The prognostic significance of prognostic nutritional index in gastrointestinal stromal tumors: A systematic review and meta-analysis

Abstract

Background: Risk assessment before treatment is important for gastrointestinal stromal tumors (GISTs), which will determine the priority of surgery or preoperative treatment. The prognostic nutritional index (PNI) is an integrated parameter consisting of serum albumin and lymphocyte count. Immunonutritional status defined in this manner is well-known to be closely linked to the prognosis of several other cancers. Nevertheless, the prognostic value of PNI specifically in GISTs has not been well-established. This study aimed to verify the prognostic role of PNI in patients with GISTs. Methods: A comprehensive literature search was conducted on medical databases up to June, 2022, and the raw data (hazard ratios and 95% confidence intervals [CIs]) focusing on the prognostic value of PNI in patients with GISTs regarding recurrence-free survival were extracted and synthesized adopting the random-effects model. This review was registered in the PROSPERO database (CRD42022345440). Results: A total of 8 eligible studies including 2627 patients with GISTs was analyzed and the pooled results confirmed that an elevated PNI was associated with a better recurrence-free survival (hazard ratio: 0.52, 95% CI: 0.40–0.68), with a moderate heterogeneity (I-square, 38%). The findings from subgroup analysis were consistent with the overall pooled results, and a sensitivity analysis, not the subgroup analysis, identified the source of heterogeneity. Conclusion: Elevated pretreatment PNI may be a useful indicator for assessing risk of recurrence in patients from China with GISTs. Studies in other countries and regions are needed to further verify the prognostic value of PNI in GISTs.

Prognostic Nutritional Index is a valuable prognostic marker in Mexican patients operated on and not on gastrointestinal stromal tumors. A retrospective cohort study

“…However, without exception, these studies were performed in patients who underwent curative GIST resection. Of note, in almost all studies, the PNI has repeatedly been an independent prognostic factor, as also demonstrated in several meta-analyses, including in patients receiving or not receiving tyrosine kinase inhibitors [30][31][32].…”

Correlation of Prognostic Nutritional Index and Systemic Immune-Inflammation Index with the Recurrence and Prognosis in Oral Squamous Cell Carcinoma with the Stage of III/IV

“…PNI can reflect the immune and nutritional status of cancer patients. 18 PNI is an effective prognostic factor in patients with various tumors. [19][20][21] It was used to evaluate the preoperative surgical risk and postoperative complications of patients with tumors.…”

Value of the Prognostic Nutritional Index in Surgery for Crohn Disease in China and the Effects on Outcome: A Retrospective Study

“…The Prognostic Nutritional Index (PNI), which is calculated using the serum albumin (ALB) concentration and total lymphocyte count in peripheral blood, is a prognostic marker for many malignant tumors, but it is rarely mentioned in the context of CD. Furthermore, the PNI is rarely used in China 10,11. Therefore, the aim of this study was to determine the application value of PNI in CD surgery and its effects on the outcome.…”

“…Furthermore, the PNI is rarely used in China. 10 , 11 Therefore, the aim of this study was to determine the application value of PNI in CD surgery and its effects on the outcome.…”