title: Prognostic nutritional index predicts outcomes of malignant pleural mesothelioma.
abstract: OBJECTIVE
  Nutritional status has been associated with long-time outcomes in cancer patients. We investigated whether the prognostic nutritional index (PNI), an indicator of nutritional status, affects overall survival in patients with malignant pleural mesothelioma (MPM).
  
  
  METHODS
  We enrolled 121 patients with histologically confirmed MPM, who had successfully undergone biopsy by medical thoracoscopy in this study. Demographic, clinical and laboratory data were collected retrospectively. The PNI was calculated as 10× serum albumin value (g/dl) + 0.005 × total lymphocyte count (per mm(3)) in peripheral blood. Univariate and multivariate analyses were used to identify prognostic factors.
  
  
  RESULTS
  Mean pretreatment PNI was 44.6. PNI was significantly associated with age (P = 0.031), smoking habits (P = 0.039) and weight loss (P = 0.029). Survival analysis showed PNI to be an independent prognostic factor in MPM. Patients with lower PNIs (PNI < 44.6) had greater risk of death than those with higher PNIs (PNI ≥ 44.6; hazard ratio: 2.290; 95 % confidence interval: 1.415-3.706; P = 0.001). These analyses were adjusted for patient age, gender, smoking habits, dyspnea, chest pain, weight loss, primary site of tumor, histology, platinum-based systemic chemotherapy, hospital and stage.
  
  
  CONCLUSIONS
  Pretreatment PNI is a novel independent prognostic factor in MPM.
authors.affiliation: Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong Province, People's Republic of China.
authors.forename: Zhou-Hong
authors.initials: ZH
authors.lastname: Yao
authors.forename: Guang-Yan
authors.initials: GY
authors.lastname: Tian
authors.forename: Yun-Yan
authors.initials: YY
authors.lastname: Wan
authors.forename: Yan-Meng
authors.initials: YM
authors.lastname: Kang
authors.forename: Hai-Sheng
authors.initials: HS
authors.lastname: Guo
authors.forename: Qing-Hua
authors.initials: QH
authors.lastname: Liu
authors.forename: Dian-Jie
authors.initials: DJ
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008654:Mesothelioma / Q000401:mortality*; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D015596:Nutrition Assessment; D010997:Pleural Neoplasms / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult