Prognostic nutritional index predicts postoperative complications and long-term outcomes of gastric cancer

被引:134
作者
Jiang, Nan [1 ,2 ]
Deng, Jing-Yu [1 ,2 ]
Ding, Xue-Wei [1 ,2 ]
Ke, Bin [1 ,2 ]
Liu, Ning [1 ,2 ]
Zhang, Ru-Peng [1 ,2 ]
Liang, Han [1 ,2 ]
机构
[1] Tianjin Med Univ, Canc Inst & Hosp, Key Lab Canc Prevent & Therapy, Natl Clin Res Ctr Canc,Dept Gastrointestinal Onco, Tianjin 300060, Peoples R China
[2] Key Lab Canc Prevent & Therapy, Tianjin 300060, Peoples R China
关键词
Prognostic nutritional index; gastric cancer; postoperative complications; total gastrectomy; prognosis; MALIGNANT PLEURAL MESOTHELIOMA; TOTAL GASTRECTOMY; CONSECUTIVE SERIES; CARCINOMA; SURVIVAL; TRIAL; MORTALITY; RESECTION; IMPROVES; LEAKAGE;
D O I
10.3748/wjg.v20.i30.10537
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
AIM: To investigate the impact of prognostic nutritional index (PNI) on the postoperative complications and long-term outcomes in gastric cancer patients undergoing total gastrectomy. METHODS: The data for 386 patients with gastric cancer were extracted and analyzed between January 2003 and December 2008 in our center. The patients were divided into two groups according to the cutoff value of the PNI: those with a PNI >= 46 and those with a PNI < 46. Clinicopathological features were compared between the two groups and potential prognostic factors were analyzed. The relationship between postoperative complications and PNI was analyzed by logistic regression. The univariate and multivariate hazard ratios were calculated using the Cox proportional hazard model. RESULTS: The optimal cutoff value of the PNI was set at 46, and patients with a PNI >= 46 and those with a PNI < 46 were classified into PNI-high and PNI-low groups, respectively. Patients in the PNI-low group were more likely to have advanced tumor (T), node (N), and TNM stages than patients in the PNI-high group. The low PNI is an independent risk factor for the incidence of postoperative complications (OR = 2.223). The 5-year overall survival (OS) rates were 54.1% and 21.1% for patients with a PNI = 46 and those with a PNI >= 46, respectively. The OS rates were significantly lower in the PNI-low group than in the PNI-high group among patients with stages. (P = 0.001) and. (P < 0.001) disease. CONCLUSION: The PNI is a simple and useful marker not only to identify patients at increased risk for postoperative complications, but also to predict long-term survival after total gastrectomy. The PNI should be included in the routine assessment of advanced gastric cancer patients. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
引用
收藏
页码:10537 / 10544
页数:8
相关论文
共 30 条
[1]  
Andreoli A, 2011, EUR REV MED PHARMACO, V15, P469
[2]   Malignant Pleural Mesothelioma: Clinicopathologic and Survival Characteristic in a Consecutive Series of 40 Patients [J].
Bagheri, Reza ;
Haghi, Seyed Ziaollah ;
Rahim, Mohammad Bagher ;
Attaran, Davoud ;
Toosi, Mehdi Silanian .
ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY, 2011, 17 (02) :130-136
[3]   Malignant pleural mesothelioma:: Clinicopathologic and survival characteristics in a consecutive series of 394 patients [J].
Borasio, Piero ;
Berruti, Alfredo ;
Bille, Andrea ;
Lausi, Paolo ;
Levra, Matteo Giaj ;
Giardino, Roberto ;
Ardissone, Francesco .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2008, 33 (02) :307-313
[4]   Preoperative oral arginine and n-3 fatty acid supplementation improves the immunometabolic host response and outcome after colorectal resection for cancer [J].
Braga, M ;
Gianotti, L ;
Vignali, A ;
Di Carlo, V .
SURGERY, 2002, 132 (05) :805-814
[5]   Postoperative morbidity and mortality after D-1 and D-2 resections for gastric cancer: Preliminary results of the MRC randomised controlled surgical trial [J].
Cuschieri, A ;
Fayers, P ;
Fielding, J ;
Craven, J ;
Bancewicz, J ;
Joypaul, V ;
Cook, P .
LANCET, 1996, 347 (9007) :995-999
[6]  
Feng J, 2011, ASIAN PAC J CANCER P, V12, P3289
[7]   Prospective randomized trial of preoperative enteral immunonutrition followed by elective total gastrectomy for gastric cancer [J].
Fujitani, K. ;
Tsujinaka, T. ;
Fujita, J. ;
Miyashiro, I. ;
Imamura, H. ;
Kimura, Y. ;
Kobayashi, K. ;
Kurokawa, Y. ;
Shimokawa, T. ;
Furukawa, H. .
BRITISH JOURNAL OF SURGERY, 2012, 99 (05) :621-629
[8]   Onodera's Prognostic Nutritional Index as a Risk Factor for Mortality in Peritoneal Dialysis Patients [J].
Kang, Seok Hui ;
Cho, Kyu Hyang ;
Park, Jong Won ;
Yoon, Kyung Woo ;
Do, Jun Young .
JOURNAL OF KOREAN MEDICAL SCIENCE, 2012, 27 (11) :1354-1358
[9]   The immunomodulating enteral nutrition in malnourished surgical patients - A prospective, randomized, double-blind clinical trial [J].
Klek, Stanislaw ;
Sierzega, Mara ;
Szybinski, Piotr ;
Szczepanek, Kinga ;
Scislo, Lucyna ;
Walewska, Elzbieta ;
Kulig, Jan .
CLINICAL NUTRITION, 2011, 30 (03) :282-288
[10]  
Lee Hosun, 2013, Clin Nutr Res, V2, P12, DOI 10.7762/cnr.2013.2.1.12