Significance Of Prognostic Nutritional Index In Long-Term Outcome For Patients With Gallbladder Carcinoma

Purpose: Preoperative immunological parameters and nutritional status might influence the long-term outcomes for patients with malignancies. A prognostic nutritional index, calculated from the serum albumin levels and peripheral lymphocyte counts, has been used to assess outcomes for various malignancies. The study was carried out to investigate the impact of prognostic nutritional index(PNI)on outcomes for gallbladder carcinoma(GBC) patients undergoing surgical surgery.Methods: We retrospectively analyzed 58 patients with gallbladder carcinoma treated in our hospital between October 2007 and October 2012. The prognostic nutritional index(PNI) was introduced, and all patients were classified as high PNI(?45; n =38) or low PNI(?45; n = 20) group by using the optimal cutoff PNI value of 45.Clinicopathological characteristics and long-term outcomes were compared. The independent prognostic risk factors of gallbladder carcinoma were analyzed by Cox proportional hazard model, and the effect of PNI on the prognosis of patients with gallbladder carcinoma was analyzed according to the TNM stage.Results: The 3-year survival rates of patients with high PNI(?45) or low PNI(?45)were 40.0% and 10.5%, respectively(p < 0.001). Univariate analysis demonstrated that lymph node metastasis, distant metastasis, TNM stage, surgical methods, liver invasion, choledoch invasion, jaundice and PNI were significant prognostic factors.Multivariate analysis identified TNM stage and the PNI as independent prognostic factors. In subgroup analysis, the 3-year overall survival(OS) at stage ?+ ?disease were significantly better in the high PNI group than that in the low PNI group.Conclusions: The PNI was a significant prognostic factor for OS of GBC patients with stage ?+ ?disease receiving surgery.