Preoperative prognostic nutritional index as an independent prognostic factor for resected ampulla of Vater cancer

Abstract

Introduction Prognostic nutritional index (PNI) reflects the nutritional and immunologic status of the patients. The clinical application of PNI is already well-known in various kinds of solid tumors. However, there is no study investigating the relationship between PNI and oncological outcome of the resected ampulla of Vater (AoV) cancer. Materials and methods From January 2005 to December 2012, the medical records of patients who underwent pancreaticoduodenectomy for pathologically confirmed AoV cancer were retrospectively reviewed. Long-term oncological outcomes were compared according to the preoperative PNI value. Result A total of 118 patients were enrolled in this study. The preoperative PNI was 46.13±6.63, while the mean disease-free survival was 43.88 months and the mean disease-specific survival was 55.3 months. In the multivariate Cox analysis, initial CA19-9 (p = 0.0399), lymphovascular invasion (p = 0.0031), AJCC 8 th N-stage (p = 0.0018), and preoperative PNI (p = 0.0081) were identified as significant prognostic factors for resected AoV cancer. The disease-specific survival was better in the high preoperative PNI group (�48.85: 40.77 months vs. >48.85: 68.05 months, p = 0.0015). A highly accurate nomogram was developed based on four clinical components to predict the 1, 3, and 5-year disease-specific survival probability (C-index 0.8169, 0.8426, and 0.8233, respectively). Conclusion In resected AoV cancer, preoperative PNI can play a significant role as an independent prognostic factor for predicting disease-specific survival.

WITHDRAWN: Importance of lymph node metastasis to the pancreatic head region in patients with ampulla of Vater carcinoma

“…In previous reports, factors predicting survival among patients with AVC included tumor node metastasis (TNM) stage, resection margin, lymph node metastasis (LNM), vascular invasion, perineural involvement, differentiation grade, and perioperative nutritional status [5][6][7][8][9]. Although the effects of recurrence on postoperative mortality have been well studied in patients with periampullary cancers, such as pancreatic and distal bile duct cancers, there are few analyses of its impact on AVC [10,11].…”

A combined prediction model for biliary tract cancer using the prognostic nutritional index and pathological findings: a single-center retrospective study

“…The prognostic nutritional index (PNI) is a marker of nutritional status and systemic inflammation, based on serum albumin concentration and total lymphocyte count, both of which can be easily obtained from routine preoperative blood tests [6]. Several studies [7][8][9][10][11] have shown that the PNI can be used as a prognostic marker in patients with various cancers. However, few studies have evaluated the prognostic value of the PNI in patients with BTC.…”

The role of prognostic nutritional index for clinical outcomes of gastric cancer after total gastrectomy

“…The most notable features are its low oxygen, low pH and high pressure. More and more researches indicate systemic nutrition has been found to be a crucial ingredient of the tumor microenvironment that plays remarkable roles in tumor growth, progression and metastasis 2 . For patients with malignant tumors, the tumor itself will consume a lot of protein, causing damage to tissue structure and organ functions; in addition, gastrointestinal obstruction caused by digestive organ tumors can lead to loss of appetite, nausea, vomiting, diarrhea which is also associated with poor nutrition and immunosuppression 3 – 5 .…”