title: The Significance of the Prognostic Nutritional Index for All Stages of Pancreatic Cancer.
abstract: Nutritional status affects the prognosis of various tumors. The prognostic nutritional index (PNI) is the known predictor of postoperative outcome in resectable pancreatic cancer patients. This study aimed to validate the prognostic value of PNI in all stages of pancreatic cancer. We retrospectively reviewed 499 patients with pancreatic cancer who were diagnosed at Severance Hospital between January 2006 and December 2011. The PNI value was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/mm3) at initial diagnosis. The median patient age was 62 yr, and 289 were men. The study group comprised resectable disease (n = 121), locally advanced disease (n = 118), and metastatic disease (n = 260). Univariate and multivariate analysis revealed that PNI ≤ 49.5 at initial diagnosis, together with performance status, platelet count, and clinical stage, was significantly associated with overall survival (hazard ratio, 1.562; all P < 0.05). Patients with PNI ≤ 49.5 (n = 208) had shorter median overall survival compared to patients with high PNI (9.8 vs. 14.2 mo; log rank, P < 0.001). In clinical stage subgroup analysis, initial PNI ≤49.5 independently predicted shorter overall survival, especially in resectable and metastatic disease (P = 0.041, P = 0.002, respectively).
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Moon Jae
authors.initials: MJ
authors.lastname: Chung
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Bun
authors.initials: B
authors.lastname: Kim
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Hee Seung
authors.initials: HS
authors.lastname: Lee
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Hyun Jik
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Ja Yoon
authors.initials: JY
authors.lastname: Heo
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Yeong Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Jeong Youp
authors.initials: JY
authors.lastname: Park
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Seungmin
authors.initials: S
authors.lastname: Bang
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Si Young
authors.initials: SY
authors.lastname: Song
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Jae Bock
authors.initials: JB
authors.lastname: Chung
mesh_terms: D000368:Aged; D015992:Body Mass Index; D018572:Disease-Free Survival; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D012709:Serum Albumin