Prognostic nutritional index in predicting survival of patients with gastric or gastroesophageal junction...

Area of Science:

• Oncology
• Surgical Oncology
• Nutritional Science

Background:

• Gastric cancer is a leading cause of cancer-related death globally, with high mortality rates despite surgical intervention.
• Prognosis after gastrectomy remains poor, necessitating improved methods for survival prediction.
• Preoperative nutritional status is increasingly recognized as a significant factor influencing postoperative outcomes.

Purpose of the Study:

• To systematically review and assess the prognostic value of the preoperative Prognostic Nutritional Index (PNI) in predicting overall survival (OS) for patients with gastric or gastroesophageal adenocarcinoma.
• To evaluate the role of PNI as a predictive marker in patients undergoing gastrectomy with curative intent.

Main Methods:

• A comprehensive literature search was conducted on PubMed and the Cochrane Library, adhering to PRISMA guidelines.
• Sixteen studies involving 14,551 patients who underwent gastrectomy for gastric or gastroesophageal junction adenocarcinoma were included.
• Patients were categorized into high- and low-PNI groups to compare overall survival rates.

Main Results:

• Patients with a high preoperative PNI demonstrated significantly better 5-year overall survival (54.9%–95.8%) compared to those with a low PNI (39%–70.6%).
• Low preoperative PNI was consistently identified as an independent prognostic factor for poor survival in multivariate analyses.
• This finding was observed across various surgical approaches (open, laparoscopic, robotic) and with or without adjuvant chemotherapy.

Conclusions:

• Low preoperative Prognostic Nutritional Index (PNI) is a significant indicator of poor overall survival in patients undergoing gastrectomy for gastric or gastroesophageal cancer.
• PNI serves as a valuable and independent prognostic tool for assessing survival outcomes in this patient population.
• Further research could explore interventions to optimize PNI preoperatively to improve patient outcomes.