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Cancer Management and Research Volume 13, 2021 - Issue
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Original Research

Preoperative Prognostic Nutrition Index as a Prognostic Indicator of Survival in Elderly Patients Undergoing Gastric Cancer Surgery

Xiaonan Zhang1 Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of ChinaORCID Iconhttps://orcid.org/0000-0003-4147-1450
ORCID Icon,
Huimin Fang1 Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China
,
Zhigang Zeng1 Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China
,
Kaijun Zhang1 Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China
,
Zhanyi Lin1 Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China;2 School of Medicine, South China University of Technology, Guangzhou, 510641, People’s Republic of China
,
Gang Deng1 Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China
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Weiping Deng1 Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China
,
Lichang Guan1 Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China
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Xuebiao Wei1 Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China
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Xinyi Li2 School of Medicine, South China University of Technology, Guangzhou, 510641, People’s Republic of China
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Lei Jiang1 Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China;2 School of Medicine, South China University of Technology, Guangzhou, 510641, People’s Republic of China;3 The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People’s Republic of ChinaCorrespondence[email protected] [email protected]
ORCID Iconhttps://orcid.org/0000-0002-3505-4020
ORCID Icon &
Lishu Xu1 Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China;2 School of Medicine, South China University of Technology, Guangzhou, 510641, People’s Republic of China;3 The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People’s Republic of China
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Pages 5263-5273 | Published online: 02 Jul 2021
 
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Abstract

Purpose

Gastric cancer is a common tumor type associated with nutritional and immune status. The aim of the current study was to investigate the prognostic value of a preoperative prognostic nutritional index (PNI), composed of nutritional factors and immune factors in elderly patients undergoing gastric cancer surgery.

Patients and Methods

A total of 454 patients undergoing gastric cancer surgery were divided into two groups based on preoperative PNI scores: ≤45.1 (n = 307) and >45.1 (n = 147). Survival analysis was performed using the Kaplan–Meier method and Log rank tests. Univariate and multivariate analyses were conducted to identify independent prognostic factors using a Cox proportional hazards model.

Results

According to the X-tile program, the optimal cutoff value for predicting overall survival (OS) with the PNI was 45.1. The receiver operating characteristic analysis revealed that PNI exhibited 70.6% sensitivity and 56.5% specificity for predicting death during long-term follow-up. The cumulative incidence of postoperative 4-year mortality indicated that the risk of death increased significantly for PNI ≤45.1. In multivariate analysis, preoperative PNI was a significant independent predictor of mortality. In the age-stratified subgroup analysis, preoperative PNI was more sensitive for the old elderly subgroup than for the young elderly subgroup.

Conclusion

Preoperative PNI is a sensitive and specific prognostic predictor among elderly patients undergoing gastric cancer surgery.

Acknowledgments

This study was supported by the National Key R&D Program of China [grant number 2018YFC2000301]; National Natural Science Foundation [grant no. 81800262]; Science and Technology Planning Project of Guangzhou [grant numbers 202002030101 and 201903010005]; Medical Science and Technology Research Fund Project of Guangdong [grant number 202051422855320]; and the High-level Hospital Construction Project [grant number DFJH2020002].

Disclosure

The authors report no conflicts of interest in this work.

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