Prognostic Significance of the Prognostic Nutritional Index in Patients with Recurrent Esophageal Squamous Cell Carcinoma

The aim of this study was to evaluate the prognostic impact of the prognostic nutritional index (PNI) in patients with recurrent esophageal squamous cell carcinoma (ESCC). We retrospectively reviewed 76 ESCC patients who developed recurrence after curative subtotal esophagectomy at Nara Medical University Hospital between January 2001 and October 2016. The PNI at ESCC recurrence was calculated as 10x serum albumin (g/dl) + 0.005 x total lymphocyte count (/mm(3)). The cutoff value of the PNI was set at 45. Multivariate analysis was performed to identify the prognostic factors. The mean PNI was 44.0 +/- 5.8, and 42 (55.3%) patients had a PNI <45 at recurrence. The multivariate analysis identified a low PNI (P = 0.047), multiple recurrence sites (P = 0.002), and no treatment for recurrence (P = 0.034) as independent factors for a short survival time after recurrence. A low PNI was significantly associated with a high performance status score, high C-reactive protein level, and short duration of treatment for recurrence. In conclusion, the PNI at recurrence can predict the survival time in patients with recurrent ESCC.