Prognostic Nutritional Index is a valuable prognostic marker in Mexican patients operated on and not on gastrointestinal stromal tumors. A retrospective cohort study

Abstract

Purpose. The immune-nutritional status of patients with cancer has a profound impact on their lifespan. The Prognostic Nutritional Index (PNI) has been used to evaluate, among others, the prognosis in operated patients harboring neoplastic as well as non-neoplastic conditions. This study estimates the survival of Mexican patients suffering from gastrointestinal stromal tumors (GIST) operated on or not based on PNI. Methods. The immune-nutritional status was retrospectively analyzed in a cohort of 146 patients with GIST. Receiver operating characteristic (ROC) curves were used to estimate optimal cutoff point and to predict overall survival (OS) for prognostic nutritional index (PNI). Survival curves were obtained with the Kaplan-Meier method and log-rank tests. A Multivariate analysis of survival was performed with Cox regression. Results. PNI cutoff was 36.5 and the only independent prognostic score (0.007); the PNI-high group had better survival (p = 0.001). High PNI was correlated with surgical intervention and low mitotic index. Conclusions. PNI < 36.5 entails a worse prognosis for Mexican patients suffering from GIST. PNI has a high ability to predict survival, even in patients for whom surgery is not a feasible option. The PNI is a simple and reliable calculation tool, as well as an inexpensive, reproducible, and powerful factor to predict patient prognosis, besides the pathological approach.