Value of Prognostic Nutritional Index as a Predictor of Lymph Node Metastasis in Gastric Cancer

• Published in: Anticancer research Vol. 39; no. 12; pp. 6843 - 6849
• Main Authors: KOSUGA, TOSHIYUKI, KONISHI, TOMOKI, KUBOTA, TAKESHI, SHODA, KATSUTOSHI, KONISHI, HIROTAKA, SHIOZAKI, ATSUSHI, OKAMOTO, KAZUMA, FUJIWARA, HITOSHI, KUDOU, MICHIHIRO, ARITA, TOMOHIRO, MORIMURA, RYO, MURAYAMA, YASUTOSHI, KURIU, YOSHIAKI, IKOMA, HISASHI, NAKANISHI, MASAYOSHI, OTSUJI, EIGO
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.12.2019
• Subjects: Accuracy; Adenocarcinoma; Adjuvants; Adult; Aged; Aged, 80 and over; Cancer; Chemotherapy; Computed tomography; Diagnosis; Disease; Female; Gastrectomy; Gastric cancer; Gastrointestinal surgery; Humans; Lymph nodes; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic Metastasis; Lymphatic system; Male; Malnutrition; Metastases; Metastasis; Middle Aged; Multivariate analysis; Nutrition Assessment; Nutritional status; Patients; Prognosis; Retrospective Studies; ROC Curve; Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Survival Analysis; Tomography, X-Ray Computed; Japan; prognostic nutritional index; gastrectomy; Gastric cancer; staging; lymph node metastasis
• ISSN: 0250-7005; 1791-7530; 1791-7530
• DOI: 10.21873/anticanres.13901

This study examined whether the prognostic nutritional index (PNI) is a useful predictor of pathological lymph node metastasis (pN+) in gastric cancer (GC). This study retrospectively examined 167 patients with advanced GC (cT2-T4) undergoing curative gastrectomy. The predictive ability of PNI for pN+ was evaluated in comparison with that of clinical lymph node metastasis (cN+) determined by computed tomography (CT). The optimal cut-off value of PNI for predicting pN+ was 46 according to the receiver operating characteristic curve analysis. Multivariate analysis revealed a PNI<46 [odds ratio (OR)=2.905; 95% confidence interval (CI)=1.347-6.638, p=0.006], cN+ (OR=2.323; 95%CI=1.204-4.579, p=0.012), and undifferentiated-type adenocarcinoma (OR=2.032; 95%CI=1.060-3.947, p=0.033) to be independent predictors of pN+. PNI detected pN+ with a higher specificity (84.9%) and positive predictive value (PPV) (75.6%) than cN+ (68.5% and 68.1%, respectively). When the subjects were limited to patients with cN+, the specificity and PPV of a PNI<46 for pN+ became markedly high (91.3% and 90.5%, respectively). PNI predicts pN+ with a high specificity in patients with a clinical diagnosis of advanced GC; therefore, PNI may aid in the definitive diagnosis of pN+, especially in combination with CT findings.