title: Prognostic nutritional index is associated with survival after total gastrectomy for patients with gastric cancer.
abstract: OBJECTIVE
  To investigate the influence of clinical characteristics including nutritional markers on postoperative survival in patients undergoing total gastrectomy (TG) for gastric cancer (GC).
  
  
  METHODS
  One hundred fifty-four patients were enrolled. Uni- and multivariate analyses using the Cox proportional hazard model were performed to explore the most valuable clinical characteristic that was associated with postoperative survival.
  
  
  RESULTS
  Multivariate analysis using twelve clinical characteristics selected from univariate analyses revealed that age (≤ 72/>72), carcinoembryonic antigen (≤ 20/>20) (ng/ml), white blood cell count (≤ 9.5/>9.5) (× 10(3)/mm(3)), prognostic nutritional index (PNI) (≤ 45/>45) and lymph node metastasis (negative/positive) were associated with postoperative survival. Kaplan-Meier analysis and log-rank test showed that patients with higher PNI (>45) had a higher postoperative survival rate than those with lower PNI (≤ 45) (p<0.001).
  
  
  CONCLUSIONS
  PNI is associated with postoperative survival of patients undergoing TG for GC and is able to divide such patients into two independent groups before surgery.
authors: Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan mm-ishizuka@umin.ac.jp.
authors: Mitsuru
authors: M
authors: Ishizuka
authors: Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
authors: Yusuke
authors: Y
authors: Oyama
authors: Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
authors: Akihito
authors: A
authors: Abe
authors: Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
authors: Kazuma
authors: K
authors: Tago
authors: Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
authors: Genki
authors: G
authors: Tanaka
authors: Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
authors: Keiichi
authors: K
authors: Kubota
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*
keywords: Gastric cancer; prognostic nutritional index; total gastrectomy