Prognostic Nutritional Index as a Prognostic Indicator for the Occurrence of Postoperative Complications in Patients with Esophageal Squamous Cell Carcinoma Following Neoadjuvant Immunochemotherapy

Abstract

Background & Aims

The objective of this study was to evaluate the prognostic nutritional index (PNI) as a predictor of short-term postoperative complications in esophageal squamous cell carcinoma patients undergoing neoadjuvant immunochemotherapy.

Methods

Clinical data were collected from 77 patients undergoing radical esophageal cancer surgery after neoadjuvant immunochemotherapy at Tongji Hospital from January 2022 to January 2023. The receiver operating characteristic curve (ROC) was utilized to establish the optimal cut-off point for the PNI. Subsequently, patients were stratified into low and high PNI groups according to this cut-off point, and comparisons were made between the two groups in terms of clinical data and postoperative complications.

Results

Out of the 77 patients included in the study, 31 were categorized in the low PNI group and 46 in the high PNI group, with a defined cutoff point of 47.38. Significant statistical variances were noted in the occurrence rates of general complications (P < 0.001), pulmonary infections (P < 0.001), and anastomotic fistula (P = 0.034) between the two groups. The low PNI group displayed elevated rates of these complications in comparison to the high PNI group.

Conclusion

The research findings indicate that preoperative nutritional assessment using the PNI can effectively predict short-term postoperative complications in esophageal squamous cell carcinoma patients who have undergone neoadjuvant therapy. Furthermore, the results suggest that implementing nutritional interventions for patients with moderate-to-severe malnutrition, as indicated by preoperative PNI evaluation, may help reduce the incidence of postoperative complications.

Keywords:

• prognostic nutritional index
• neoadjuvant immunochemotherapy
• postoperative complications
• esophageal squamous cell carcinoma

Institutional Review Board Statement

Ethical review and approval were waived for this study due to this study is a retrospective analysis.

Data Sharing Statement

The raw data supporting the conclusions of this article will be made available by the corresponding author on request.

Ethics Approval

This study was conducted at the Department of Thoracic surgery, Tongji Hospital of Huazhong University of Science & Technology. This study was conducted according to the Declaration of Helsinki and approved by the ethic committee of Tongji Medical College of Huazhong University of Science & Technology (approval number, TJ-IRB20210624). Informed consent from the patients was waived by the IRB because the nature of this retrospective study was reanalyzing of existing data, which does not involve any potential risks and benefits to the patients.

Informed Consent Statement

Written informed consent has been obtained from the patients to publish this paper.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Wenbin Zou and Wan Kuang are co-first authors for this study. The authors declare that they have no conflicts of interest in this work.

Additional information

Funding

This research received no external funding.