Prognostic Nutritional Index In Patients Research Articles

Prognostic nutritional index as a novel marker for prediction of prognosis in patients with peripartum cardiomyopathy.

The clinical significance of poor nutritional status in patients with peripartum cardiomyopathy (PPCM) is not clearly understood. Prognostic nutritional index (PNI) is a simple nutritional assessment tool, which was first demonstrated to be valuable in patients with colorectal surgeries. We aimed to investigate the predictive value of PNI in patients with PPCM.A total of 92 patients diagnosed with PPCM were enrolled in this study. PNI was calculated using the following formula: 10 × serum albumin value (g/dL) + 0.005 × total lymphocyte count. The primary endpoint was defined as composite adverse cardiac events that included cardiac death or hospitalization due to worsening heart failure (HF). Cardiac death, hospitalization due to worsening HF, and persistent left ventricular (LV) systolic dysfunction were evaluated, respectively, as secondary endpoints.Primary composite endpoint was higher in the lower PNI group. After adjusting for other risk factors, PNI was found to be as an independent predictor of primary composite endpoint (odds ratio 0.805; 95% confidence interval 0.729–0.888; P < .001). In addition, PNI was significantly associated with secondary endpoints; persistent LV systolic dysfunction as well as cardiac death.This study identified nutritional status assessed by the PNI seems to be a novel predictor of adverse cardiovascular outcomes in patients with PPCM.

Clinical significance of prognostic nutritional index in predicting the efficacy in patients with B-cell lymphoma.

To investigate the clinical significance of prognostic nutritional index (PNI) in predicting the efficacy in patients with B-cell lymphoma. The clinical data from 111 patients with B-cell lymphoma (B-cell lymphoma group), who were newly diagnosed in the Third Xiangya Hospital of Central South University from February 2013 to September 2018, were retrospectively analyzed. A total of 93 volunteers selected from the Health Management Center in the Third Xiangya Hospital were set as control, The PNI was compared between the 2 groups. The PNI cut-off value was determined by receiver operating characteristic (ROC) curve analysis. According to the PNI values of patients before chemotherapy, the patients were also divided into a high PNI group (≥43.5) and a low PNI group (<43.5). The correlation of baseline characteristics was evaluated. The correlation between changes in PNI levels and efficacy were evaluated before and after chemotherapy. The PNI value in the B-cell lymphoma group was significantly lower than that in the healthy control group (P<0.05). Lactate dehydrogenase (LDH), presence or absence of B symptoms, international prognostic index (IPI), Eastern Cooperative Oncology Group (ECOG) performance status, source of germinal center, and the efficacy between the high PNI group and the low PNI group were significantly different (all P<0.05). The mean PNI in the effective patients in the low PNI group was increased from 38.10 before chemotherapy to 42.66 after chemotherapy, with significant difference (t=-2.562, P<0.05). The PNI value in the ineffective patients in the high PNI group was decreased from 50.50 before chemotherapy to 41.45 after chemotherapy, with significant difference (t=3.044, P<0.05). The level of PNI in patients with B-cell lymphoma is significantly lower than that in healthy people, and it is related to the baseline characteristics of prognosis. The change of PNI level before and after chemotherapy can provide certain basis for efficacy evaluation.

Clinical significance of the prognostic nutritional index in patients undergoing cardiovascular surgery.

The prognostic nutrition index is an immunonutritional indicator and postoperative predictor of oncological surgery. However, its prognostic value in cardiovascular disease is unknown. This study assessed the value of the prognostic nutrition index in cardiovascular surgery. This retrospective study included 453 patients who underwent cardiovascular surgery. The patients were divided according to cutoff values of the prognostic nutrition index: < 48, low prognostic nutrition index group and ≥ 48, high prognostic nutrition index group. Clinicopathologic features, including the preoperative state, surgical procedure, and postoperative morbidity and mortality, were compared between the groups. The Mann-Whitney U or Chi-square test, univariate and multivariate analyses, and log-rank test were used in the statistical analyses. Old age, a low body mass index, and elevated creatinine levels correlated significantly with a low prognostic nutrition index. Logistic regression analysis demonstrated that a high prognostic nutrition index status was statistically related to a shorter length of intensive care unit stay, shorter intubation time, and lower incidences of mediastinitis and pneumonia. Multivariate analysis revealed that male sex (hazard ratio 3.93; 95% confidence interval 1.29-11.91, p = 0.016), age (hazard ratio 3.35; 95% confidence interval 1.11-10.15 p = 0.032), and the prognostic nutrition index (hazard ratio 0.40; 95% confidence interval 0.18-0.90, p = 0.026) were independently associated with postoperative survival. A low prognostic nutrition index was significantly associated with postoperative complications and survival. The prognostic nutrition index may be useful and reliable as a preoperative assessment of nutritional status, and it should be considered in the indication and strategy of cardiovascular surgery.

