2026 Volume 21 Issue 1 Pages 20-26
Objective: The Glasgow Prognostic Score (GPS), Prognostic Nutritional Index (PNI), and Neutrophil-to-Lymphocyte Ratio (NLR) have been shown to predict the prognosis of various cancer types. However, the prognostic roles of GPS, PNI, and NLR in patients with extensive-stage small cell lung cancer (ES-SCLC) remain controversial. This study aimed to assess the prognostic value of these three immunonutritional indicators in patients with ES-SCLC.
Patients and Methods: We retrospectively analyzed 102 ES-SCLC patients who received first-line platinum-doublet chemotherapy. The GPS, PNI, and NLR were assessed before the initiation of first-line chemotherapy. Based on previous reports, the optimal cut-off levels were 40 for PNI and 3 for NLR. The Kaplan–Meier method and Cox proportional hazards models were used to evaluate progression-free survival (PFS) and overall survival (OS).
Results: Of the total participants, 102 had ES-SCLC. Patients with a GPS of 0/1 showed significantly longer PFS than those with a GPS of 2 (133 vs. 63 days, P<0.001), and a high PNI was also associated with longer PFS (133 vs. 80 days, P=0.007). No significant difference in PFS was observed between the low and high NLR groups (P=0.471). Similarly, OS was significantly longer in patients with a GPS of 0/1 than in those with a GPS of 2 (300 vs. 117 days, P<0.001) and in those with a high PNI than in those with a low PNI (296 vs. 136 days, P<0.001). The OS did not differ significantly in the NLR group (P=0.303). Multivariate analyses revealed that the GPS and PNI were independently associated with worse PFS and OS.
Conclusion: Our study demonstrated that both the GPS and PNI were significantly associated with PFS and OS in patients with ES-SCLC. The GPS may be a simple and reliable immunonutritional marker for predicting outcomes in patients with ES-SCLC treated with platinum doublet chemotherapy.
