The Prognostic Role of Prognostic Nutritional Index and Controlling Nutritional Status in Predicting Survival in Older Adults with Oncological Disease: A Systematic Review.

Simple Summary: Most new cancers worldwide are diagnosed in older adults, highlighting the need for accessible and easy-to-use prognostic tools that contribute to lowering the burden of the disease in this age group. The aim of this systematic review is to understand whether the Prognostic Nutritional Index (PNI) and the Controlling Nutritional Status (CONUT) can predict survival in older adult cancer patients. The 38 studies included in this review vary substantially in terms of patients, cancer types, survival outcomes, and what is considered high and low PNI or CONUT. Overall, PNI showed an association with overall survival in most studies, indicating that it is an inexpensive biomarker that could be used as a prognostic tool in older adults diagnosed with cancer. The increase in new cancer diagnoses in the elderly calls for new, accessible, and easy-to-use prognostic tools that contribute to lowering the burden of the disease. Recognising the importance of inflammation and nutritional status in the progression of the disease, the purpose of this systematic review was to synthesise the evidence on the prognostic role of Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) in predicting survival of older adult cancer patients. A comprehensive search was conducted in PubMed and Web of Science Core Collection databases until 22 February 2024. The articles included in this review (n = 38) examined the relationships of PNI and CONUT with survival outcomes in elderly cancer patients. Despite high heterogeneity between the studies, most concluded that low PNI values are associated with poor overall survival (OS), particularly in gastric cancer patients. Most studies did not find an association between PNI and cancer-specific survival, progression-free survival, disease-free survival, recurrence-free survival, and mortality. Results regarding the prognostic role of CONUT in predicting survival were inconclusive. This study suggests that PNI could be used to predict OS in elderly cancer patients, while more studies are needed to assess the prognostic role of CONUT. [ABSTRACT FROM AUTHOR]