The role of nutrition-based index in predicting survival of breast cancer patients: A systematic review and meta-analysis
Patricia Diana, Bernard Agung Baskoro, Timotius Ivan Hariyanto
Abstract
Background Prognostic nutritional index (PNI) and Controlling Nutritional Status (CONUT) are two model that incorporates the role of inflammation and nutrition factors to predict the progression of tumor. The primary objective of this investigation is to examine the ability of PNI and CONUT score for predicting the survival in breast cancer patients. Methods A comprehensive search was conducted on the Cochrane Library, Scopus, Europe PMC, and Medline databases up until August 14th, 2023, utilizing a combination of relevant keywords. This review incorporates literature that examines the relationship between PNI, CONUT, and survival in breast cancer. We employed random-effect models to analyze the hazard ratio (HR) and present the outcomes together with their corresponding 95 % confidence intervals (CI). Results A total of sixteen studies were incorporated. The results of our meta-analysis indicated that high PNI was associated with better overall survival (OS) (HR 0.38; 95%CI: 0.28–0.51, p < 0.00001, I 2 = 32 %), but not disease-free survival (DFS) (HR 0.60; 95%CI: 0.33–1.10, p = 0.10, I 2 = 78 %) than low PNI in breast cancer patients. Meta-analysis also indicated that high CONUT was associated with worse OS (HR 1.66; 95%CI: 1.21–2.28, p = 0.002, I 2 = 78 %) and worse DFS (HR 2.09; 95%CI: 1.60–2.73, p < 0.00001, I 2 = 41 %) in breast cancer patients. Conclusions This study suggests the prognostic role of both PNI and CONUT score for predicting survival in breast cancer patients.