title: A Novel Prognostic Score, Based on Preoperative Nutritional Status, Predicts Outcomes of Patients after Curative Resection for Gastric Cancer.
abstract: PURPOSE:We aimed to determine whether preoperative nutritional status (PNS) was a valuable predictor of outcome in patients with gastric cancer (GC).METHODS:We retrospectively evaluated 1320 patients with GC undergoing curative resection. The PNS score was constructed based on four objective and easily measurable criteria: prognostic nutritional index (PNI) score 1, serum albumin <35 g/L, body mass index (BMI) <18.5 kg/m2, or preoperative weight loss ≥5% of body weight. The PNS score was 2 for patients who met three or four criteria, 1 for those who met one or two criteria, and 0 for those who didn't meet all of these criteria.RESULTS:The overall survival (OS) rates in patients with PNS scores 0, 1, and 2 were 59.1%, 42.4%, and 23.4%, respectively (P < 0.001). Multivariate analyses revealed the PNS was an independent predictor for OS (HR for PNS 1 and PNS 2: 1.497, 95 % CI: 1.230-1.820 and 2.434, 95 % CI: 1.773-3.340, respectively; p < 0.001). Furthermore, 5-year OS ranged from 92% (stage I) to 37% (stage III), while the combination of TNM and PNS stratified 5-year OS from 95% (TNM I, PNS 0) to 19% (TNM III, PNS 3). Of note, the prognostic significance of PNS was still maintained when stratified by TNM stage, age, sex, tumor size, anemia and adjuvant chemotherapy (All P < 0.05).CONCLUSIONS:The PNS, a novel nutritional-based prognostic score, is independently associated with OS in GC. Prospective studies are needed to validate its clinical utility.
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Xuechao
authors.initials: X
authors.lastname: Liu
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Qiu
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Shangxiang
authors.initials: S
authors.lastname: Chen
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Dazhi
authors.initials: D
authors.lastname: Xu
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Youqing
authors.initials: Y
authors.lastname: Zhan
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Yuanfang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Yingbo
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Sun
keywords: adjuvant chemotherapy; gastric cancer; preoperative nutritional status; prognosis