Effect of the prognostic nutritional index on prognosis in patients undergoing gastric cancer surgery

Abstract

Objective: The leading concern among cancer patients is posttreatment complications and survival, which are associated with patient-related, tumor-related and treatment-related factors. We present here an analysis of the Prognostic Nutritional Index (PNI) as a preoperatively improvable prognostic factor. Material and methods: A retrospective review was made of 228 patients operated on for gastric cancer between January 2011 and October 2019. The patients were divided into two groups based on PNI (PNI <45 and PNI ≥45). The clinicopathological characteristics and prognosis of the patients were recorded and analyzed. Results: PNI was ≥45 in 162 patients and <45 in 66 patients. An examination of the patients’ clinicopathological and demographic characteristics revealed a statistically significant difference in postoperative complications (p=0.014), age (p=0.054), tumor size (p=0.027), and Body Mass Index (BMI) (p=0.041) between the two groups. Using a Kaplan-Meier test, overall survival analysis revealed a difference between the two groups (p=0.001). A multivariate Cox regression analysis of the factors impacting overall survival revealed the T stage (p=0.031), N stage (p<0.001), and PNI (p=0.041) to be significant. Conclusion: The prognostic nutritional index is easy to calculate, a simple and practical approach to assessing nutritional status. Based on the present study's findings, the preoperative calculation of the prognostic nutritional index can serve as an indicator of postoperative complications and prognosis. The most important benefit of this marker is that it can be improved preoperatively.

Keywords

• Prognostic Nutritional Index
• Gastric Cancer
• Prognosis
• Complications