分为两组（低分组和高分组）。采用Kaplan-Meier法和对数秩检验分析总生存期。使用Cox比例风险模型进行单因素和多因素分析，以研究总生存期的预后因素。
中位总生存期为24.3个月（平均37.3个月），高PNI组的总生存期明显长于低PNI组（p<0.0001）。在其他营养和炎症参数中，PNI是总生存期最显著的单因素（HR：5.64，95%CI：2.26-14.12，p=0.0002）。根据先前关于患者特征和PNI的分析建议，使用具有预后潜力的变量建立多变量比例风险模型。作为潜在的混杂因素，我们纳入了PNI、分期、年龄和肿瘤位置。在多因素分析中，PNI也是独立的预后因素（HR：7.02，CI：2.52-19.40，p=0.0002）。
在软组织肉瘤患者总生存期的各种参数中，PNI是一个有用的预后因素。
