Prognostic Value Of The Prognostic Nutritional Index For Gastric Cancer Treated With Neoadjuvant Chemotherapy

BackgroundPrognostic nutritional index (PNI) is a useful parameter indicating immune and nutritional status of cancer patients and this study aims to investigate the prognostic value of PNI for gastric cancer patients treated with neoadjuvant chemotherapy.MethodsWe retrospectively reviewed171gastric cancer patients who received neoadjuvant chemotherapy and radical surgery between2004and2011. PNI was calculated as10×serum albumin (g/dl)+0.005×total lymphocyte count (per mm3) The cut-off was set at45as reported and all patients were divided into PNI high (PNI≥45) and PNI low (PNI<45)groups Clinicopathological features were compared between the pre-chemotherapy PNI high and low groups. Survival analysis was performed with Kaplan-Meier survival curves and Cox proportional hazard model was used to discover the independent prognostic factor. ResultsThere was no significant difference between pre-chemotherapy and post-chemotherapy PNI (p>0.05). Low pre-chemotherapy PNI was significant associated with older age (p<0.01). Overall survival (OS) was better in pre-chemotherapy PNI high group than PNI low group (p<0.05), while there is no significant difference of OS between post-chemotherapy PNI high and PNI low groups (p>0.05). The Cox regression analysis indicated that ypT, ypN stage and pre-chemotherapy PNI were independent prognostic factors of OS (ypT:p=0.004, ypN:p<0.001; pre-chemotherapy PNI:p=0.007).ConclusionsPre-chemotherapy PNI is a useful marker to predict the long-term outcome of gastric cancer treated with neoadjuvant chemotherapy.