title: Low nutritional prognostic index correlates with poor survival in patients with stage IV colorectal cancer following palliative resection of the primary tumor.
abstract: BACKGROUND
  We retrospectively investigated the prognostic significance of various clinicopathological factors and preoperative nutritional status to select patients with stage IV colorectal cancer (CRC) who will have a poor prognosis after palliative resection of the primary tumor.
  
  
  METHODS
  A total of 100 stage IV CRC patients who underwent palliative resection were enrolled. Various clinicopathological factors and Onodera's prognostic nutritional index (OPNI) were evaluated to identify any possible relationship with the prognosis.
  
  
  RESULTS
  At the time of the analysis, 83 patients had died, and the median survival time was 21 months. Of the 100 patients, 24 had primary tumor-related symptoms such as obstruction or bleeding. No significant correlation was noted between the OPNI and various clinicopathological factors. The multivariate analysis of patients without primary tumor-related symptoms revealed that the OPNI was an independent prognostic factor. The overall survival of the low-OPNI group was significantly worse than that of the high-OPNI group.
  
  
  CONCLUSIONS
  This retrospective study suggested that patients with a low OPNI may not be candidates for palliative resection, because it provides no survival benefit to these patients.
authors.affiliation: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan, m1378386@med.osaka-cu.ac.jp.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Maeda
authors.forename: Masatsune
authors.initials: M
authors.lastname: Shibutani
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Otani
authors.forename: Hisashi
authors.initials: H
authors.lastname: Nagahara
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugano
authors.forename: Teturo
authors.initials: T
authors.lastname: Ikeya
authors.forename: Naoshi
authors.initials: N
authors.lastname: Kubo
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Amano
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kimura
authors.forename: Kazuya
authors.initials: K
authors.lastname: Muguruma
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015596:Nutrition Assessment; D009752:Nutritional Status; D010166:Palliative Care; D012189:Retrospective Studies; D015996:Survival Rate