Is Prognostic Nutritional Index an Indicator for Postoperative 90-Day Mortality in Laparoscopic Gastric Cancer Surgery?

Zengin, Akile; Bağ, Yusuf Murat; Aydın, Mehmet Can; Kocaaslan, Huseyin; Kaplan, Kuntay; Sümer, Fatih; Kayaalp, Cüneyt

doi:10.1080/01635581.2021.2002920

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…As an easily obtainable biological indicator, PNI has been widely considered to dynamically reflect the immune function and nutritional status of the whole body ( 19 ). Since the innovative application of PNI by Onodera T for assessing the surgical risk and prognosis of patients with gastrointestinal malignancies, numerous studies ( 20 – 23 ), including our work, have demonstrated that PNI could be a significant prognostic factor for evaluating both short- and long-term outcomes of GC patients. Wang et al ( 15 ) found that the fibrinogen and PNI (FPNI) score was significantly associated with advanced age, large tumor size, high American Society of Anesthesiologists (ASA) scores, late TNM stage, and poor prognosis ( P < 0.01).…”

Section: Discussionmentioning

confidence: 83%

A novel nomogram based on the prognostic nutritional index for predicting postoperative outcomes in patients with stage I–III gastric cancer undergoing robotic radical gastrectomy

Shen

Zhou²,

Jin-yuan³

et al. 2022

Front. Surg.

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BackgroundThe inflammation and nutrition status are crucial factors influencing the outcome of patients with gastric cancer. This study aims to investigate the prognostic value of the preoperative prognostic nutritional index (PNI) in patients with stage I–III gastric cancer undergoing robotic radical gastrectomy combined with Enhanced Recovery after Surgery (ERAS), and further to create a clinical prognosis prediction model.Study525 patients with stage I–III gastric cancer who underwent ERAS combined with RRG from July 2010 to June 2018 were included in this work, and were divided randomly into training and validating groups in a 7-to-3 ratio. The association between PNI and overall survival (OS) was assessed by Kaplan-Meier analysis and the log-rank test. Independent risk factors impacting postoperative survival were analyzed with the Cox proportional hazards regression model. A nomogram for predicting OS was constructed based on multivariate analysis, and its predictive performance was evaluated using Harrell's concordance index (C-index), calibration plots, ROC curve, decision curve analysis (DCA), and time-dependent ROC curve analysis.ResultsSurvival analyses revealed the presence of a significant correlation between low preoperative PNI and shortened postoperative survival (P = 0.001). According to multivariate analysis, postoperative complications (P < 0.001), pTNM stage (II: P = 0.007; III: P < 0.001), PNI (P = 0.048) and lymph node ratio (LNR) (P = 0.003) were independent prognostic factors in patients undergoing ERAS combined with RRG. The nomogram constructed based on PNI, pTNM stage, complications, and LNR was superior to the pTNM stage model in terms of predictive performance. The C-indexes of the nomogram model were respectively 0.765 and 0.754 in the training and testing set, while AUC values for 1-year, 3-year, and 5-year OS were 0.68, 0.71, and 0.74 in the training set and 0.60, 0.67, and 0.72 in the validation set.ConclusionPreoperative PNI is an independent prognostic factor for patients with stage I–III gastric cancer undergoing ERAS combined with robotic radical gastrectomy. Based on PNI, we constructed a nomogram for predicting postoperative outcomes of gastric cancer patients, which might be utilized clinically.

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Section: Discussionmentioning

confidence: 83%

A novel nomogram based on the prognostic nutritional index for predicting postoperative outcomes in patients with stage I–III gastric cancer undergoing robotic radical gastrectomy

Shen

Zhou²,

Jin-yuan³

et al. 2022

Front. Surg.

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Pharmacist-led standardization of total parenteral nutrition improves postoperative nutritional status in colorectal cancer patients

Tong¹,

Sun²,

Xin³

et al. 2022

Ann Transl Med

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Combined systemic inflammatory immunity index and prognostic nutritional index scores as a screening marker for sarcopenia in patients with locally advanced gastric cancer

Ding

Sun

et al. 2022

Front. Nutr.

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BackgroundSarcopenia is associated with poor clinical outcomes in patients with locally advanced gastric cancer (LAGC). Currently, the diagnostic criteria for sarcopenia are complex and laborious. Increased evidence suggests the inflammatory state of the body is closely associated with the development of sarcopenia. The systemic immune-inflammatory index (SII) and the prognostic nutritional index (PNI) are representative blood indicators of the status of the systemic inflammatory response, but the clinical significance of the combined testing of these two indicators remains unclear. We aimed to develop a simple and practical risk score (SII-PNI score) to screen patients with LAGC for sarcopenia on admission for early diagnosis.MethodsWe registered a prospective clinical study from January 2011 to May 2016 involving 134 patients with LAGC undergoing radical surgical resection. All patients followed the definition of sarcopenia in the Asian Working Group on Sarcopenia (AWGS) guidelines and were divided into sarcopenia and non-sarcopenia groups. SII-PNI score 0–2 was scored as 2 for high SII (≥432.9) and low PNI ( ≤ 49.5); score 1, either high SII or low PNI; score 0, no high SII or low PNI.ResultsAll patients underwent radical surgery, including 31 patients (23.13%) with sarcopenia according to AWGS criteria. The SII-PNI score was significantly lower in the non-sarcopenic patients than in the sarcopenic patients (p < 0.001). Logistic multivariate analysis showed that the SII-PNI score predicted an independent prognostic factor for sarcopenia (p < 0.001). Patients with high SII-PNI scores had significantly worse prognosis than those with low SII-PNI scores (p < 0.001). The SII-PNI score was an independent prognostic factor for predicting overall survival and disease-free survival (p = 0.016, 0.023).ConclusionPeripheral blood parameters SII-PNI scores accurately identify sarcopenia in patients with LAGC and could be used as potential systemic markers.

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Is Prognostic Nutritional Index an Indicator for Postoperative 90-Day Mortality in Laparoscopic Gastric Cancer Surgery?

Cited by 3 publications

References 16 publications

A novel nomogram based on the prognostic nutritional index for predicting postoperative outcomes in patients with stage I–III gastric cancer undergoing robotic radical gastrectomy

A novel nomogram based on the prognostic nutritional index for predicting postoperative outcomes in patients with stage I–III gastric cancer undergoing robotic radical gastrectomy

Pharmacist-led standardization of total parenteral nutrition improves postoperative nutritional status in colorectal cancer patients

Combined systemic inflammatory immunity index and prognostic nutritional index scores as a screening marker for sarcopenia in patients with locally advanced gastric cancer

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