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

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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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Data availability

All authors are available for the data of this study.

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Acknowledgements

The authors would like to thank Enago (www.enago.jp) for the English language review.

Funding

The authors have no financial support to declare.

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Authors and Affiliations

  1. Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan

    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 & Yoshiyuki Fujiwara

  2. Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, 680‑8517, Japan

    Hiroaki Saito

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  1. Kozo Miyatani
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Corresponding author

Correspondence to Kozo Miyatani.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional review board/ethics committee, the national research committee, and the 1964 Declaration of Helsinki and its later amendments. The Institutional Review Board of Tottori University Hospital approved the study (approval no. 20A243) and waived the requirement for informed consent.

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Miyatani, K., Sakano, Y., Makinoya, M. et al. A low cumulative perioperative prognostic nutritional index predicts poor long-term outcomes in patients with gastric cancer: A single-center retrospective study in Japan. Surg Today 53, 1294–1304 (2023). https://doi.org/10.1007/s00595-023-02688-8

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  • DOI: https://doi.org/10.1007/s00595-023-02688-8

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