Prognostic Significance of Preoperative Prognostic Nutritional Index in Patients Undergoing Nephrectomy for Nonmetastatic Renal Cell Carcinoma.

The objective of this study was to assess the value of a preoperative Prognostic Nutritional Index (PNI) for predicting the survival of patients with nonmetastatic renal cell carcinoma (RCC) treated with partial or radical nephrectomy. The medical records of 480 patients with RCC who underwent partial or radical nephrectomy at 2 institutions between June 1994 and July 2017 were retrospectively reviewed. After the exclusion of 21 patients with lymph node or distant metastasis, the data of 459 patients with nonmetastatic RCC were included. The PNI was calculated using a combination of serum albumin level and lymphocyte count in the peripheral blood, as described previously. The prognostic significance of various clinicopathologic variables, including the PNI, was assessed in univariate and multivariate analyses. The univariate analysis identified anemia, PNI, tumor size, T stage, Fuhrman nuclear grade, sarcomatoid differentiation, and lymphovascular invasion as significant prognostic factors of recurrence-free survival (RFS) and cancer-specific survival (CSS). In the multivariate analysis, anemia (P=0.010), PNI (P<0.001), tumor size (P<0.001), T stage (P<0.001), Fuhrman nuclear grade (P=0.023), sarcomatoid differentiation (P=0.003), and lymphovascular invasion (P=0.005) were independent prognostic factors for RFS, versus anemia (P=0.020), PNI (P=0.002), tumor size (P<0.001), T stage (P<0.001), sarcomatoid differentiation (P<0.001), and lymphovascular invasion (P=0.018) for CSS. The PNI is an independent prognostic factor for RFS and CSS in patients with nonmetastatic RCC treated with partial or radical nephrectomy. It may, therefore, be a useful tool for predicting recurrence and survival in these patients.

Clinical Implications of the Cut-off Value of the Preoperative Prognostic Nutritional Index in Patients with Early Stage Gastric Cancer

Clinical Implications of the Cut-off Value of the Preoperative Prognostic Nutritional Index in Patients with Early Stage Gastric Cancer

171P - The clinical value of prognostic nutritional index in patients with anastomotic leakage after minimally invasive esophagectomy

BackgroundTo evaluate the prognostic value of prognostic nutritional index(PNI)in esophageal cancer patients under minimally invasive esophagectomy (MIE) with peritoneal metastasis. MethodsThe clinical and pathological data of 197 patients under MIE with anastomotic leakage from January 2013 to December 2015 were analyzed retrospectively. ResultsPNI was not associated with various clinicopathological factors such as age, gender, smoking history, tumor location, tumor length, differentiation degree, T stage, N stage, treatment mode, TNM stage and lymph node metastasis rate (P > 0.05). Univariate survival analysis showed that male, smoking history, advanced tumor stage, tumor length>5cm, advanced N stage, higher lymph node metastasis rate, advanced TNM stage, and treatment modality were associated with poor prognosis. Multivariate analysis showed that N stage (HR = 6.108, CI:1.614-23.113, P = 0.008) and treatment modality (HR = 0.362, CI: 0.213-0.617, P < 0.001) are independent risk factors. PNI is not an independent risk factor. ConclusionsPrognostic nutritional index is not an independent risk factor of the prognosis for patients under minimally invasive esophagectomy with anastomotic leakage. Treatment method and lymph node metastasis are still the main factors affecting long-term survival in this group. Legal entity responsible for the studyThe 4th Hospital of Hebei Medical University. FundingHas not received any funding. DisclosureThe author has declared no conflicts of interest.

