The predictive value of prognostic immune and nutritional index in esophageal squamous cell carcinoma receiving neoadjuvant immunochemotherapy: a retrospective propensity score matching study - Report - MDSpire
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The predictive value of prognostic immune and nutritional index in esophageal squamous cell carcinoma receiving neoadjuvant immunochemotherapy: a retrospective propensity score matching study
Clinical Report: Prognostic Significance of Immune and Nutritional Indices in ESCC
Overview
This study evaluates the prognostic immune and nutritional index (PINI) in esophageal squamous cell carcinoma (ESCC) patients undergoing neoadjuvant immunochemotherapy (NICT). Findings indicate that a higher PINI correlates with improved disease-free survival (DFS) and overall survival (OS), suggesting its potential role in enhancing prognostic models.
Background
Esophageal cancer, particularly esophageal squamous cell carcinoma (ESCC), presents significant treatment challenges and poor prognoses despite advancements in therapy. Current prognostic models primarily rely on TNM staging, which does not account for critical factors such as nutritional and immune status. The integration of immune and nutritional indices like PINI may provide a more comprehensive assessment of patient prognosis.
Data Highlights
Parameter
Low PINI (n=97)
High PINI (n=96)
3-year DFS
43.3%
76.0%
3-year OS
58.8%
84.4%
Key Findings
The optimal PINI cutoff was determined to be 3.320.
Patients with low PINI had significantly worse 3-year DFS and OS compared to those with high PINI.
Before propensity score matching (PSM), DFS was 43.3% vs. 76.0% (P<0.001) and OS was 58.8% vs. 84.4% (P<0.001).
After PSM, DFS was 48.4% vs. 68.8% (P=0.021) and OS was 64.1% vs. 81.2% (P=0.033).
PINI was confirmed as an independent prognostic index for DFS (HR = 0.423, P = 0.001) and OS (HR = 0.461, P = 0.013) in the pre-matched cohort.
After PSM, PINI remained independently predictive of DFS (HR = 0.543, P = 0.034).
Clinical Implications
Incorporating PINI into clinical practice may enhance the ability to stratify patients with ESCC based on their prognosis, particularly in predicting disease-free survival. This could aid in personalizing treatment strategies and improving patient outcomes in those undergoing NICT.
Conclusion
The prognostic immune and nutritional index (PINI) serves as a significant independent predictor of outcomes in ESCC patients receiving NICT, particularly for disease-free survival. Its integration into existing prognostic frameworks may enhance risk stratification and therapeutic decision-making.
