Association of the cholesterol-modified prognostic nutritional index with the survival following lung resection for older patients with non–small cell lung cancer

Several predictive markers of survival have been reported in patients with non-small cell lung cancer (NSCLC). In this study, we evaluated the utility of the cholesterol-modified prognostic nutritional index (CPNI) for assessing nutritional status and predicting survival in older patients with NSCLC. In a cohort of 181 patients aged >75 years who underwent curative resection for NSCLC at National Hospital Organization Osaka National Hospital between 2006 and 2021, we examined the association between baseline characteristics, including laboratory parameters, histology, pathological stage, nutritional indices, CPNI, and overall survival (OS) and recurrence-free survival (RFS) using Kaplan–Meier curves and Cox proportional hazard regression models. Ninety-seven patients (53.6%) were male, with the most common histology being adenocarcinoma in 140 (77.3%). The median follow-up duration was 61 months. During follow-up, 81 patients (44.8%) died, while 41(22.7%) experienced recurrences. In multivariate data analysis, the following were identified as independent prognostic factors for OS: male, pathological stage (≥II), pleural invasion, and high CPNI (p = 0.014). For RFS, high CPNI was also identified as independent prognostic factor (p=0.003). High preoperative CPNI was associated with shorter survival and may predict OS and RFS in older patients with NSCLC following lung resection.