The prognostic nutritional index might predict clinical outcomes in patients with idiopathic dilated cardiomyopathy

Background and aimsThe prognostic nutritional index (PNI) had been associated with adverse outcomes in numerous clinical conditions. However, its influence on idiopathic dilated cardiomyopathy (DCM) was not determined. This aim of this study was to determine the predictive ability of PNI in patients with idiopathic DCM. Methods and resultsA total of 1021 consecutive patients with idiopathic DCM were retrospectively included and divided into three groups based on admission PNI tertiles: <41.7 (n = 339), 41.7–47.3 (n = 342), >47.3 (n = 340). The association of PNI with in-hospital major adverse clinical events (MACEs) and death during follow-up was evaluated. In-hospital mortality (2.9% vs. 1.5% vs. 0.0%, respectively; p = 0.006) and MACEs (13.6% vs. 6.7% vs. 3.5%, respectively; p < 0.001) decreased from the lowest to the highest PNI tertile. The optimal cut-off value of PNI to predict in-hospital MACEs was 44.0 (area under the curve: 0.689; 95% confidence interval [CI]: 0.626–0.753; p < 0.001). Multivariate analysis showed that a PNI≤44.0 was an independent risk factor of in-hospital MACEs (odd ratio: 2.86; 95% CI: 1.64–4.98; p < 0.001) and all-cause mortality at a median follow-up of 27 months (hazard ratio: 1.67; 95% CI: 1.11–2.49; p = 0.013). In addition, patients with a PNI≤44.0 had a lower cumulative survival rate during follow-up (log-rank: 35.62; p < 0.001). ConclusionThe PNI was an independent risk factor for in-hospital MACEs and all-cause mortality at a median follow-up of 27 months in patients with idiopathic DCM; hence, it may be considered a tool for risk assessment.

Objective evaluation of nutritional status using the prognostic nutritional index during and after chemoradiotherapy in Japanese patients with head and neck cancer: a retrospective study

ObjectivesThe incidence of severe mucosal damage due to low nutritional status is high in patients receiving concurrent chemoradiotherapy (CCRT) for head and neck cancer. Objective assessments do not exist for...

Development of Novel Prognostic Prediction Models including the Prognostic Nutritional Index for Patients with Colorectal Cancer after Curative Resection.

Objectives: It has been reported that there is an association between the nutritional condition and the prognosis of cancer. Here, we evaluated the relation between the prognostic nutritional index (PNI) and colorectal cancer (CRC). Methods: A total of 184 patients with CRC who underwent curative surgery from October 2011 to December 2012 at the Osaka University Hospital were investigated. According to the median PNI value of our data set, patients were classified into a high-PNI (≥46) group and a low-PNI (<46) group. The relationship between the PNI and the disease-free survival (DFS) and overall survival (OS) was analyzed by a Cox regression model. Results: A low PNI was significantly associated with poor DFS (P = 0.006) and OS (P < 0.001). A multivariate analysis showed that low PNI, venous invasion (present), and tumor location (rectum) were independent risk factors for recurrence. Low PNI, advanced age, and venous invasion were found to be independent risk factors for mortality. Using these clinicopathological factors, we developed nomograms to predict DFS and OS. The concordance index was 0.828 for DFS and 0.756 for OS. Conclusions: A low PNI is a prognostic indicator for recurrence and mortality in CRC. Nomograms constructed by clinicopathological factors including the PNI can provide individual prognostic outcomes.

The prognostic nutritional index in resected high-grade pulmonary neuroendocrine carcinoma.

The prognostic nutritional index is a potential predictive indicator in other cancers and can be easily determined at low cost. To identify useful prognostic markers for high-grade neuroendocrine carcinomas, we examined the prognostic significance of the prognostic nutritional index in patients with resected high-grade pulmonary neuroendocrine carcinoma. We retrospectively reviewed perioperative clinical and laboratory data of patients who underwent pulmonary resection for high-grade neuroendocrine carcinoma between January 2000 and December 2014. Associations between the preoperative prognostic nutritional index and the patients' clinicopathological characteristics were analyzed to determine its prognostic significance. The study comprised 61 patients, the majority of whom were men (85%). The median age was 70.0years, and the median follow-up period was 42months. No significant differences in the clinicopathological characteristics were observed between the high and low prognostic nutritional index groups. The 5-year overall survival and recurrence-free survival times were significantly shorter in the low prognostic nutritional index group than in the high prognostic nutritional index group (78.8% vs. 51.4% and 71.7% vs. 34.5%, respectively; p < 0.05). The prognostic nutritional index was confirmed as an independent prognostic factor (hazard ratio: 2.419, 95.0% confidence interval: 1.044-5.606; p < 0.05). A significantly greater proportion of patients developed distant metastases in the low prognostic nutritional index group than in the high prognostic nutritional index group (p < 0.05). A low prognostic nutritional index is associated with poor survival in patients with resected high-grade pulmonary neuroendocrine carcinoma.

