ArticleBMC medicine2023
Cholesterol-modified prognostic nutritional index (CPNI) as an effective tool for assessing the nutrition status and predicting survival in patients with breast cancer.
Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 4 of them syntheses that pooled it.
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Who cites it
60 citing papers in PubMed, 4 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Prevalence of disease related malnutrition assessed by NRS2002, STAMP, MNA-SF, one-step and two-step GLIM at admission and discharge: A systematic review and meta-analysis.Asia Pacific journal of clinical nutrition · 2026Pooled it
- Predicting the prognosis of breast cancer patients by using nutrition-based index: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- Body mass index and cancer survival: a meta-analysis of cohort studies.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Pooled it
- Diagnostic performance of GLIM and PG-SGA for malnutrition assessment in adult cancer patients: a systematic review and meta-analysis.BMC cancer · 2025Pooled it
- Integration of objective nutritional status and tumor burden predicts 5-year survival after gastric cancer surgery: a multicenter real-world study.Surgical endoscopy · 2026Article
- Pre-radiotherapy modified prognostic nutritional index predicts acute radiation enteritis in patients with cervical cancer undergoing radiotherapy: A retrospective study.Oncology letters · 2026Article
- Baseline and Early On-Treatment Prognostic Nutritional Index in Hormone Receptor-Positive, HER2-Negative Metastatic Breast Cancer Treated with CDK4/6 Inhibitors.Journal of clinical medicine · 2026Article
- Predictive value of the prognostic nutritional index and aggregate index of systemic inflammation for pulmonary complications in children with influenza.Translational pediatrics · 2026Article
- ALNCR.TNM as a Novel Prognostic Tool for Cancer Survival.Journal of cachexia, sarcopenia and muscle · 2026Article
- Article
- Dynamic prognostic nutritional index and 28-day mortality in sepsis: a joint modeling analysis.Nutrition & metabolism · 2026Article
- Prognostic Impact of PET/CT-Derived Sarcopenia in Metastatic Breast Cancer Treated with CDK4/6 Inhibitors.Journal of clinical medicine · 2026Article
- Prognostic nutritional index improved the survival prediction of the revised Tokuhashi and Tomita scores for patients with lung cancer spinal metastases.BMC cancer · 2026Article
- Total knee arthroplasty: considerations for multidisciplinary teams in patients' postsurgical pain management.Journal of anesthesia · 2026Article
- [The value of the nutritional assessment index or score in prognostic evaluation for patients with liver cancer].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Diagnostic utility and discriminative ability of cholesterol-modified prognostic nutritional index and inflammatory indicators in colorectal cancer: a retrospective case-control study.Scientific reports · 2026Article
- Application and Modification of Nutritional Assessment Tools in Hematologic Malignancies.Cancers · 2026Article
- An integrated SII-PNI immune-nutritional scoring system predicts efficacy and immune-related adverse events in locally advanced gastric cancer patients undergoing neoadjuvant immunotherapy.Frontiers in immunology · 2026Article
- The predictive value of modified-Naples prognostic score for patients with locally advanced non-small cell lung cancer undergoing surgery after neoadjuvant chemotherapy.Frontiers in immunology · 2026Article
- Life's Essential 8 and the Risk of Overall and Specific-Site Cancer Types: A Large-Scale Prospective Cohort Study.Cancer medicine · 2026Article
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Authors and funding
19 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundMalnutrition is associated with poor overall survival (OS) in breast cancer patients; however, the most predictive nutritional indicators for the prognosis of patients with breast cancer are not well-established. This study aimed to compare the predictive effects of common nutritional indicators on OS and to refine existing nutritional indicators, thereby identifying a more effective nutritional evaluation indicator for predicting the prognosis in breast cancer patients.
methodsThis prospective study analyzed data from 776 breast cancer patients enrolled in the "Investigation on Nutritional Status and its Clinical Outcome of Common Cancers" (INSCOC) project, which was conducted in 40 hospitals in China. We used the time-dependent receiver operating characteristic curve (ROC), Kaplan-Meier survival curve, and Cox regression analysis to evaluate the predictive effects of several nutritional assessments. These assessments included the patient-generated subjective nutrition assessment (PGSGA), the global leadership initiative on malnutrition (GLIM), the controlling nutritional status (CONUT), the nutritional risk index (NRI), and the prognostic nutritional index (PNI). Utilizing machine learning, these nutritional indicators were screened through single-factor analysis, and relatively important variables were selected to modify the PNI. The modified PNI, termed the cholesterol-modified prognostic nutritional index (CPNI), was evaluated for its predictive effect on the prognosis of patients.
resultsAmong the nutritional assessments (including PGSGA, GLIM, CONUT, NRI, and PNI), PNI showed the highest predictive ability for patient prognosis (time-dependent ROC = 0.58). CPNI, which evolved from PNI, emerged as the superior nutritional index for OS in breast cancer patients, with the time-dependent ROC of 0.65. It also acted as an independent risk factor for mortality (p < 0.05). Moreover, the risk of malnutrition and mortality was observed to increase gradually among both premenopausal and postmenopausal age women, as well as among women categorized as non-overweight, overweight, and obese.
conclusionsThe CPNI proves to be an effective nutritional assessment tool for predicting the prognosis of patients with breast cancer.
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