The Prognostic Nutritional Index (PNI): A New Biomarker for Determining Prognosis in Metastatic Castration-Sensitive Prostate Carcinoma

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Ellez H. İ., Keskinkılıç M., Semiz H. S., Arayıcı M. E., Kısa E., Öztop İ.

JOURNAL OF CLINICAL MEDICINE, vol.12, no.17, pp.196-211, 2023 (SCI-Expanded)

  • Publication Type: Article / Article
  • Volume: 12 Issue: 17
  • Publication Date: 2023
  • Doi Number: 10.3390/jcm12175434
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Directory of Open Access Journals
  • Page Numbers: pp.196-211
  • Dokuz Eylül University Affiliated: Yes


Prognostic nutritional index (PNI), which is calculated using the albumin level reflecting nutritional status and lymphocyte count reflecting immune status, is useful in showing nutritional and immunological status related to survival and prognosis in many cancers. In this study, we aimed to evaluate the biomarker potential and effect of PNI in determining the prognosis of metastatic castration-sensitive prostate cancer (mCSPC). This retrospective observational study included the complete data of 108 patients with mCPSC who were treated for at least three months between 1 January 2010, and 1 June 2021. The relationships between cancer-specific survival (CSS), overall survival (OS), progression-free survival (PFS), and PNI were evaluated. The Kaplan–Meier method for OS, PFS, and CSS, as well as univariate and multivariate Cox regression models, were used for the statistical analyses. The median age of 108 patients included in the study was 68.54 (61.05–74.19) years. A value of 49.75 was determined to be the best cut-off point for the PNI. OS (months) was found to be significantly lower in patients with low PNI (median: 34.93, 95% CI: 21.52–48.34) than in patients with high PNI (median: 65.60, 95% CI: 39.36–91.83) (p = 0.016). Patients with high PNI (median: 48.20, 95% CI: 34.66–61.73) had significantly better CSS (months) than patients with low PNI (median: 27.86, 95% CI: 24.16–31.57) (p = 0.001). There was no statistically significant difference in PFS between patients with high PNI values (median: 24.60, 95% CI: 10.15–39.05) and patients with low PNI values (median: 20.03, 95% CI: 11.06–29.03) (p = 0.092). The PNI is a good predictor of OS and CSS in patients with mCSPC. The prediction of PFS, albeit showing a trend towards significance, was not statistically significant, probably due to the small number of cases.