Prognostic nutritional index is an independent prognostic factor for gastric cancer patients with peritoneal dissemination

Abstract

ObjectiveThe predictive and prognostic role of prognostic nutritional index (PNI) in gastric cancer patients with peritoneal dissemination remains unclear. This study aims to explore the role of the PNI in predicting outcomes of gastric cancer patients with peritoneal dissemination.MethodsA total of 660 patients diagnosed with gastric adenocarcinoma with peritoneal metastasis between January 2000 and April 2014 at Sun Yat-sen University Cancer Center and the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The clinicopathologic characteristics and clinical outcomes of patients with peritoneal dissemination were analyzed.ResultsCompared with PNI-high group, PNI-low group was correlated with advanced age (P=0.036), worse performance status (P<0.001), higher frequency of ascites (P<0.001) and higher frequency of multisite distant metastasis (P<0.001). Kaplan-Meier survival curves showed that PNI-high group had a significantly longer median overall survival than PNI-low group (13.13 vs. 9.03 months, P<0.001). Multivariate survival analysis revealed that Borrmann type IV (P=0.014), presence of ascites (P=0.017) and lower PNI (P=0.041) were independent poor prognostic factors, and palliative surgery (P<0.001) and first-line chemotherapy (P<0.001) were good prognostic factors. For patients receiving palliative surgery, the postoperative morbidity rates in the PNI-low group and PNI-high group were 9.1% and 9.9%, respectively (P=0.797). The postoperative mortality rate was not significantly different between PNI-low and PNI-high groups (2.3% vs. 0.9%, P=0.362). ConclusionsPNI is a useful and practical tool for evaluating the nutritional status of gastric cancer patients with peritoneal dissemination, and is an independent prognostic factor for these patients.

Prognostic significance of malignant ascites in gastric cancer patients with peritoneal metastasis: A systemic review and meta-analysis

“…Among the 15 studies, 9[15-17,19,21,22,25-27] assessed the difference in prognosis between patients with and without ascites, and 3[15,20,24] compared the prognosis between patients with massive ascites with those with mild to moderate ascites. The other 3 studies[4,18,23] compared the prognosis of the massive ascites group with the none-mod group (including patients with no ascites, mild ascites, and moderate ascites).…”

Prognostic significance of the controlling nutritional status (CONUT) score in epithelial ovarian cancer

“…Nutrition-related indicators, such as the prognostic nutritional index and the skeletal muscle index, have recently been reported to reflect the prognosis of various cancers 5 6. The controlling nutritional status (CONUT) score is another nutritional indicator that is mainly used to evaluate the nutritional status of patients in the early stages of disease; it is calculated using serum albumin levels, total lymphocyte count, and total cholesterol 7 8.…”

Prognostic Value of the Nutritional Risk Screening 2002 Scale in Metastatic Gastric Cancer: A Large-Scale Cohort Study

“…Both tumor-related and host-related factors can predict the prognosis of cancer patients 9. Advanced gastric cancer patients are often accompanied with large tumor burdens and suffer from oral intake deficiency, outlet obstruction, tumor bleeding and ascites, which debilitates the nutrition of the patients 10. The malnutrition, in return, accelerates the development of the tumor by suppressing the immunity of the patients 11.…”

“…The malnutrition, in return, accelerates the development of the tumor by suppressing the immunity of the patients 11. Previous studies have reported that various nutritional indexes are associated with the prognosis of gastric cancer 10, 12-14. Among them, nutritional risk screening 2002 (NRS 2002) is an easily applied and reproducible tool to predict the nutritional risk for in hospital patients 15.…”