The Prognostic Value of Nutritional and Immune Indices for Stage IB Non-Small Cell Lung Cancer Patients: Insights...

Postoperative recurrence is a critical factor affecting the prognosis of stage IB non-small cell lung cancer (NSCLC). We aimed to evaluate the prognostic value of Nutritional and Immune Indices (NII) for postoperative recurrence among IB NSCLC patients.

Clinical data of patients with pathological stage IB NSCLC who underwent surgical resection were collected. Cut-off values for NII were calculated using ROC curves, and patients were grouped accordingly. Univariable and multivariable logistic regression analyses were conducted to identify the association between NII and prognosis. A predictive model and corresponding nomogram were developed based on the identified risk factors. The model's performance was evaluated using the AUC and C-index. Additionally, interactions between NII and tumor marker indices were assessed, and recurrence-free survival (RFS) was analyzed using the Cox proportional hazards model.

A total of 918 patients were included in this study. The results showed that patients with higher preoperative PNI or lower SII, PLR, and MLR had better RFS. For postoperative NII, patients with a higher postoperative PNI or lower PLR demonstrated better RFS. Preoperative PNI (HR = 0.920 [0.910, 0.940], p < 0.0001), postoperative MLR (HR = 1.428 [1.015, 2.010], p = 0.041) and △ (post-pre) PNI (HR = 1.018 [1.002, 1.034], p = 0.031) were identified as independent prognostic factors for postoperative recurrence in stage IB NSCLC. The nomogram model indicated that preoperative PNI was the optimal predictor for postoperative recurrence, achieving the highest C-index (0.658). Additionally, the interaction between preoperative PNI and NSE emerged as an independent prognostic factor for RFS in stage IB NSCLC patients, with a HR of 1.176 (95% CI: 1.159-1.200, p = 0.004).

This study underscores the value of an NII-based prognostic strategy, with preoperative PNI emerging as a particularly reliable indicator of postoperative recurrence risk in stage IB NSCLC patients.