Significance of Preoperative Prognostic Nutritional Index in the Perioperative Management of Gastric Cancer
Background Malnutrition leads to accelerated tumor progression through the suppression of tumor immunity. The present study examined the significance of the preoperative prognostic nutritional index (PNI) for predicting postoperative survival outcomes in gastric cancer (GC). Methods A total of 447 p...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2022-03, Vol.26 (3), p.558-569 |
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| creator | Konishi, Tomoki Kosuga, Toshiyuki Inoue, Hiroyuki Konishi, Hirotaka Shiozaki, Atsushi Kubota, Takeshi Okamoto, Kazuma Fujiwara, Hitoshi Otsuji, Eigo |
| description | Background
Malnutrition leads to accelerated tumor progression through the suppression of tumor immunity. The present study examined the significance of the preoperative prognostic nutritional index (PNI) for predicting postoperative survival outcomes in gastric cancer (GC).
Methods
A total of 447 patients who underwent curative gastrectomy for GC were included in the present study. PNI was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte counts (per mm
3
). The prognostic impact of preoperative PNI was examined using two multivariate analysis models.
Results
The optimal cutoff value of preoperative PNI for predicting overall survival (OS) was 48 based on a receiver operating characteristic curve. The 5-year OS rate was 59.5% in the PNI |
| doi_str_mv | 10.1007/s11605-021-05168-x |
| format | Article |
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Malnutrition leads to accelerated tumor progression through the suppression of tumor immunity. The present study examined the significance of the preoperative prognostic nutritional index (PNI) for predicting postoperative survival outcomes in gastric cancer (GC).
Methods
A total of 447 patients who underwent curative gastrectomy for GC were included in the present study. PNI was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte counts (per mm
3
). The prognostic impact of preoperative PNI was examined using two multivariate analysis models.
Results
The optimal cutoff value of preoperative PNI for predicting overall survival (OS) was 48 based on a receiver operating characteristic curve. The 5-year OS rate was 59.5% in the PNI<48 group and 91.3% in the PNI≥48 group (
p
<0.001). In the first multivariate survival analysis where all explanatory variables were composed of preoperative factors alone, a PNI<48 (hazard ratio [HR] 3.33; 95% confidence interval [CI] 2.01–5.56,
p
<0.001), upper-third GC and cT2–T4 were identified as independent indicators of a poor OS. In the second survival analysis where explanatory variables were composed of preoperative, intraoperative, and pathological factors, a PNI<48 (HR 2.80; 95% CI 1.65–4.78,
p
<0.001), hypertension, open gastrectomy, intraoperative blood loss≥100g, pT2–T4, and pN+ were independent prognostic factors.
Conclusion
Preoperative PNI may be a useful predictor of postoperative survival outcomes both before and immediately after surgery in GC. Appropriate perioperative interventions and the meticulous surveillance of GC relapse are necessary for patients with PNI<48.]]></description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-021-05168-x</identifier><identifier>PMID: 34725783</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Gastric cancer ; Gastroenterology ; Gastrointestinal surgery ; Humans ; Medical prognosis ; Medicine ; Medicine & Public Health ; Neoplasm Recurrence, Local ; Nutrition Assessment ; Nutritional Status ; Original Article ; Prognosis ; Retrospective Studies ; Stomach Neoplasms - pathology ; Surgery ; Survival analysis</subject><ispartof>Journal of gastrointestinal surgery, 2022-03, Vol.26 (3), p.558-569</ispartof><rights>The Society for Surgery of the Alimentary Tract 2021</rights><rights>2021. The Society for Surgery of the Alimentary Tract.</rights><rights>The Society for Surgery of the Alimentary Tract 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-e236c7d15b2e2b06f48a45791738111717d5ec2d54b87930b41c1cb27db145773</citedby><cites>FETCH-LOGICAL-c441t-e236c7d15b2e2b06f48a45791738111717d5ec2d54b87930b41c1cb27db145773</cites><orcidid>0000-0002-1657-7272</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-021-05168-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-021-05168-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34725783$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Konishi, Tomoki</creatorcontrib><creatorcontrib>Kosuga, Toshiyuki</creatorcontrib><creatorcontrib>Inoue, Hiroyuki</creatorcontrib><creatorcontrib>Konishi, Hirotaka</creatorcontrib><creatorcontrib>Shiozaki, Atsushi</creatorcontrib><creatorcontrib>Kubota, Takeshi</creatorcontrib><creatorcontrib>Okamoto, Kazuma</creatorcontrib><creatorcontrib>Fujiwara, Hitoshi</creatorcontrib><creatorcontrib>Otsuji, Eigo</creatorcontrib><title>Significance of Preoperative Prognostic Nutritional Index in the Perioperative Management of Gastric Cancer</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description><![CDATA[Background
Malnutrition leads to accelerated tumor progression through the suppression of tumor immunity. The present study examined the significance of the preoperative prognostic nutritional index (PNI) for predicting postoperative survival outcomes in gastric cancer (GC).
