Objective To explore the value of prognostic nutritional index (PNI) and neutrophil-to-lymphocyte ratio (NLR) in predicting the prognosis of patients with osteosarcoma.

Methods From 2000 to 2018, medical records of 92 patients with osteosarcoma were collected from two comprehensive hospitals in Yibin city and clinical outcomes of patients were followed up. Receiver operating characteristic (ROC) curve was used to analyze the cut-off values of PNI and NLR for prognosis prediction; the Kaplan-Meier method was used to draw survival curve; the Log-rank test and Cox regression model were used to analyze the influencing factors of prognosis.

Results The average follow-up time of 92 patients was 58 months, with an average survival time of 50 (23, 61) months; during the follow-up period, 47 patients (51.09%) died, with a 5-year survival rate of 51.09%. The areas under the curve of ROC curves for PNI and NLR were 0.957 and 0.788 respectively, with the optimal cut-off values of 46.35 and 2.10. Cox regression model showed that metastasis at diagnosis and PNI < 46.35 were the risk factors for prognosis, with hazard ratio and its 95% confidence intervalHR (95%CI) of4.361(2.021 to 9.410) and 15.361 (5.797 to 46.118) respectively; NLR < 2.10 was a protective factor for prognosis, with HR (95%CI) of0.781 (0.631 to 0.967). The 5-year survival rates of patients with and without metastasis at diagnosis were 10.26% and 81.13% respectively; the 5-year survival rates of patients with PNI < 46.35 and ≥46.35 were 11.11% and 89.36% respectively; the 5-year survival rates of patients with NLR < 2.10 and ≥2.10 were 87.10% and 32.79% respectively.

Conclusion PNI, NLR and status of metastasis at diagnosis are associated with prognosis of patients with osteosarcoma.