The prognostic nutritional index is prognostic factor of gynecological cancer: A systematic review and meta-analysis.

Many reports have shown that the prognostic nutritional index (PNI) is associated with the progression of malignant tumors. We comprehensively evaluated the prognostic significance of the PNI in patients with gynecological cancer. We identified relevant studies by searching PubMed, Embase, the Cochrane Library, and the Web of Science. The hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI) were used to explore the correlation between PNI and overall survival (OS), progression-free survival (PFS), and the characteristics of gynecological cancer. All analyses were performed using Review Manager ver. 5.2 software. We included nine studies with 2373 patients. The PNI correlated closely with the OS and PFS of gynecological cancer; the pooled HRs were respectively 2.66 (95% CI 1.56-4.55) and 2.43 (95% CI 2.07-2.86) on univariate analysis (UVA) and 1.88 (95% CI 1.10-3.20) and 1.92 (95% CI 1.52-2.44) on multivariate analysis (MVA). The PNI is significantly associated with the prognosis of patients with gynecological cancer, and may, in fact, be independently prognostic.

Prognostic significance of the pretreatment prognostic nutritional index in patients with epithelial ovarian cancer.

ObjectiveWe retrospectively investigated the prognostic significance of the pretreatment prognostic nutritional index (PNI) in patients with epithelial ovarian cancer (EOC) according to the clinical stage.MethodsThe baseline characteristics and clinical outcomes of 308 EOC patients were collected and retrospectively reviewed. PNI was defined as 10 × serum albumin (g/L) + 0.005 × lymphocyte count (per mm3) in the peripheral blood. The cut-off value of PNI was defined by time-dependent receiver operating characteristics (ROC) analysis. Univariate or multivariate analysis was conducted to evaluate the association between pretreatment PNI, progression-free survival (PFS), and disease-specific survival (DSS) according to the clinical stage.ResultsThe cut-off value of PNI was defined as 44.7 in early-stage patients and 42.9 in advanced-stage patient by ROC analysis, respectively. Although decreased PNI was not associated with short PFS or DSS in early-stage patients, it was significantly correlated with short PFS (p<0.0001) and DSS (p<0.0001) in advanced-stage patients. In multivariate analysis, decreased PNI was an independent prognostic predictor of recurrence and short survival in advanced-stage patients.ConclusionA decreased pretreatment PNI was an independent poor prognostic factor in patients with advanced EOC.

PROGNOSTIC NUTRITIONAL INDEX AS A PREDICTOR OF PROGNOSIS IN PATIENTS WITH CRITICAL LIMB ISCHEMIA WHO UNDERWENT ENDOVASCULAR REVASCULARIZATION THERAPY

Patients with critical limb ischemia (CLI) have poor prognosis. Prognostic nutritional index (PNI) is an established independent predictor of adverse outcome in various chronic illnesses. The use of PNI in patients with CLI has not been studied. To evaluate the impact of PNI on 12-month adverse

Prognostic nutritional index is associated with disease severity and relapse in ANCA-associated vasculitis.

The prognostic nutritional index (PNI), calculated by serum albumin and peripheral blood lymphocyte count, is considered to reflect immune-related nutritional status. In this study, we first investigated the clinical significance of PNI in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Medical records of 160 patients classified as AAV from October 2000 to September 2017 were reviewed. We calculated the Birmingham vasculitis activity score (BVAS) and collected laboratory data including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, white blood cell, lymphocyte, and platelet counts, and serum albumin, aspartate aminotransferase, and alanine aminotransferase levels at diagnosis. PNI at diagnosis was calculated as (10×serum albumin [g/dL] + 0.005×lymphocyte count [/mm3 ]). Associations between laboratory variables, PNI, and BVAS were assessed by linear regression analyses, and Cox proportional hazard analysis was used to evaluate factors associated with disease relapse. The mean age was 55.2years and 48 patients (30.0%) were male. In univariable linear regression analysis, BVAS was positively correlated with ESR and CRP and negatively with lymphocyte count, serum albumin, and PNI (r=-0.307). In multivariable linear regression analysis, among ESR, CRP, and PNI, PNI was associated with BVAS (β=-0.299). PNI also significantly correlated with the included laboratory data. In Cox proportional hazard analysis, myeloperoxidase-antineutrophil cytoplasmic antibody positivity (odds ratio [OR] 2.875, P=0.003) and PNI ≤36.75 (OR 2.066, P=0.042) revealed to be independent predictors of disease relapse during the follow-up period. Prognostic nutritional index at diagnosis might be useful for assessing disease severity and predicting the prognosis of AAV patients.

