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Surgery Today
Published in: Surgery Today 11/2023

18-04-2023 | Metastasis | Original Article

A low cumulative perioperative prognostic nutritional index predicts poor long-term outcomes in patients with gastric cancer: A single-center retrospective study in Japan

Authors: Kozo Miyatani, Yu Sakano, Masahiro Makinoya, Wataru Miyauchi, Shota Shimizu, Yuji Shishido, Takehiko Hanaki, Kyoichi Kihara, Tomoyuki Matsunaga, Manabu Yamamoto, Naruo Tokuyasu, Shuichi Takano, Teruhisa Sakamoto, Toshimichi Hasegawa, Hiroaki Saito, Yoshiyuki Fujiwara

Published in: Surgery Today | Issue 11/2023

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Abstract

Purpose

Perioperative surgical stress and systemic inflammation resulting from complex interactions between cancer and the host play an important role in cancer progression. This retrospective study compared the prognostic impact of various perioperative cumulative inflammation- and nutrition-based markers in patients with gastric cancer (GC).

Methods

This study included 301 patients with a histopathological diagnosis of gastric adenocarcinoma who underwent curative surgery. Perioperative cumulative markers were calculated using the newly developed trapezoidal area method.

Results

The cumulative prognostic nutritional index (cum-PNI) had the highest area under the receiver operating characteristic (ROC) curve for predicting the overall survival (OS) as well as the relapse-free survival (RFS). The cum-PNI was significantly correlated with tumor-related factors, including tumor size, depth of invasion, lymph node metastasis, lymphatic involvement, vascular involvement, and TNM stage classification. The cum-PNI was also significantly correlated with surgical factors, including surgical approach, gastrectomy, lymphadenectomy, intraoperative blood loss, and postoperative complications. Furthermore, the OS and RFS were poorer in patients with a low cum-PNI (< 236.3) than in those with a high cum-PNI (> 236.3). A multivariate analysis indicated that a low cum-PNI was an independent prognostic indicator in patients with GC.

Conclusions

The cum-PNI might be useful for predicting the prognosis and guiding the perioperative management of patients with GC.
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Metadata
Title
A low cumulative perioperative prognostic nutritional index predicts poor long-term outcomes in patients with gastric cancer: A single-center retrospective study in Japan
Authors
Kozo Miyatani
Yu Sakano
Masahiro Makinoya
Wataru Miyauchi
Shota Shimizu
Yuji Shishido
Takehiko Hanaki
Kyoichi Kihara
Tomoyuki Matsunaga
Manabu Yamamoto
Naruo Tokuyasu
Shuichi Takano
Teruhisa Sakamoto
Toshimichi Hasegawa
Hiroaki Saito
Yoshiyuki Fujiwara
Publication date
18-04-2023
Publisher
Springer Nature Singapore
Published in
Surgery Today / Issue 11/2023
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-023-02688-8

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