Impact of perioperative prognostic nutritional index changes on the survival of patients with stage II/III colorectal cancer

IF 2.9 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of Gastroenterological Surgery Pub Date : 2024-05-30 DOI:10.1002/ags3.12826

Kyota Tatsuta, Mayu Sakata, Tadahiro Kojima, Toshiya Akai, Mikihiro Shimizu, Yoshifumi Morita, Hirotoshi Kikuchi, Yoshihiro Hiramatsu, Kiyotaka Kurachi, Hiroya Takeuchi

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Abstract

Aim

To assess the impact of perioperative prognostic nutritional index (PNI) changes on prognosis and recurrence after colorectal cancer surgery.

Methods

A total of 475 patients who underwent curative resection for primary colorectal adenocarcinoma and were diagnosed with pathological stage (pStage) II/III were retrospectively reviewed. The patients were divided into two groups: the high group (preoperative PNI ≤ postoperative PNI, n = 290) and the low group (preoperative PNI > postoperative PNI, n = 185).

Results

The low group exhibited significantly higher recurrence and mortality rates (all p < 0.001). Kaplan–Meier analysis showed worse overall and recurrence-free survival in the low group (all p < 0.001). Perioperative PNI changes predicted prognosis and recurrence independent of preoperative nutritional conditions. Subgroup analyses showed better overall survival and recurrence-free survival in the high group across various parameters, such as patient background, surgical outcomes, adjuvant chemotherapy, and pathological characteristics. Multivariate analysis revealed that the low group based on perioperative PNI changes (hazard ratio [HR]: 5.809, 95% confidence interval [CI]: 3.451–9.779, p < 0.001), pathological T stage (HR: 1.962, 95% CI: 1.184–3.253, p = 0.009), and pathological N stage (HR: 3.434, 95% CI: 1.964–6.004, p < 0.001) were identified as independent predictors of worse overall survival.

Conclusions

Patients with pStage II/III colorectal cancer who demonstrate a lower postoperative PNI levels compared to preoperative had poorer overall survival and recurrence-free survival. Perioperative PNI changes can serve as useful biomarkers for predicting survival and recurrence.

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围手术期预后营养指数变化对 II/III 期结直肠癌患者生存期的影响。

目的：评估围手术期预后营养指数（PNI）变化对结直肠癌手术后预后和复发的影响：方法：回顾性研究了475例接受根治性切除术的原发性结直肠腺癌患者，这些患者被诊断为病理分期（pStage）II/III期。患者被分为两组：高组（术前 PNI ≤ 术后 PNI，n = 290）和低组（术前 PNI > 术后 PNI，n = 185）：与术前相比，术后 PNI 水平较低的 p2/III 期结直肠癌患者的总生存率和无复发生存率较低。围手术期 PNI 变化可作为预测生存和复发的有用生物标记物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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