Preoperative Prognostic Nutrition Index as a Prognostic Indicator of Survival in Elderly Patients Undergoing Gastric Cancer Surgery

Abstract

Purpose Gastric cancer is a common tumor type associated with nutritional and immune status. The aim of the current study was to investigate the prognostic value of a preoperative prognostic nutritional index (PNI), composed of nutritional factors and immune factors in elderly patients undergoing gastric cancer surgery. Patients and Methods A total of 454 patients undergoing gastric cancer surgery were divided into two groups based on preoperative PNI scores: ≤45.1 ( n = 307) and >45.1 ( n = 147). Survival analysis was performed using the Kaplan–Meier method and Log rank tests. Univariate and multivariate analyses were conducted to identify independent prognostic factors using a Cox proportional hazards model. Results According to the X-tile program, the optimal cutoff value for predicting overall survival (OS) with the PNI was 45.1. The receiver operating characteristic analysis revealed that PNI exhibited 70.6% sensitivity and 56.5% specificity for predicting death during long-term follow-up. The cumulative incidence of postoperative 4-year mortality indicated that the risk of death increased significantly for PNI ≤45.1. In multivariate analysis, preoperative PNI was a significant independent predictor of mortality. In the age-stratified subgroup analysis, preoperative PNI was more sensitive for the old elderly subgroup than for the young elderly subgroup. Conclusion Preoperative PNI is a sensitive and specific prognostic predictor among elderly patients undergoing gastric cancer surgery.

Preoperative Nutritional Status and Risk Factors Associated with Delayed Discharge in Geriatric Patients Undergoing Gastrectomy: A Single-Center Retrospective Study

“…The preoperative PNI is an independent prognostic factor for disease-free along with age and TNM stage in GC patients after surgery [21]. A recent study found that preoperative PNI is a sensitive and specific prognostic predictor among elderly patients undergoing gastric cancer surgery [22]. The result in our study showed that low PNI is an independent risk factor associated with prolonged LOS, suggesting that PNI is a predictor for both short-term and long-term outcomes for elderly patients.…”

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

“…Currently, screening for these markers requires additional cost to the patient and redundant targeted testing. As a highly accessible and reproducible biomarker, the association of PNI nutritional status indicators and SII inflammatory indicators with prognosis in patients with various tumors, including gastric cancer, has received increasing attention ( 39 – 41 ). However, few studies have focused on the relationship between SII and PNI on sarcopenia.…”

The relationship of prognostic nutritional index with prognosis and inflammation in patient with heart failure and reduced ejection fraction

“…A significant proportion of HF patients have malnutrition due to chronic energy loss, inflammation, hemodilution, concomitant liver/kidney diseases, infection, and inadequate self-care (Ajayi et al, 1999;Carr et al, 1989;Pasini et al, 2003). It is known that malnutrition predisposes to recurrent infections as well as causes chronic inflammation (Zhang et al, 2021a(Zhang et al, , 2021b.…”

“…The prognostic nutritional index (PNI) (Buzby et al, 1980), first proposed by Buzby et al in 1980, is calculated mainly by counting serum albumin and peripheral blood lymphocytes, and can comprehensively reflect the nutritional status and immune status of patients (Kwag et al, 2014; Schwegler et al, 2010). It has been shown in some studies that malnutrition scoring systems may be associated with prognosis in various malignancies, chronic inflammatory diseases, and chronic cardiovascular diseases (Ren et al, 2021; Wu et al, 2021; Zhang et al, 2021a, 2021b).…”