title: Predictive Potential of Preoperative Nutritional Status in Long-Term Outcome Projections for Patients with Gastric Cancer.
abstract: BACKGROUND
  Preoperative nutritional status not only correlates with the incidence of postoperative complications but also may be indicative of long-term outcomes for patients with cancer. The impact of preoperative nutritional status on outcomes for patients undergoing gastrectomy for gastric cancer (GC) was investigated.
  
  
  METHODS
  The study reviewed 594 patients treated for GC by gastrectomy at the authors' hospital between January, 2004 and December, 2010. Onodera's prognostic nutritional index (PNI) was invoked, using an optimal cut point to group patients as having high (PNI > 45; n = 449) or low (PNI ≤ 45; n = 145) nutritional status. Clinicopathologic features, perioperative results, and long-term outcomes, including cause of death, were compared.
  
  
  RESULTS
  Multivariate analysis of 5-year overall survival (OS) and disease-specific survival (DSS) indicated that low PNI was independently associated with unfavorable outcomes for patients with GC. In subgroup analysis, the 5-year OS and DSS rates for patients with GC at stages 1 and 2 were significantly worse in the low PNI group than in the high PNI group. Although wound and extrasurgical field infections also tended to be more frequent in the low PNI group, postoperative intraabdominal infections did not differ significantly by group.
  
  
  CONCLUSIONS
  Preoperative PNI may have merit as a gauge of prognosis for patients with GC at stages 1 and 2, but PNI and postoperative morbidity showed no correlation in this setting.
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan. m1157473@med.osaka-cu.ac.jp.
authors: Katsunobu
authors: K
authors: Sakurai
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Masaichi
authors: M
authors: Ohira
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Tatsuro
authors: T
authors: Tamura
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Takahiro
authors: T
authors: Toyokawa
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Ryosuke
authors: R
authors: Amano
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Naoshi
authors: N
authors: Kubo
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Hiroaki
authors: H
authors: Tanaka
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Kazuya
authors: K
authors: Muguruma
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Masakazu
authors: M
authors: Yashiro
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Kiyoshi
authors: K
authors: Maeda
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Kosei
authors: K
authors: Hirakawa
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D015596:Nutrition Assessment; D009752:Nutritional Status; D011183:Postoperative Complications; D057234:Preoperative Period; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000556:secondary / Q000601:surgery*; D015996:Survival Rate