title: The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage.
abstract: OBJECTIVE
  The aim of this study was to investigate the impact of the prognostic nutritional index (PNI) on the long-term outcomes in gastric cancer patients.
  
  
  METHODS
  This study reviewed the medical records of 548 patients with gastric cancer who underwent gastrectomy. The PNI was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm(3)). The receiver operating characteristic (ROC) curve analysis was performed to determine the cutoff value of the PNI. The multivariate analysis was performed to identify the prognostic factors.
  
  
  RESULTS
  The mean PNI was significantly lower in patients with T3-T4 tumors (P < 0.001) and lymph node metastasis (P < 0.001) than in those without such factors. Patients who had a postoperative complication had a lower mean PNI than those without (P = 0.023). When the ROC curve analysis was performed, the optimal cutoff value of the PNI for predicting the 5-year survival was 48. In the multivariate analysis, a low PNI was an independent predictor for poor overall survival (P < 0.001). In the subgroup analysis, the overall and relapse-free survival rates were significantly lower in the PNI-low group than in the PNI-high group among patients with stage I and stage III disease.
  
  
  CONCLUSIONS
  The PNI is a simple and useful marker for predicting the long-term outcomes of gastric cancer patients independent of the tumor stage. Based on our results, we suggest that the PNI should be included in the routine assessment of gastric cancer patients.
authors: Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan. kmigita@naramed-u.ac.jp
authors: Kazuhiro
authors: K
authors: Migita
authors: Tomoyoshi
authors: T
authors: Takayama
authors: Keigo
authors: K
authors: Saeki
authors: Sohei
authors: S
authors: Matsumoto
authors: Kohei
authors: K
authors: Wakatsuki
authors: Koji
authors: K
authors: Enomoto
authors: Tetsuya
authors: T
authors: Tanaka
authors: Masahiro
authors: M
authors: Ito
authors: Norio
authors: N
authors: Kurumatani
authors: Yoshiyuki
authors: Y
authors: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002272:Carcinoembryonic Antigen / Q000097:blood; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D004338:Drug Combinations; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D008207:Lymphatic Metastasis; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010094:Oxonic Acid / Q000008:administration & dosage; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000097:blood* / Q000473:pathology / Q000628:therapy*; D005641:Tegafur / Q000008:administration & dosage; D013997:Time Factors; D014498:Uracil / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D002272:Carcinoembryonic Antigen; D004338:Drug Combinations; D012709:Serum Albumin; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D014498:Uracil; D010094:Oxonic Acid; C418208:5'-deoxy-5-fluorocytidine; D002945:Cisplatin; D005472:Fluorouracil