The value of preoperative prognostic nutritional index in elderly patients with gastric cancer / 中华普通外科杂志

ABSTRACT

Objective To evaluate the impact of preoperative prognostic nutritional index (PNI) on surgical outcomes and long-term survival of elderly patients with gastric cancer.Methods From Jan 2007 to Dec 2012,the clinicopathological data of 165 elderly patients (age ＞ 65 years old) with gastric cancer undergoing radical gastrectomy in the Second Hospital of Tianjin Medical University were analyzed retrospectively.PNI value was calculated by serum albumin (g/L) + 5 × lymphocyte count (× 109/L).The receiver operating characteristic (ROC) curve and Youden index was used to determine the cut-off value of PNI.Patients were then divided into low PNI group and high PNI group based on the cut-off value.The two groups were compared according to clinicopathological characteristics,postoperative complication and longterm survival.Results The mean PNI value was 46.1-± 5.3,When the PN1 was 46.4,the Youden index was maximal,with a sensitivity of 78％ and specificity of 59％.There were 79 patients in the low PNI group and 86 patients in high PNI group.No significant correlations between PNI and gender,age,BMI,pathological type,tumor diameter,extranodal metastasis and postoperative morbidity were observed.There were significant difference in the depth of invasion (x2 =6.732,P =0.009),N stage(x2 =13.191,P =0.004),TNM stage(x2 =12.137,P =0.000) and postoperative hospital stay (t =4.595,P =0.000).By Kaplan-Meier method,PNI (P =0.000),depth of invasion (P =0.002),N stage (P =0.000),TNM stage(P =0.000) and extranodal metastasis (P =0.031) had significant impacts on overall survival.PNI (P =0.016)and N stage (P =0.018) were independent factors for predicting overall survival rate.Conclusions PNI helps in evaluating preoperative nutritional status and postoperative prognosis for elderly patients with gastric cancer.