Low Prognostic Nutrition Index Predicts Poorer Quality Of Life In Late Stage Lung Cancer

Background: Quality of life (QOL) is one of the most important endpoints in lung cancer care. Both nutritional and immune status reportedly correlate with QOL, so we investigated whether the prognostic nutritional index (PNI), a reliable marker of nutritional and immune status, can predict QOL in late-stage lung cancer.Methods: We enrolled 80 lung cancer patients and their clinical data including PNI were obtained. The FACT-L questionnaire in Chinese version 4 was administered to every patient.Results: Of the 80 lung cancer patients, 16 were stage III and 64 were stage IV. The average PNI value was 44.24 +/- 5.53. The average FACT-L score was 99.58 +/- 21.84, indicating impaired QOL. The FACT-L score in the stage IV group was significantly lower than that in the stage III group (P=0.001), especially for the four subscales of physical, social/family, emotional, and functioning well-being. In the stage IV group, the FACT-L score in the high PNI group was significantly higher than that in the low PNI group (P=0.042), with especially higher score for the physical well-being subscale. PNI was significantly related to both the FACT-L score (r=0.3265, P=0.0085) and physical well-being subscale (r=0.4746, P<0.0001).Conclusions: PNI is a simple but valuable biomarker of QOL in stage IV lung cancer patients. A lower PNI may indicate the need for detailed QOL evaluation and intervention.