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

Authors
 Gyoung Tae Noh  ;  Jeonghee Han  ;  Min Soo Cho  ;  Hyuk Hur  ;  Byung Soh Min  ;  Kang Young Lee  ;  Nam Kyu Kim 
Citation
 JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, Vol.143(7) : 1235-1242, 2017 
Journal Title
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
ISSN
 0171-5216 
Issue Date
2017
MeSH
Adult ; Aged ; Colorectal Neoplasms/mortality* ; Colorectal Neoplasms/pathology* ; Colorectal Neoplasms/surgery ; Disease-Free Survival ; Female ; Gastrectomy ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Nutrition Assessment* ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Analysis ; Treatment Outcome
Keywords
Colorectal cancer ; Oncologic outcome ; tumor phenotype ; Postoperative complication ; Prognostic nutritional index
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.
Full Text
https://link.springer.com/article/10.1007%2Fs00432-017-2366-x
DOI
10.1007/s00432-017-2366-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Lee, Kang Young(이강영)
Cho, Min Soo(조민수)
Han, Jeong Hee(한정희)
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161269
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