Abstract
Evidences showed that Prognostic Nutritional Index (PNI) is one important predictive factor for some cancers. However, the association between PNI and colorectal cancer is still unclear. In this study, we aim to explore the association between PNI and death in patients with locally advanced colorectal cancer. We enrolled 400 patients with colorectal cancer. The pathological results was used to confirm it. The patients received radical resection. The PNI at baseline was set as the exposure variable, death was the outcome variable, and other potential confounders were also analyzed. There was no association between PNI and the deaths of local advanced colorectal cancer and radical resection of colorectal cancer (HR=0.88; 95% CI, 0.78-1.00).Applying the cubic spline function, we found that it is not linear between PNI and death. Two-piecewise cox model showed that there was 68% decrease of risk of deaths when PNI change per 1 (HR=0.32; 95% CI, 0.13-0.79) on the left side of the inflection point (41.35). On the right of the inflection point, there was no association between PNI and death. PNI and deaths are linear correlation. Within a certain range (PNI=26-41), PNI is an independent protective factor for death risk.
Highlights
Colorectal cancer is one common cancer worldwide (Yiu & Yiu, 2016).There was increasing trend with living standard improvement and lifestyle changes (Zhou et al, 2017)
We found that the risk of death in colorectal cancer patients was reduced by 12% when the prognostic nutritional index (PNI) value was increased 1 unit, the P value was not significant
Studies showed that PNI is an important prognostic indicator for various malignant tumors (Sun et al, 2014; Chan et al, 2015; Kanda et al, 2011; Fu et al, 2016; Jeon et al, 2016; Migita et al, 2013) Malnutrition is very common in patients with colorectal cancer, and its incidence is as high as 31.0% (Gur et al, 2009)
Summary
Colorectal cancer is one common cancer worldwide (Yiu & Yiu, 2016).There was increasing trend with living standard improvement and lifestyle changes (Zhou et al, 2017). The prognosis of colorectal cancer is dependent on various factors. The Established prognostic factors include tumor grad, venous or lymphatic invasion (Zlobec & Lugli, 2008; Allegra et al, 2009). These prognosis tools are very useful in clinical management. Malnutrition is a significant public health problem worldwide. Studies showed that up to 50% of adults admitted to hospital suffered from malnutrition. Malnutrition affects prognosis in many groups of patients (Lukaski et al, 2017)
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