Prognostic impact of prognostic nutritional index in advanced (stage IIIB/IV) non-small cell lung cancer patients.

Prognostic nutritional index (PNI) is a parameter reflecting prognosis for various cancers, including resected lung cancer. However, there were few reports to study the relationship between the PNI and overall survival (OS) in patients with advanced (stage IIIB/IV) non-small lung cancer (NSCLC). In this study, we collected the clinical data of 315 patients with advanced (stage IIIB/IV) NSCLC who had received chemotherapy or epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) between January 2010 and June 2011. Survival curves were plotted using the Kaplan-Meier method. Multivariate analyses were used to evaluate prognostic significance of PNI in patients with advanced (stage IIIB/IV) NSCLC. In our analysis, we found that PNI (p=0.001) was significantly associated with OS in patients with advanced (stage IIIB/IV) NSCLC, so was smoking (p<0.001) and disease stage (p=0.005). We demonstrated that PNI could be utilized to predict survival outcomes in patients with advanced (stage IIIB/IV) NSCLC. Patients with a lower PNI may have worse prognosis.

Clinical importance of preoperative and postoperative prognostic nutritional index in patients with pancreatic ductal adenocarcinoma

Backgrounds/AimsThe prognostic nutritional index (PNI) is based on the albumin concentration and absolute lymphocyte count and is designed to assess the nutritional and immunological status of patients. In this study, we evaluated the prognostic importance of the preoperative and postoperative PNI in patients who underwent curative resection of pancreatic ductal adenocarcinoma (PDAC).MethodsFrom 2006 to 2017, 50 patients with PDAC underwent curative resection at our hospital. We performed distal pancreatectomy (DP) with splenectomy in 15 patients, pancreaticoduodenectomy (PD) in 27 patients, PD combined with portal vein partial resection in 6 patients, and total pancreatectomy with splenectomy in 2 patients. We compared the preoperative PNI and postoperative PNI (1 and 2 months postoperatively) and analyzed the prognostic importance for these patients. ResultsThe mean PNI significantly decreased from 45.5 preoperatively to 39.8 at 1 month postoperatively (p<0.001), but recovered to 42.7 at 2 months postoperatively. In 23 patients, the PNI at 2 months postoperatively recovered to the preoperative level (recovered group), but in the remaining 27 patients, the PNI at 2 months postoperatively did not reach the preoperative level (non-recovered group). The overall median survival time in the recovered group (29 months) was significantly longer than that in the non-recovered group (12 months, p=0.003). The multivariate overall analysis demonstrated that good recovery of the postoperative PNI was strongly correlated with a better prognosis.ConclusionsEffective postoperative nutrition may have a prognostic benefit for patients with operable PDAC.

Clinical Significance of Prognostic Nutritional Index for Patients with Diffuse Large B-cell Lymphoma

To analyze the clinical characteristics and prognostic value of prognostic nutritional index (PNI) for diffuse large B-cell lymphoma (DLBCL) treated in the rituximab era, baseline clinical and disease characteristics were recorded in our hospital. Concentration of T-helper cell type (Th1/Th2/Th17) cytokine profiles were measured by flow cytometry. DLBCL patients were classified into low and high PNI group based on the cutoff value as previously reported. Clinical features and survivals were compared between high and low group. In all, 114 (37%) out of 309 patients were classified as low PNI group. The low group had lower levels of albumin, hemoglobin and lymphocyte counts, and older age, and high lactate dehydroxygenase (LDH), and high frequencies of advanced stage, poor performance status, B symptoms, extranodal involvement, and higher level of interferon gamma (INF-γ). Low PNI was associated with poor overall survival (OS) in univariate analyses. But these significances did not stand in the paired patients matched by the well-established prognostic factors. In parallel, there was no significance between survival and PNI in the multivariate analyses. PNI was closely correlated with the well-established prognostic factors for DLBCL patients and was not an independent prognostic factor in our study.

