Preoperative prognostic nutritional index predicts risk of recurrence after curative resection for stage IIA colon cancer

Am J Surg. 2021 Jul;222(1):179-185. doi: 10.1016/j.amjsurg.2020.10.032. Epub 2020 Oct 29.

Abstract

Background: Preoperative nutritional and inflammatory indices have been reported to be associated with the prognosis of patients with malignancy. We evaluated clinicopathological factors, including nutritional and inflammatory indices, and recurrence prognosis in patients with stage IIA colon cancer (CC) who underwent curative surgery.

Methods: This retrospective study included 197 patients with stage IIA CC who had undergone curative resection. We evaluated the association between prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) with clinicopathological factors and prognosis for recurrence. For the recurrence-free survival (RFS) analysis, receiver operating characteristic (ROC) curves were used to determine appropriate cutoff values for PNI, NLR, and PLR.

Results: Univariate analyses showed that PNI<44.8 (P = 0.028) was significantly associated with worse RFS in patients with stage IIA CC patients. In the multivariate analyses, PNI<44.8 (hazard ratio [HR] 2.082; 95% confidence interval [CI] 1.005-4.317; P = 0.049) independently and significantly predicted RFS.

Conclusion: PNI is a useful marker for predicting recurrence prognosis in post-resection patients with stage IIA CC.

Keywords: Adjuvant chemotherapy; Prognostic nutritional index; Stage IIA colon Cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chemotherapy, Adjuvant
  • Clinical Decision-Making / methods*
  • Colectomy*
  • Colonic Neoplasms / blood
  • Colonic Neoplasms / diagnosis
  • Colonic Neoplasms / mortality
  • Colonic Neoplasms / therapy*
  • Disease-Free Survival
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation / blood
  • Inflammation / diagnosis
  • Inflammation / immunology
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Staging
  • Neutrophils / immunology
  • Nutrition Assessment*
  • Platelet Count
  • Preoperative Period
  • Prognosis
  • Proportional Hazards Models
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment / methods
  • Risk Assessment / statistics & numerical data