Journal of Cancer · 2026
Prognostic Value of the Prognostic Nutritional Index in Patients with Metastatic Melanoma.
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Sahbazlar Mustafa, Akar Hikmet, Erdogan Atike Pinar, Ekinci Ferhat
Аннотация
BACKGROUND: Prognostic outcomes vary considerably among patients with metastatic melanoma. We examined the association of the prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) with overall survival in this patient population.
METHODS: We retrospectively evaluated 60 patients with metastatic melanoma treated at a single center. PNI was derived from serum albumin and absolute lymphocyte count. A cut-off of 52 was identified by ROC analysis and used to define the PNI groups. Overall survival was analyzed using the Kaplan-Meier method and Cox proportional hazards regression. PNI was entered into separate multivariable models with NLR or SII.
RESULTS: Overall survival was longer in patients with PNI ≥52 than in those with PNI <52 (log-rank p = 0.008). PNI, NLR, SII, and immunotherapy use were associated with OS in univariate Cox analysis. After multivariable adjustment, PNI remained significant in the model containing NLR (HR: 0.36, 95% CI: 0.15-0.85; p = 0.020) and in the model containing SII (HR: 0.37, 95% CI: 0.16-0.88; p = 0.024). Immunotherapy use was also independently associated with OS, whereas NLR and SII were not. PNI remained associated with OS when analyzed as a continuous variable (HR: 0.91, 95% CI: 0.84-0.98; p = 0.008). The AUC for PNI was 0.706 (95% CI: 0.551-0.833; p = 0.015).
CONCLUSION: Higher PNI was independently associated with longer overall survival in this cohort of patients with metastatic melanoma. These findings support further investigation of PNI as a readily available prognostic marker, although validation in larger independent cohorts is needed.
METHODS: We retrospectively evaluated 60 patients with metastatic melanoma treated at a single center. PNI was derived from serum albumin and absolute lymphocyte count. A cut-off of 52 was identified by ROC analysis and used to define the PNI groups. Overall survival was analyzed using the Kaplan-Meier method and Cox proportional hazards regression. PNI was entered into separate multivariable models with NLR or SII.
RESULTS: Overall survival was longer in patients with PNI ≥52 than in those with PNI <52 (log-rank p = 0.008). PNI, NLR, SII, and immunotherapy use were associated with OS in univariate Cox analysis. After multivariable adjustment, PNI remained significant in the model containing NLR (HR: 0.36, 95% CI: 0.15-0.85; p = 0.020) and in the model containing SII (HR: 0.37, 95% CI: 0.16-0.88; p = 0.024). Immunotherapy use was also independently associated with OS, whereas NLR and SII were not. PNI remained associated with OS when analyzed as a continuous variable (HR: 0.91, 95% CI: 0.84-0.98; p = 0.008). The AUC for PNI was 0.706 (95% CI: 0.551-0.833; p = 0.015).
CONCLUSION: Higher PNI was independently associated with longer overall survival in this cohort of patients with metastatic melanoma. These findings support further investigation of PNI as a readily available prognostic marker, although validation in larger independent cohorts is needed.