The clinical value of prognostic nutritional index in gastric cancer patients with peritoneal metastasis / 中华普通外科杂志

ABSTRACT

Objective To evaluate the prognostic value of prognostic nutritional index (PNI) in gastric cancer patients with peritoneal metastasis.Methods 287 gastric cancer patients with peritoneal metastasis were enrolled from Jan 2010 to Dec 2016.Results Compared with PNI ＞ 45,patients in PNI≤45 group were elder [(59 ± 11) vs.(54 ± 11),t =3.734,P =0.000],lower albumin [(35 ± 4) g/L vs.(42 ± 4)g/L,t =15.988,P =0.003)],lower plasm hemoglobin concentration [(110 ± 22)g/L vs.(129 ±24) g/L,t =6.245,P =0.000),higher platelet count/lymphocyte count ratio [PLR,(210 ± 89) vs.(150 ± 66),t =6.547,P =0.000],higher neutrophil count/lymphocyte count ratio [NLR,(3.7 ± 2.9)vs.(2.4 ± 1.2),t =4.628,P =0.000],lower percentage of pallative gastrectomy (45.5％ to 58.5％,x2 =4.45,P =0.035).Logistic regression analysis showed that age ＞ 58-years,NLR ＞ 2.87,PLR ＞ 170,hemoglobin ≤ 130 g/L,local organ infiltration were risk factors leading to low-PNI (all P ＜ 0.05).The median survival time for all patients was 8.7 months.Univariate analysis revealed that,PNI ＞ 45,serum albumin ＞ 40 g/L,no ascites,lower-grade of peritoneal metastasis,pallative gastrectomy,postoperation chemotherapy were positively associated with better prognosis (all P ＜ 0.05).Multivariate analysis demonstarted that,PNI (HR =0.717,P =0.039).Grade of peritoneal metastasis (HR =1.206,P =0.044),pallative gastrectomy (HR =1.529,P =0.001) were independent prognostic risk factors for the patients with peritoneal metastasis.Conclusion PNI are both predictors of nutrition assessment and of prognosis for gastric cancer patients with peritoneal metastasis.