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J Cancer Res Clin Oncol. 2017 Jul;143(7):1235-1242. doi: 10.1007/s00432-017-2366-x. Epub 2017 Feb 27.

Impact of the prognostic nutritional index on the recovery and long-term oncologic outcome of patients with colorectal cancer.

Author information

1
Department of Surgery, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
2
Department of Surgery, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea. namkyuk@yuhs.ac.

Abstract

PURPOSE:

The prognostic nutritional index (PNI) has been reported to be a predictive marker for surgical outcomes and prognosis in gastrointestinal malignancies. In this study, we aimed to identify the impact of preoperative PNI on the recovery and long-term oncologic outcome of patients with colorectal cancer (CRC).

METHODS:

A total of 3569 patients who underwent curative resection for CRC were enrolled, and their medical records were analyzed retrospectively. Preoperative PNI was calculated as 10× serum albumin concentration (g/dL) + 0.005 × total lymphocyte count (/mm3). The occurrence of postoperative complications, duration of hospital stay, disease-free survival, and overall survival were analyzed according to the preoperative PNI. In addition, PNI was compared according to the status of pathologic factors.

RESULTS:

The postoperative complication rate and postoperative duration of hospital stay increased significantly as PNI increased. Patients with a lower PNI showed a worse survival outcome. Increased depth of tumor invasion, presence of distant metastasis, and poorer histologic grade were associated with a lower PNI. The cut-point of preoperative PNI was calculated as 50, and patients with PNI > 50 showed a markedly better survival outcome. Furthermore, patients with PNI > 50 showed better results in postoperative complication rate and postoperative duration of hospital stay.

CONCLUSION:

Preoperative PNI is a simple and efficient indicator (cut-point 50) for estimating the recovery and oncologic outcome of patients. A low PNI was associated with increased occurrence of postoperative complications, prolonged hospital stay, poor oncologic outcome, and aggressive tumor phenotypes.

KEYWORDS:

Colorectal cancer; Oncologic outcome; tumor phenotype; Postoperative complication; Prognostic nutritional index

PMID:
28243747
DOI:
10.1007/s00432-017-2366-x
[Indexed for MEDLINE]

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