ArticleFrontiers in nutrition2026
Joint association of estimated skeletal muscle mass index and prognostic nutritional index with all-cause mortality in individuals with non-metastatic nasopharyngeal cancer.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The prognostic interplay between skeletal muscle mass and nutritional/immune status in non-metastatic nasopharyngeal carcinoma (NPC) is unclear. This study investigates the independent and joint association of estimated skeletal muscle mass index (eSMI) and Prognostic Nutritional Index (PNI) with all-cause mortality. Methods: We analyzed 942 non-metastatic NPC patients. Low muscle mass was defined by sex-specific 20th percentiles of eSMI. PNI was categorized using a clinical cutoff of 45. Patients were stratified into four groups: normal eSMI & high PNI (reference), normal eSMI & Low PNI, low eSMI & high PNI, and low eSMI & low PNI. Multivariate Cox models and a win ratio analysis were used to evaluate joint prognostic value. Results: During a median follow-up of 54 months, 204 deaths (21.7%) occurred. In multivariate Cox analysis, low PNI was independently associated with higher risk (HR = 1.68, Conclusion: Joint assessment of eSMI and PNI provides superior risk stratification. Pre-treatment assessment of these simple markers may facilitate targeted nutritional and supportive interventions.
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