Prognostic role of the prognostic nutritional index in patients with pancreatic cancer who underwent curative resection without preoperative neoadjuvant treatment: A systematic review and meta-analysis

Abstract

BackgroundThe prognostic nutrition index (PNI), which has been evaluated in various kinds of cancers, offered a simple yet effective approach to predict the prognosis. The aim of this meta-analysis is to reveal the correlation between preoperative PNI and the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) who underwent curative resection.MethodsWe searched the PubMed, Embase, Web of Science and Cochrane Library databases, and extracted the hazard ratio (HR) with 95% confidential interval (CI) from eligible studies. The pooled HR with 95% CI was applied to evaluate the association between PNI and overall survival (OS), recurrence-free survival (RFS).ResultsA total of fourteen studies with 3,385 patients were included for meta-analysis. The results (the pooled HR: 1.664, 95% CI: 1.424–1.994, I² = 42.6%, p value = 0.046) indicated that low preoperative PNI was closely related to poor OS. In addition, the results suggested that PNI was negatively correlated with RFS (the pooled HR: 1.369, 95%CI: 1.080–1.734). The robustness of these pooled results was verified by our subgroup analysis and sensitivity analysis. Moreover, different cutoff values among studies are responsible for the heterogeneity of pooled HR of OS through meta-regression analysis (p value = 0.042). Funnel plots, Begg's test (p value = 0.228) and Egger’s test (p value = 0.702) indicated no significant publication bias in OS.ConclusionPreoperative PNI might be a promising marker to predict the prognosis of PDAC patients who underwent curative resection.

RETRACTED: The impact of sarcopenia on prognosis of patients with pancreatic cancer: A systematic review and meta-analysis

“…A recent meta-analysis with ∼2300 patients from seven studies found that high CONUT score (HR of 1.56) was able to predict OS in patients with PC. 55 Another meta-analysis 56 that included 14 studies of ∼3500 patients, found that low preoperative PNI was related to poor OS (HR 1.67) and RFS (HR 1.4) in PC patients who underwent curative resection without preoperative neoadjuvant treatment. 56 Xie et al conducted a meta-analysis with nine studies ( n = 2153 patients) and found that low GNRI was associated with poor OS in patients with gastrointestinal cancer (HR = 1.94) and a higher risk of complications (OR = 2.19).…”

“…55 Another meta-analysis 56 that included 14 studies of ∼3500 patients, found that low preoperative PNI was related to poor OS (HR 1.67) and RFS (HR 1.4) in PC patients who underwent curative resection without preoperative neoadjuvant treatment. 56 Xie et al conducted a meta-analysis with nine studies ( n = 2153 patients) and found that low GNRI was associated with poor OS in patients with gastrointestinal cancer (HR = 1.94) and a higher risk of complications (OR = 2.19). 57 While these nutritional indices show correlation with outcomes in patients with PC, the use of these indices has limitations.…”

The predictive value of systemic immune-inflammation index for vascular access survival in chronic hemodialysis patients

“…Eight systemic immune-inflammation indices in the existing literature were computed based on laboratory examination results prior to the HD access procedures, including neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), albumin-toalkaline phosphatase ratio (AAPR), systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), prognostic nutritional index (PNI), platelet-to-lymphocyte ratio (PLR), and lung immune prognostic index (LIPI) (12,(20)(21)(22)(23) (see the details of calculation in Supplementary Table 1).…”

Nutritional support as a component of enhanced recovery program in hepatopancreatobiliary surgery

“…По данным систематического обзора и метаанализа 14 рандомизированных исследований, включавших 3385 больных, оперированных по поводу рака ПЖ, низкий PNI был ассоциирован с низкой послеоперационной выживаемостью [11].…”