Background The clinical value of the prognostic nutritional index (PNI) in gastric cancer (GC) remains controversial. Therefore, we performed the meta-analysis to determine the prognostic and clinicopathological values of PNI in patients with GC. Methods A literature search was performed in the PubMed, Embase, and Web of Science databases. Hazard ratios (HRs) and odds ratios (ORs) were extracted to estimate the association of PNI with survival and clinicopathological characteristics, respectively. Results Ten studies involving 3396 patients with GC were analyzed. The pooled results indicated that a low PNI was a significant predictor of poor overall survival (OS) (HR = 1.89, 95% confidence interval [CI] = 1.67–2.13, P  Conclusion PNI was a predictive indicator of survival and postoperative complications, and was associated with clinicopathological features in GC patients. However, a low PNI was not significantly associated with poor OS in patients with GC at stage IV.

The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer: A meta-analysis

Selected patients with advanced non-small cell lung cancer (NSCLC) benefit from immunotherapy, especially immune checkpoint inhibitors such as PD-1 (programmed cell death protein 1) inhibitor. Peripheral blood biomarkers would be most convenient to predict treatment outcome and immune-related adverse events (irAEs) in candidate patients. This study explored associations between inflammation-related peripheral blood markers and onset of irAEs and outcome in patients with advanced NSCLC receiving PD-1 inhibitors. A retrospective analysis was conducted of 102 patients with advanced NSCLC receiving PD-1 inhibitors from January 2017 to May 2019. Cox regression models were employed to assess the prognostic effect of low/high neutrophil/lymphocyte ratio (NLR), lactate dehydrogenase (LDH), and prognostic nutrition index (PNI) on overall survival (OS) and progression-free survival (PFS). Logistic regression models were used to analyze the correlation between peripheral blood markers and the onset of irAEs. NLR < 5, LDH < 240 U/L, or PNI ≥ 45 was favorably associated with significantly better outcomes compared with higher, higher, or lower values, respectively. The multivariate analysis determined that these parameters were independently associated with both better PFS (p = 0.049, 0.046, 0.014, respectively) and longer OS (p = 0.007, 0.031, < 0.001, respectively). Patients with three favorable factors among NLR, LDH, and PNI had better PFS and OS than did those with two, one, or none. PNI and NLR were associated with the onset of irAEs. In patients with advanced NSCLC treated with PD-1 inhibitors, pretreatment NLR, LDH, and PNI may be useful predictive markers of clinical outcome and irAEs.

/pdf/peripheral-blood-markers-predictive-of-outcome-and-immune-45chaj5igg.pdf

Peripheral blood markers predictive of outcome and immune-related adverse events in advanced non-small cell lung cancer treated with PD-1 inhibitors

Objective: In this study, we performed a systematic review and meta-analysis to evaluate the impact of preoperative underweight status on postoperative complications and survival outcome of gastric...

The Impact of Preoperative Underweight Status on Postoperative Complication and Survival Outcome of Gastric Cancer Patients: A Systematic Review and Meta-analysis.

The prognostic nutritional index (PNI) has been correlated with long-term outcomes in cancer patients. However, the relationship between PNI, the postoperative complications, and long-term outcomes in patients with colorectal cancer (CRC) undergoing curative laparoscopic surgery has not been fully investigated. This retrospective study was conducted in the Beijing Hospital between January 2009 and January 2012. A total of 228 patients diagnosed with primary CRC undergoing curative laparoscopic surgery in the center were analyzed. The last follow-up date was December 2015. The associations of the PNI status with postoperative outcomes were examined using univariate and multivariate analyses. The optimal cutoff value of the preoperative PNI was set at 44.55 using the receiver operating characteristic curve. The patients were classified into PNI-high (≥44.55) and PNI-low groups (<44.55). The patients in the PNI-low group were more likely to have increased levels of tumor markers such as carcinoembryonic antigen and carbohydrate antigen 19-9, aggressive histological features, advanced tumor-nodes-metastasis (TNM) stages (all P < 0.05). Multivariate analyses revealed PNI<44.55 as an independent factor associated with the incidence of severe postoperative complications and overall survival. In conclusion, for patients with CRC undergoing curative laparoscopic surgery, PNI is a valuable biomarker in preoperative estimation as well as prognosis prediction.

Preoperative Prognostic Nutritional Index Correlates with Severe Complications and Poor Survival in Patients with Colorectal Cancer Undergoing Curative Laparoscopic Surgery: A Retrospective Study in a Single Chinese Institution.

Various blood cell ratios exist which seem to have an impact on prognosis for resected gastric cancer patients. The aim of this systematic review was to investigate the prognostic role of blood cell ratios in patients with gastric cancer undergoing surgery in a curative attempt. A systematic literature search in MEDLINE (via PubMed), CENTRAL, and Web of Science was performed. Information on survival and cut-off values from all studies investigating any blood cell ratio in resected gastric cancer patients were extracted. Prognostic significance and optimal cut-off values were calculated by meta-analyses and a summary of the receiver operating characteristic. From 2831 articles, 65 studies investigated six different blood cell ratios (prognostic nutritional index (PNI), lymphocyte to monocyte ratio (LMR), systemic immune-inflammation index (SII), monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR)). There was a significant association for the PNI and NLR with overall survival and disease-free survival and for LMR and NLR with 5-year survival. The used cut-off values had high heterogeneity. The available literature is flawed by the use of different cut-off values hampering evidence-based patient treatment and counselling. This article provides optimal cut-off values recommendations for future research.

/pdf/systematic-review-of-prognostic-role-of-blood-cell-ratios-in-2yd4a4qt.pdf

Systematic Review of Prognostic Role of Blood Cell Ratios in Patients with Gastric Cancer Undergoing Surgery

Nutritional status has been associated with long-term outcomes in cancer patients. The prognostic nutritional index (PNI) is calculated by serum albumin concentration and absolute lymphocyte count, and it may be a surrogate biomarker for nutritional status and possibly predicts overall survival (OS) of gastric cancer. We evaluated the value of the PNI as a predictor for disease-free survival (DFS) in addition to OS in a cohort of 314 gastric cancer patients who underwent curative surgical resection. There were 77 patients in PNI-low group (PNI ≤ 47.3) and 237 patients in PNI-high group (PNI > 47.3). With a median follow-up of 36.5 mo, 5-yr DFS rates in PNI-low group and PNI-high group were 63.5% and 83.6% and 5-yr OS rates in PNI-low group and PNI-high group were 63.5% and 88.4%, respectively (DFS, P < 0.0001; OS, P < 0.0001). In the multivariate analysis, the only predictors for DFS were PNI, tumor-node-metastasis (TNM) stage, and perineural invasion, whereas the only predictors for OS were PNI, age, TNM stage, and perineural invasion. In addition, the PNI was independent of various inflammatory markers. In conclusion, the PNI is an independent prognostic factor for both DFS and OS, and provides additional prognostic information beyond pathologic parameters.

The Prognostic Nutritional Index Predicts Survival and Identifies Aggressiveness of Gastric Cancer

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The Prognostic Nutritional Index Predicts Survival and Identifies Aggressiveness of Gastric Cancer