Prognostic Nutritional Index as a predictive factor of survival in patients with gastric cancer in a Mexican population.

Abstract

85 Background: Gastric cancer is a health problem that is gaining great relevance because despite the multidisciplinary treatment the clinical outcomes are not encouraging; with a diversified prognosis, considering that the results are not only influenced by tumor properties, but also by the patient's condition in an integral way, especially by the nutritional and immunological state. In this study we studied the prognostic nutritionalindex (PNI) as predictive value of survival in patients with gastric cancer. Methods: This is a observational study, 251 patients with diagnosis of gastric adenocarcinoma with locally advanced disease (confirmed by computed tomography (CT)) were analyzed from January 2010 to June 2016. Patients with locally advanced disease confirmed by laparoscopy were taken to radical surgery. Those patients who were taken to laparoscopy and who have been documented metastatic disease, were treated only in a palliative form (chemotherapy, radiotherapy, palliative care). Results: In the analysis of survival through the curves of Kaplan-Meier, and the test log-rank, it was found that patients with a larger tumor size pathological (PT) (3/4/unclassifiable vs 1/2) had an average survival of 25.5 versus 55.5 months (P = < 0.0001). With advanced pathological stages (EP) (III/IV/non-classifiable vs. complete pathological response/I/II) reaching a survival average of 20.4 versus 59.1 months (P = < 0.0001). In the multivariate analysis, it was found that the EP (Hazard radio [HR]: 1.54, confidence interval 95% [CI]: 1.323-1.810, p = < 0.0001) and having received adjuvant chemotherapy (HR: 0332, CI 95%: 0.217-0.508, p = < 0.0001), were independently associated with the overall survival. Conclusions: This study demonstrates that low levels of PNI are associated with advanced diseases and, therefore, worse prognosis, with a tendency towards a decrease in overall survival.