Clinical significance of prognostic nutritional index in patients with glioblastomas.

Preoperative prognostic nutritional index (PNI) has been proven to be associated with clinical outcomes in patients with malignancies. However, data regarding the role of PNI in human glioblastomas (GBMs) is lacking. We, therefore, aimed to investigate the association between PNI and clinical parameters and survival in GBM patients.This retrospective analysis included 300 GBM patients who were surgically treated at our institute from 2008 to 2017. PNI was calculated as albumin (g/L) + 5×total lymphocyte count (10/L). SPSS 22.0, GraphPad Prism 5, and X tile were the primary tools used for data analysis, figuring drawing, and calculating optimal cutoffs, respectively.Mean albumin value, lymphocyte count, and PNI were 42.13 ± 4.43 g/L, 1.73 ± 0.71 × 10/L, and 50.80 ± 6.01, respectively. PNI was increased in patients aged ≤60 years and in men. Moreover, PNI ≥44 was associated with improved overall survival in younger patients and women. PNI was not associated with isocitric dehydrogenase (IDH)-1 mutations or predicted survival in GBM patients without such mutations. Univariate analysis showed that a high preoperative Karnofsky performance score, gross total resection, completed chemoradiotherapy, IDH-1 mutations, and higher PNI levels were associated with favorable outcomes. Multivariate analysis showed that only completed chemoradiotherapy and IDH-1 mutations were independent prognostic factors.Our results indicated that PNI is associated with age and sex in GBM patients but fails to provide independent prognostic values.

Prognostic value of pretreatment prognostic nutritional index in non-small cell lung cancer: A systematic review and meta-analysis.

The pretreatment prognostic nutritional index has been considered a potential prognostic biomarker in patients with non-small cell lung cancer (NSCLC), but this remains controversial. Therefore, we performed a meta-analysis to systematically assess the prognostic value of the prognostic nutritional index in patients with NSCLC. We systematically searched PubMed, EMBASE, Web of Science, and CNKI. The hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs) were used to evaluate the link between the prognostic nutritional index and the oncological outcomes of patients with NSCLC, including overall survival, disease-free survival/recurrence-free survival, and progression-free survival. Fifteen studies were included in this meta-analysis. Twelve of these studies explored the association between the prognostic nutritional index and the overall survival of patients with NSCLC. Our pooled analysis indicated that a low prognostic nutritional index was significantly related to adverse overall survival (HR 1.61; 95% CI 1.44, 1.81; P < 0.001). Our results also showed that the prognostic nutritional index was a negative predictor for disease-free survival/recurrence-free survival, and progression-free survival in patients with NSCLC. Our meta-analysis demonstrated that there was a close association between the prognostic nutritional index value and prognosis in NSCLC patients and that the prognostic nutritional index may act as a useful prognostic biomarker in NSCLC patients.

Prognostic Value of Preoperative Nutritional and Immunological Factors in Patients with Pancreatic Ductal Adenocarcinoma.

Preoperative nutritional and immunological patient factors have been found to be associated with prognostic outcomes of malignant tumors; however, the clinical significance of these factors in pancreatic ductal adenocarcinoma (PDAC) remains controversial. The aim of this study was to evaluate the prognostic value of nutritional and immunological factors in predicting survival of patients with PDAC. Retrospective studies of 329 patients who underwent surgical resection for PDAC and 95 patients who underwent palliative surgery were separately conducted to investigate the prognostic impact of tumor-related factors and patient-related factors, including Glasgow Prognostic Score (GPS), modified GPS, Prognostic Nutritional Index (PNI), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio, and lymphocyte/monocyte ratio. In multivariate analysis for patients with surgical resection for PDAC, PNI was an independent factor for overall survival (OS) and disease-free survival. The median OS of patients with PNI ≤ 45 was significantly shorter than that of patients with PNI > 45 (17.5 and 36.2months, respectively; p < 0.001). In multivariate analysis for patients undergoing palliative surgery for PDAC, only NLR was an independent prognosis factor. The median OS of patients with NLR > 5 was significantly shorter than that of patients with NLR ≤ 5 (2.7 and 8.9months, respectively; p < 0.001). PNI in patients with surgical resection and NLR in patients with palliative surgery for PDAC may be useful prognostic factors.