Prognostic impact of preoperative prognostic nutritional index in resected advanced gastric cancer: A multicenter propensity score analysis

Luo, Zeyu; Zhou, Lin; Balde, Alpha Ibrahima; Zhou, Li; Li, He; ZhenWei, Cai; Zou, Z W; Huang, Sheng‐Yi; Han, Shuai; Zhou, Min; Zhang, Gang Qing; Cai, Zhai

doi:10.1016/j.ejso.2018.09.004

Cited by 36 publications

(24 citation statements)

References 22 publications

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“…Thus, a proper preoperative assessment of the nutritional status of gastric cancer patients should be performed. Numerous studies have sought to develop a reliable, valid scoring system that can identify patients with poor nutritional status and some systems have been used successfully to predict complications after gastrectomy [36][37][38].…”

Section: Nutritionmentioning

confidence: 99%

Preoperative predictors of postoperative complications after gastric cancer resection

Kanda¹

2019

Surg Today

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Risk management is becoming an increasingly important healthcare issue. Gastrectomy with lymphadenectomy is still the mainstay of treatment for localized gastric cancer, but it is sometimes associated with postoperative complications that compromise the patient's quality of life, tolerability of adjuvant treatment, and prognosis. Parameters based exclusively on preoperative factors can identify patients most at risk of postoperative complications, whereby surgeons can provide the patient with precise informed consent information and optimal perioperative management. Ultimately, these predictive tools can also help minimize medical costs. In this context, many studies have identified factors that predict postoperative complications, including indicators based on body constitution, nutrition, inflammation, organ function and hypercoagulation. This review presents our current understanding and discusses some future perspectives of preoperatively identified factors predictive of complications after resection for gastric cancer.

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Section: Nutritionmentioning

confidence: 99%

Preoperative predictors of postoperative complications after gastric cancer resection

Kanda¹

2019

Surg Today

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“…Many studies have indicated that not only tumorrelated factors, but also patient-related factors such as systemic inflammation and nutritional status, are involved in the prognosis of patients with cancer. Several inflammation-based and/or nutritional markers have recently been developed and preoperative markers, such as C-reactive protein to albumin ratio (CAR) [3,4], neutrophils to lymphocyte ratio (NLR) [5,6], platelets to lymphocyte ratio (PLR) [7,8], as well as prognostic nutritional index (PNI) [9,10], Glasgow prognostic score (GPS) [11,12] and prognostic index (PI) [13,14] are prognostic for various cancers. These markers are promising as clinical prognostic predictors of cancer because they are inexpensive and simple to estimate.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of prognostic inflammation-based and/or nutritional markers in patients with stage III gastric cancer

et al. 2020

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Background: Although many studies have identified several inflammation-based and/or nutritional markers with prognostic value for patients with various types of cancer, the optimal markers and cutoff values for these markers remain obscure. Therefore, this retrospective study aimed to identify optimal markers and their cutoffs. Methods: We compared prognostic values among established preoperative inflammation-based and/or nutritional markers in 225 patients who underwent R0 resection for stage III gastric cancer. Inflammationbased and/or nutritional markers comprised C-reactive protein to albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), prognostic nutritional index (PNI), Glasgow prognostic score (GPS), and prognostic index (PI). Time-dependent receiver operating characteristic curves were analyzed to assess predictive ability and to determine the optimal cutoff values. Prognostic factors predicting overall survival (OS) and cancer specific survival (CSS) were analyzed using Cox proportional hazards models. Results: Multivariate analyses revealed that CAR and PLR cutoff values of 0.47 and 172, respectively, were independent prognostic factors for overall survival (OS) (HR, 2.257; 95% CI, 1.180-4.319; p = 0.014 and HR, 1.478; 95% CI, 1.025-2.133; p = 0.037, respectively) and cancer-specific survival (CSS) (HR, 2.771; 95% CI, 1.398-5.493; p = 0.004 and HR, 1.552; 95% CI, 1.029-2.341; p = 0.036, respectively). These results were different from those we previously reported in patients with stage II. Conclusions: Among inflammation-based and/or nutritional markers, CAR and PLR were independent prognostic factors of OS and CSS in patients with stage III gastric cancer. The optimal markers and their cutoff values should be determined in specific populations.

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“…Recently, a variety of prognostic indicators based on cancer-related inflammation have been developed to predict surgical risk and tumor prognosis (17,18). PNI, established by Onodera et al (19), is a simple and easy parameter to reflect the immune and inflammatory status and has been proved to be an effective prognostic indicator for various malignancy (7)(8)(9). The latest research suggested that serum albumin was associated with systemic inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…The evaluation of preoperative immunenutritional status can predict the risk and survival rate of surgery, which is helpful to determine strategies to prevent postoperative complications and improve the prognosis. The prognostic nutritional index (PNI), which combines nutritional and immune parameters, has been proven to be a good predictor of postoperative complications and survival rates for many malignancy (7)(8)(9). Tokunaga et al (8) conducted a study of 556 cases of CRC in 2015.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Prognostic Nutritional Index in Patients With Colorectal Cancer Undergoing Surgical Treatment

Xie

Wei²,

Yuan³

et al. 2022

Front. Nutr.

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BackgroundTo investigate the relationship between prognostic nutritional index (PNI) and the survival of patients with colorectal cancer (CRC) undergoing surgical treatment.MethodsIn total 1,014 CRC patients who underwent surgical treatment were enrolled. Logistic regression analysis was used to identify the features that influenced postoperative complications in CRC patients. Restricted cubic spline was used to assess the dose-response relationship between PNI and survival in CRC patients. Kaplan-Meier method and log-rank test were used to compare survival differences between groups of CRC patients. Cox proportional risk regression models was used to assess independent risk factors for progression-free survival (PFS) and overall survival (OS) of CRC patients.ResultsLow PNI was associated with high tumor burden, invasive pathological features, and poor host status. Compared with patients with high PNI, patients with low PNI have a higher incidence of complications and longer hospital stay. Low PNI was an independent risk factor for postoperative complications in CRC patients. for every SD increased in PNI, the risk of poor prognosis for CRC patients was reduced by 2.3% (HR = 0.977, 95%CI = 0.962–0.993, p = 0.004) in PFS, and 2.3% (HR = 0.977, 95%CI = 0.962–0.993, p = 0.004) in OS. PNI was an independent prognostic factor affecting the PFS and OS of CRC patients. Finally, we constructed the PNI-based nomograms to predict postoperative complications, 1–5 years PFS and OS in CRC patients. Concordance index and calibration curve indicated that the PNI-based nomograms have moderate prediction accuracy.ConclusionPNI is an independent risk factor affecting postoperative complications, PFS and OS of CRC patients, and is a useful supplement to the TNM stage.

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Prognostic impact of preoperative prognostic nutritional index in resected advanced gastric cancer: A multicenter propensity score analysis

Cited by 36 publications

References 22 publications

Preoperative predictors of postoperative complications after gastric cancer resection

Preoperative predictors of postoperative complications after gastric cancer resection

Clinical significance of prognostic inflammation-based and/or nutritional markers in patients with stage III gastric cancer

Prognostic Value of Prognostic Nutritional Index in Patients With Colorectal Cancer Undergoing Surgical Treatment

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