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Prognostic Nutritional Index as a Predictor of Complications Following Robot-Assisted Radical Cystectomy
Masayuki Kurokawa1, Toru Sugihara1, Risako Watanabe1
1Department of Urology, Jichi Medical University, Shimotsuke, JPN.
Cureus
|June 20, 2025
Summary
Preoperative prognostic nutritional index (PNI) is a key predictor of complications after robot-assisted radical cystectomy (RARC). Low PNI indicates higher risk for overall complications and postoperative ileus, suggesting nutritional screening is vital.
Area of Science:
- Urology
- Surgical Oncology
- Nutritional Science
Background:
- Robot-assisted radical cystectomy (RARC) is a standard treatment for bladder cancer.
- Postoperative complications can significantly impact patient outcomes after RARC.
- The prognostic nutritional index (PNI) reflects a patient's nutritional and immune status.
Purpose of the Study:
- To evaluate the association between preoperative prognostic nutritional index (PNI) and postoperative complications in patients undergoing RARC.
- To identify PNI as a potential predictor for complications following RARC.
Main Methods:
- Retrospective analysis of 103 RARC patients.
- PNI calculated using serum albumin and total lymphocyte count.
- Patients categorized into high- and low-PNI groups (threshold: 45).
- Comparison of 30-day postoperative complication rates between groups.
- Multivariate logistic regression for risk factor identification.
Main Results:
- Overall complication rate was 48.5% (8% severe).
- Low-PNI group showed significantly higher overall complication rates (70% vs. 47%) and postoperative ileus (48% vs. 18%).
- Low PNI (OR 3.82) and intestinal urinary diversion (OR 3.33) were independent risk factors for overall complications.
Conclusions:
- Preoperative PNI is a significant predictor of overall complications and postoperative ileus after RARC.
- Low PNI identifies patients at higher risk for adverse outcomes.
- Preoperative immunonutritional assessment and intervention may improve RARC outcomes.
