Value of the preoperative prognostic nutritional index for the evaluation of patient prognosis after radical gastrectomy

Abstract

Preoperative prognostic nutritional index (PNI) has been widely used for the clinical evaluation of patients with cancer. The present study assessed the prognostic value of preoperative PNI in patients after gastric cancer (GC) radical surgery. The clinical case and follow-up data of 170 patients undergoing GC radical surgery were retrospectively analyzed. The receiver operating characteristic (ROC) curve was used to compare the predictive ability of each inflammatory index: The PNI, neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR). The correlation between the preoperative PNI and overall survival (OS) was also analyzed via Kaplan-Meier (K-M) curves and multivariate Cox regression analyses. The results revealed that the optimal PNI cutoff was 46.030. According to this cutoff value, the whole sample was divided into PNI <46.030 (low PNI group) and PNI ≥46.030 (high PNI group). These groups were comprised of 102 and 68 cases, respectively. The area under the curve value of the PNI was 0.725, which was greater than that of traditional inflammatory indices, including the NLR and LMR. K-M survival analysis revealed that the 5 year survival rate of patients in the low PNI group was significantly lower than that of patients in the high PNI group (P<0.01). Univariate analysis and Cox multiple regression model analysis demonstrated that the T stage, N stage, pathological grade and PNI were independent risk factors for the 5 year survival rate after radical gastrectomy (P<0.05). In conclusion, the preoperative PNI is an independent risk factor for 5 year survival after radical gastrectomy and has clinical value for the prognostic evaluation of patients with GC.

Relación del índice nutricional pronóstico con complicaciones y mortalidad en los pacientes con cáncer gástrico sometidos a gastrectomía en un hospital de tercer nivel de Bogotá, Colombia

“…La respuesta inmune de los linfocitos al tumor se ha aplicado gradualmente a la evaluación pronóstica en los pacientes con cáncer en los últimos años 25 . Un estudio reciente muestra que el INP preoperatorio es superior a los marcadores inflamatorios tradicionales para la evaluación del pronóstico después de la gastrectomía y que es un factor de riesgo independiente para mortalidad después de la gastrectomía 30 . Esto puede ser explicado porque el INP preoperatorio refleja el estado nutricional y la respuesta inflamatoria del cuerpo.…”