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Vol. 33. Issue 1.
Pages 15-21 (January - February 2022)
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Vol. 33. Issue 1.
Pages 15-21 (January - February 2022)
Clinical Research
Impact of prognostic nutritional index on survival in recurrent glioblastoma
Impacto de Prognostic Nutritional Index en la supervivencia de los glioblastomas recurrentes
Ozkan Alana,
Corresponding author

Corresponding author.
, Tugba Akın Tellia, Tugba Basoğlua, Rukiye Arikana, Nazim Can Demircana, Ozlem Ercelepa, Mustafa Sakarb, Suheyla Bozkurtc, Beste Melek Atasoyd, Faysal Danea, Mustafa İbrahim Ziyalb, Perran Fulden Yumuka
a Department of Internal Medicine Division of Medical Oncology, Marmara University School of Medicine, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey
b Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey
c Department of Pathology, Marmara University School of Medicine, Istanbul, Turkey
d Department of Radiation Oncology, Marmara University School of Medicine, Istanbul, Turkey
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Figures (2)
Tables (4)
Table 1. Baseline clinicopathological characteristics of the patients.
Table 2. Clinical outcomes according to PNI.
Table 3. Cox-regression model of overall survival (OS) in glioblastoma.
Table 4. Review of current literature investigating the clinical significance of the prognostic nutritional index (PNI) in patients with high-grade gliomas.
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Primary brain tumors are relatively rare malignancy, with high-grade gliomas (glioblastoma multiforme and anaplastic gliomas) are the most common types. We aimed to evaluate the prognostic value of Prognostic Nutritional Index (PNI), which is calculated by lymphocyte count and albumin, in recurrent glioblastoma patients treated with systemic treatment.


Data of 64 patients with recurrent glioblastoma who received systemic treatment and followed in our clinic between 2012 and 2018 was retrospectively collected and analyzed. PNI was calculated as: [(10×serum albumin (g/dL))+(0.005×total lymphocyte count)]. Patients were categorized according to the median PNI value. We investigated the prognostic role of PNI groups, and survival outcomes.


Median value of PNI was 45.7, and median follow-up duration was 9 months (1–68 months). Median overall survival (OS) was 7.9 months (95%CI: 5.5–10.4). Median OS was significantly longer in patients with PNI>45.7 compared to patients with PNI45.7 (13.9 months (95%CI: 10.5–17.4), and 4.6 months (95%CI: 2.5–6.8), p<0.001, respectively). In multivariate analysis, PNI was found to be an independent prognostic factor for OS [HR:0.41 (95%CI:0.22–0.74), p=0.03)].


In our study, the PNI was found to be an independent prognostic biomarker in patients with recurrent glioblastoma, but further prospective trials are necessary to validate its prognostic role.

Prognostic nutritional index
Overall survival
Inflammatory-based indices
Systemic treatment

Los tumores cerebrales primarios son neoplasias malignas relativamente infrecuentes, siendo los gliomas de alto grado (glioblastomas multiformes y gliomas anaplásicos) los tipos más comunes. Nuestro objetivo fue evaluar el valor pronóstico de Prognostic Nutritional Index (PNI), que se calcula mediante el recuento de linfocitos y albúmina en los pacientes con glioblastoma recurrente tratados con terapia sistémica.


Se recabaron y analizaron retrospectivamente los datos de 64 pacientes con glioblastoma recurrente que recibieron tratamiento sistémico, y a quienes se realizó seguimiento en nuestra clínica entre 2012 y 2018. Se calculó PNI como: (10×albúmina sérica [g/dl]+0,005×recuento linfocitario total). Se categorizó a los pacientes con arreglo al valor medio de PNI. Estudiamos el papel pronóstico de los grupos PNI, y los resultados de supervivencia.


El valor medio de PNI fue de 45,7, siendo la duración media del seguimiento de 9 meses (1-68 meses). La supervivencia global (SG) fue de 7,9 meses (IC 95%: 5,5-10,4). La SG media fue significativamente más alta en los pacientes con PNI>45,7 en comparación con los pacientes con PNI45,7 (13,9 meses, IC 95%: 10,5-17,4 y 4,6 meses, IC 95%: 2,5-6,8; p<0,001, respectivamente). En el análisis multivariante, se encontró que PNI era un factor pronóstico independiente de la SG (HR: 0,41; IC 95%: 0,22-0,74; p=0,03).


En nuestro estudio, encontramos que PNI era un biomarcador pronóstico independiente en los pacientes con glioblastoma recurrente, aunque son necesarios más estudios prospectivos para validar su papel pronóstico.

Palabras clave:
Prognostic Nutritional Index
Supervivencia global
Índices de inflamación
Tratamiento sistémico


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