title: Prognostic nutritional index predicts prognosis in patients with metastatic nasopharyngeal carcinoma.
abstract: OBJECTIVE
  This study aimed to investigate the prognostic value of Onodera's prognostic nutritional index (PNI) in patients with metastatic nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  A total of 187 patients with metastatic NPC treated with cisplatin-based chemotherapy were retrospectively reviewed. The PNI was calculated using the following formula: serum albumin level (gram per liter) +0.005× peripheral lymphocyte count (per cubic millimeter). A receiver operating characteristics curve for overall survival (OS) with the highest Youden index was determined to calculate the best cutoff value of PNI. The relationship between PNI and clinicopathological parameters was compared with theχ2test. Survival analysis was applied to evaluate the predictive value of PNI.
  
  
  RESULTS
  The median PNI in this study was 49.0 (ranging from 32.2 to 78.4). The best cutoff value of PNI for OS was 51.0 according to the receiver operating characteristics analysis. The median OS time was 13.0 months. The multivariate analysis indicated that the complete response (hazard ratio 0.681, 95% confidence interval 0.574-0.902;P=0.013) and PNI (hazard ratio 1.732, 95% confidence interval 1.216-2.892;P=0.005) were independent prognostic factors for OS in patients with metastatic NPC.
  
  
  CONCLUSIONS
  This study revealed that PNI is a simple and effective predictor for overall survival in patients with metastatic NPC.
authors.affiliation: Department of Radiation Oncology, People's Hospital of Gaozhou, Guangdong, People's Republic of China.
authors.forename: Gan-Bao
authors.initials: GB
authors.lastname: Wei
authors.affiliation: Department of Radiation Oncology, People's Hospital of Gaozhou, Guangdong, People's Republic of China.
authors.forename: Yao-Yong
authors.initials: YY
authors.lastname: Lu
authors.affiliation: Department of Radiation Oncology, People's Hospital of Gaozhou, Guangdong, People's Republic of China.
authors.forename: Rong-Wei
authors.initials: RW
authors.lastname: Liao
authors.affiliation: Department of Radiation Oncology, People's Hospital of Gaozhou, Guangdong, People's Republic of China.
authors.forename: Qing-Sheng
authors.initials: QS
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, People's Hospital of Gaozhou, Guangdong, People's Republic of China.
authors.forename: Kun-Qiang
authors.initials: KQ
authors.lastname: Zhang
keywords: inflammation; nasopharyngeal carcinoma; prognosis; prognostic nutritional index