Methods
A total of 447 patients who underwent curative gastrectomy for GC were included in the present study. PNI was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte counts (per mm
3
). The prognostic impact of preoperative PNI was examined using two multivariate analysis models.
Results
The optimal cutoff value of preoperative PNI for predicting overall survival (OS) was 48 based on a receiver operating characteristic curve. The 5-year OS rate was 59.5% in the PNI<48 group and 91.3% in the PNI≥48 group (
p
<0.001). In the first multivariate survival analysis where all explanatory variables were composed of preoperative factors alone, a PNI<48 (hazard ratio [HR] 3.33; 95% confidence interval [CI] 2.01–5.56,
p
<0.001), upper-third GC and cT2–T4 were identified as independent indicators of a poor OS. In the second survival analysis where explanatory variables were composed of preoperative, intraoperative, and pathological factors, a PNI<48 (HR 2.80; 95% CI 1.65–4.78,
p
<0.001), hypertension, open gastrectomy, intraoperative blood loss≥100g, pT2–T4, and pN+ were independent prognostic factors.
Conclusion
Preoperative PNI may be a useful predictor of postoperative survival outcomes both before and immediately after surgery in GC. Appropriate perioperative interventions and the meticulous surveillance of GC relapse are necessary for patients with PNI<48.]]></description><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Recurrence, Local</subject><subject>Nutrition Assessment</subject><subject>Nutritional Status</subject><subject>Original Article</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - pathology</subject><subject>Surgery</subject><subject>Survival analysis</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc1OGzEUha2qiISfF-gCjcSGzbS-_hlPllXUpki0IAESO8vjuRMcEju1Z1D69nUINBKLrmzL3_mu7EPIJ6CfgVL1JQFUVJaUQUklVHW5-UDGUCteiopVH_OeTqBkUj6MyFFKC0pBUagPyYgLxaSq-Zg83bq5d52zxlssQlfcRAxrjKZ3z5gPYe5D6p0tfg19dL0L3iyLS9_ipnC-6B8zg9HtEz-NN3Ncoe-3splJOWWL6dYeT8hBZ5YJT1_XY3L__dvd9Ed5dT27nH69Kq0Q0JfIeGVVC7JhyBpadaI2QqoJKF4DgALVSrSslaKp1YTTRoAF2zDVNpA5xY_Jxc67juH3gKnXK5csLpfGYxiSZnLCeDbRLXr-Dl2EIeY3ZqoSVNaV4CxTbEfZGFKK2Ol1dCsT_2igeluF3lWhcxX6pQq9yaGzV_XQrLD9F3n7-wzwHZDylZ9j3M_-j_YvNrGUVA</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Konishi, Tomoki</creator><creator>Kosuga, Toshiyuki</creator><creator>Inoue, Hiroyuki</creator><creator>Konishi, Hirotaka</creator><creator>Shiozaki, Atsushi</creator><creator>Kubota, Takeshi</creator><creator>Okamoto, Kazuma</creator><creator>Fujiwara, Hitoshi</creator><creator>Otsuji, Eigo</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1657-7272</orcidid></search><sort><creationdate>20220301</creationdate><title>Significance of Preoperative Prognostic Nutritional Index in the Perioperative Management of Gastric Cancer</title><author>Konishi, Tomoki ; Kosuga, Toshiyuki ; Inoue, Hiroyuki ; Konishi, Hirotaka ; Shiozaki, Atsushi ; Kubota, Takeshi ; Okamoto, Kazuma ; Fujiwara, Hitoshi ; Otsuji, Eigo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-e236c7d15b2e2b06f48a45791738111717d5ec2d54b87930b41c1cb27db145773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Recurrence, Local</topic><topic>Nutrition Assessment</topic><topic>Nutritional Status</topic><topic>Original Article</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - pathology</topic><topic>Surgery</topic><topic>Survival analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Konishi, Tomoki</creatorcontrib><creatorcontrib>Kosuga, Toshiyuki</creatorcontrib><creatorcontrib>Inoue, Hiroyuki</creatorcontrib><creatorcontrib>Konishi, Hirotaka</creatorcontrib><creatorcontrib>Shiozaki, Atsushi</creatorcontrib><creatorcontrib>Kubota, Takeshi</creatorcontrib><creatorcontrib>Okamoto, Kazuma</creatorcontrib><creatorcontrib>Fujiwara, Hitoshi</creatorcontrib><creatorcontrib>Otsuji, Eigo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Konishi, Tomoki</au><au>Kosuga, Toshiyuki</au><au>Inoue, Hiroyuki</au><au>Konishi, Hirotaka</au><au>Shiozaki, Atsushi</au><au>Kubota, Takeshi</au><au>Okamoto, Kazuma</au><au>Fujiwara, Hitoshi</au><au>Otsuji, Eigo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Significance of Preoperative Prognostic Nutritional Index in the Perioperative Management of Gastric Cancer</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>26</volume><issue>3</issue><spage>558</spage><epage>569</epage><pages>558-569</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract><![CDATA[Background
Malnutrition leads to accelerated tumor progression through the suppression of tumor immunity. The present study examined the significance of the preoperative prognostic nutritional index (PNI) for predicting postoperative survival outcomes in gastric cancer (GC).
Methods
A total of 447 patients who underwent curative gastrectomy for GC were included in the present study. PNI was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte counts (per mm
3
). The prognostic impact of preoperative PNI was examined using two multivariate analysis models.
Results
The optimal cutoff value of preoperative PNI for predicting overall survival (OS) was 48 based on a receiver operating characteristic curve. The 5-year OS rate was 59.5% in the PNI<48 group and 91.3% in the PNI≥48 group (
p
<0.001). In the first multivariate survival analysis where all explanatory variables were composed of preoperative factors alone, a PNI<48 (hazard ratio [HR] 3.33; 95% confidence interval [CI] 2.01–5.56,
p
<0.001), upper-third GC and cT2–T4 were identified as independent indicators of a poor OS. In the second survival analysis where explanatory variables were composed of preoperative, intraoperative, and pathological factors, a PNI<48 (HR 2.80; 95% CI 1.65–4.78,
p
<0.001), hypertension, open gastrectomy, intraoperative blood loss≥100g, pT2–T4, and pN+ were independent prognostic factors.
Conclusion
Preoperative PNI may be a useful predictor of postoperative survival outcomes both before and immediately after surgery in GC. Appropriate perioperative interventions and the meticulous surveillance of GC relapse are necessary for patients with PNI<48.]]></abstract><cop>New York</cop><pub>Springer US</pub><pmid>34725783</pmid><doi>10.1007/s11605-021-05168-x</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-1657-7272</orcidid></addata></record> |
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| subjects | Gastric cancer Gastroenterology Gastrointestinal surgery Humans Medical prognosis Medicine Medicine & Public Health Neoplasm Recurrence, Local Nutrition Assessment Nutritional Status Original Article Prognosis Retrospective Studies Stomach Neoplasms - pathology Surgery Survival analysis |
| title | Significance of Preoperative Prognostic Nutritional Index in the Perioperative Management of Gastric Cancer |
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