Preoperative Prognostic Nutritional Index Predicts Postoperative Outcomes in Colorectal Cancer: A Propensity...

Area of Science:

• Oncology
• Surgical Oncology
• Nutritional Science

Background:

• The Prognostic Nutritional Index (PNI) assesses nutritional and immunological status using serum albumin and lymphocyte count.
• Malnutrition and inflammation impact surgical outcomes and cancer prognosis.
• The predictive role of PNI in colorectal cancer (CRC) requires further investigation.

Purpose of the Study:

• To evaluate preoperative PNI as a predictor of postoperative complications.
• To assess the association between preoperative PNI and long-term survival in CRC patients.
• To determine if PNI can refine risk stratification for CRC patients undergoing surgery.

Main Methods:

• Retrospective review of 2,026 CRC patients undergoing curative surgery (2011-2023).
• Propensity score matching (PSM) and stratification into high/low PNI groups.
• Analysis of complications, overall survival (OS), and disease-free survival (DFS) using logistic regression, Cox models, and restricted cubic spline analysis.

Main Results:

• High PNI independently predicted lower rates of overall complications, ileus, anastomotic leakage, and lung complications.
• High PNI was associated with improved 5-year OS but not DFS.
• PNI outperformed the neutrophil-to-lymphocyte ratio (NLR) in predicting complications.

Conclusions:

• Preoperative PNI is an independent predictor of postoperative complications and OS in CRC patients.
• Routine PNI assessment can aid in risk stratification and perioperative management.
• Integrating PNI into clinical practice may enhance surgical outcomes for CRC patients.