Abstract
BackgroundThe purpose of the present study is to investigate the utility of prognostic nutritional index (PNI) as a simple and readily available marker in esophageal squamous cell carcinoma (ESCC).MethodsWe retrospectively analyzed 169 patients who underwent potentially curative esophagectomy, for histologically verified ESCC. We decided to set the optimal cutoff value for preoperative PNI levels at 49.2, based on the cancer-specific survival (CSS) and the overall survival (OS) by receiver operating characteristic curve analysis.ResultsMultivariate logistic regression analysis identified that TNM pStage III [hazard ratio (HR) 3.261, p < 0.0001] and PNI < 49.2 (HR 3.887, p < 0.0001) were confirmed as independent poor predictive factors for CSS, and age >70 (HR 2.024, p < 0.0042), TNM pStage III (HR 2.510, p = 0.0002), and PNI < 49.2 (HR 2.248, p = 0.0013) were confirmed as independent poor predictive factors for OS. In non-elderly patients, TNM pStage III (CSS; HR 3.488, p < 0.0001, OS; HR 2.615, p = 0.0007) and PNI < 49.2 (CSS; HR 3.849, p < 0.0001, OS; HR 2.275, p = 0.001) were confirmed as independent poor predictive factors for CSS, and OS when multivariate logistic regression analysis was applied. But in elderly patients, univariate analyses demonstrated that the TNM pStage III was the only significant risk factor for CSS (HR 3.701, p = 0.0057) and OS (HR 1.974, p = 0.0224).ConclusionsThe PNI was a significant and independent predictor of CSS and OS of ESCC patients after curative esophagectomy. The PNI was cost-effective and readily available, and it could act as a marker of survival.
Highlights
Esophageal cancer is a disease of the elderly, with peak incidence occurring in patients in their 70 s, and the elderly population is rapidly increasing in worldwide
Background The purpose of the present study is to investigate the utility of prognostic nutritional index (PNI) as a simple and readily available marker in esophageal squamous cell carcinoma (ESCC)
Multivariate logistic regression analysis identified that TNM pathological Stage (pStage) III [hazard ratio (HR) 3.261, p \ 0.0001] and PNI \ 49.2 (HR 3.887, p \ 0.0001) were confirmed as independent poor predictive factors for cancer-specific survival (CSS), and age [70 (HR 2.024, p \ 0.0042), TNM pStage III (HR 2.510, p = 0.0002), and PNI \ 49.2 (HR 2.248, p = 0.0013) were confirmed as independent poor predictive factors for overall survival (OS)
Summary
Esophageal cancer is a disease of the elderly, with peak incidence occurring in patients in their 70 s, and the elderly population is rapidly increasing in worldwide. World J Surg (2018) 42:2199–2208 nutritional status and postoperative outcomes. There is little data to show the impact of nutritional status on long-term outcomes in patients undergoing radical thoracoscopic esophagectomy for esophageal squamous cell carcinoma (ESCC) [7, 8]. The simplified PNI proposed by Onodera et al [6] can be measured because it is based on only two laboratory parameters, namely the serum albumin level and the peripheral blood lymphocyte count. Albumin is a widely used parameter of nutrition, and its levels have been shown to correlate well with postoperative complications and long-term outcomes in several malignancies [10]. The purpose of the present study is to investigate the utility of prognostic nutritional index (PNI) as a simple and readily available marker in esophageal squamous cell carcinoma (ESCC). We decided to set the optimal cutoff value for preoperative PNI levels at 49.2, based on the cancer-specific survival (CSS) and the overall survival (OS) by receiver operating characteristic curve analysis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
