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| Role of perioperative period prognostic nutritional index for survival estimation in colorectal cancer patients |
| 1 Wu Yongjin, 2 Xue Tianhui, 2 Yan Bing |
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Department of General Surgery Unit 2, Sanya Central Hospital (HainanThirdPeople's Hospital), Sanya 572000, Hainan, China; 2Department
of Oncology, Hainan Hospital of Chinese PLA General Hospital, Sanya 572000, Hainan, China |
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Abstract Objective To explore the prognostic value of perioperative period prognostic nutritional index (PNI) (pre⁃/post⁃PNI) in
predicting the 3 years progression free survival (PFS) and overall survival (OS) in colorectal cancer patients (CRC). Method A total of
153 pathologically confirmed colorectal adenocarcinoma underwent surgery were collected from December 2012 to January 2020 in Hainan
hospital of Chinese PLA general hospital, the PNI were calculated and patients were then divided into different subgroups, the survival
differences of these subgroups were run by Kaplan⁃Meier analysis and the risk factors for survival were tested by COX proportional hazards
model. Result According to the Youden index, taking 48.73 and 45.40 as the cut⁃off points to divide patients into low or high pre⁃PNI and
post⁃PNI subgroups respectively, they have a sensitivity at 71.40%, 83.70% and a specificity at 59.60%, 46.20% individually in predicting
the survival. The lower pre⁃PNI was more obvious in T3+T4 (P=0.02), M1 (P=0.02) patients; whereas the lower post⁃PNI was more apparent
in older ones (P=0.03), both of which were more detectable in big tumor groups (all P=0.04). Both PFS and OS were inferior in lower
pre⁃PNI and post⁃PNI ones (all P<0.01). The preoperative period PNIs were risk factor for PFS and OS; however, only the post⁃PNI was
of more reliable (PFS: HR=0.31, 95%CI= 0.14-0.69, P<0.01; OS: HR=0.26, 95%CI=0.10-0.69, P=0.01). Conclusion The perioperative
period PNI played an important role in predicating the survival for colorectal cancer patients. However, the post⁃PNI was more reliable
when compared with the pre⁃PNI, additional studies are still needed in future.
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Received: 25 September 2021
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