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.

• Authors: Xiaonan Zhang, Huimin Fang, Zhigang Zeng, Kaijun Zhang, Zhanyi Lin, Gang Deng, Weiping Deng, Lichang Guan, Xuebiao Wei, Xinyi Li, Lei Jiang, Lishu Xu
• Journal: Cancer management and research (Cancer Manag Res) Vol. 13 Pg. 5263-5273 ( 2021) ISSN: 1179-1322 [Print] New Zealand
• PMID: 34239325 (Publication Type: Journal Article)
• Copyright: © 2021 Zhang et al.