Pre-operative prognostic nutritional index was associated with recurrence after surgery in giant cell tumor of bone patients

OBJECTIVES: Giant cell tumors of bone (GCT) are benign with a local recurrence rate of approximately 20–50%. Growing evidence suggests that inflammation plays an important role in tumor formation and progression. Inflammatory biomarkers, including prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have little data in predicting postoperative recurrence of GCT. METHODS: We retrospectively investigated 105 patients with surgery for GCT between March 2010 and June 2019 at our hospital. Through the analysis of receiver operating characteristics (ROC), the optimal cutoff values of PNI, NLR and PLR were determined. Clinical features between PNI, NLR and PLR were tested with the χ(2) test. Univariate and multivariate analyses were applied to identify the prognostic factors. RESULTS: The optimal cut-off points of PNI, NLR and PLR were 48.6, 2.4 and 136.9, respectively. In univariate analysis, PNI, NLR, PLR, tumor size, Campanacci stage were significantly associated with recurrence-free survival (RFS). Cox multivariate regression analysis revealed that the PNI (p = 0.003) and Campanacci stage (p = 0.001) were independent prognostic factors for GCT. CONCLUSIONS: PNI can be regarded as a novel independent prognostic factor for predicting postoperative recurrence in GCT.