Prognostic nutritional index predicts postoperative complications and long-term outcomes of gastric cancer

Table 1 Relationship between clinical characteristics and prognostic nutritional index n (%)

Characteristic	PNI-high (n = 245)	PNI-low (n = 141)	χ2	P value
Age (yr)			5.456	0.019
< 65	168 (68.6)	80 (56.7)
≥ 65	77 (31.4)	61 (43.3)
Gender			1.592	0.207
Female	75 (30.6)	52 (36.9)
Male	170 (69.4)	89 (63.1)
Tumor location			3.544	0.315
Upper 1/3	80 (32.7)	39 (27.7)
Middle 1/3	26 (10.6)	20 (14.2)
Lower 1/3	114 (46.5)	61 (43.3)
2/3 or more	25 (10.2)	21 (14.9)
BMI			10.348	0.001
< 18.5 kg/m2	31 (12.7)	36 (25.5)
≥ 18.5 kg/m2	214 (87.3)	105 (74.5)
Bleeding			0.677	0.411
≤ 200 mL	99 (40.4)	51 (36.2)
> 200 mL	146 (59.6)	90 (63.8)
Tumor size			11.628	0.001
< 5 cm	107 (43.7)	38 (26.2)
≥ 5 cm	138 (56.6)	103 (73.8)
Borrmann type			0.720	0.396
I/II	94 (38.4)	48 (34.0)
III/IV	151 (61.6)	93 (66.0)
Histology			0.610	0.435
Differentiated	68 (27.8)	34 (24.1)
Undifferentiated	177 (72.2)	107 (75.9)
Extranodal metastasis			4.155	0.042
Positive	37 (15.1)	33 (23.4)
Negative	208 (84.9)	108 (76.6)
Serosal invasion			4.257	0.039
Yes	189 (77.1)	121 (85.8)
No	56 (22.9)	20 (14.2)
Lymph node metastasis			18.913	< 0.001
pN0	90 (36.7)	34 (24.1)
pN1	41 (16.7)	17 (12.1)
pN2	56 (22.9)	27 (19.1)
pN3	58 (23.7)	63 (44.7)
TNM stage			6.859	0.032
I	29 (11.8)	10 (7.1)
II	71 (29.0)	29 (20.6)
III	145 (59.2)	102 (73.2)
Postoperative complications			12.391	< 0.001
Yes	39 (15.9)	44 (31.2)
No	205 (84.1)	97 (68.8)

PNI: Prognostic nutritional index; BMI: Body mass index.

Table 2 Univariate and multivariate logistic regression analyses of postoperative complications n (%)

Variable	No. of complications	Univariate analysis		Multivariate analysis
		χ2	P value	OR (95%CI)	P value
Age ≥ 65 yr	24 (28.9)	2.151	0.142
Gender (male)	52 (62.7)	0.948	0.330
Tumor location (Upper 1/3)	32 (38.6)	4.189	0.242
BMI < 18.5 kg/m2	15 (18.1)	0.038	0.846
PNI < 46	44 (53.0)	12.391	< 0.001	2.223 (1.344-3.676)	0.002
Bleeding > 200 mL	60 (72.3)	5.532	0.019	1.762 (1.023-3.037)	0.041
Tumor size ≥ 5 cm	60 (72.3)	4.162	0.041	1.147 (0.646-2.037)	0.640
Borrmann type III/IV	57 (68.7)	1.357	0.244
Histological type (undifferentiated)	63 (75.9)	0.295	0.587
Extranodal metastasis (positive)	14 (16.9)	0.114	0.735
Serosal invasion (yes)	76 (91.6)	8.471	0.004	2.792 (1.218-6.404)	0.015
Lymph node metastasis (pN3)	40 (48.2)	14.282	0.003	1.111 (0.889-1.390)	0.354
TNM stage (III)	60 (72.3)	4.432	0.109

PNI: Prognostic nutritional index; BMI: Body mass index.

Table 3 Univariate and multivariate Cox regression analyses of prognostic factors in patients with gastric cancer undergoing total gastrectomy

Characteristic	n	5-yr OS	Univariate analysis		Multivariate analysis
			χ2	Pvalue	HR (95%CI)	Pvalue
Age (yr)			3.753	0.053
< 65	248	44.4
≥ 65	138	37.0
Gender			0.000	1.000
Female	127	41.7
Male	259	41.7
Tumor location			9.998	0.019
Upper 1/3	119	35.5
Middle 1/3	46	47.8
Lower 1/3	175	48.6
2/3 or more	461	28.3
BMI			11.744	0.001	1.405 (1.021-1.935)	0.037
< 18.5 kg/m2	67	26.9
≥ 18.5 kg/m2	319	44.8
Bleeding			11.786	0.001	1.346 (1.018-1.780)	0.037
≤ 200 mL	150	51.3
> 200 mL	236	35.6
Tumor size			27.632	< 0.001
< 5 cm	144	57.6
≥ 5 cm	242	32.2
Borrmann type			1.613	0.204
I/II	142	46.5
III/IV	244	38.9
Histology			4.831	0.028
Differentiated	102	51.0
Undifferentiated	284	38.4
Extranodal metastasis			17.018	< 0.001
Positive	70	45.6
Negative	316	24.3
Serosal invasion			30.363	< 0.001	1.736 (1.115-2.703)	0.015
Yes	310	69.7
No	76	34.8
Lymph node metastasis			131.31	< 0.001	1.685 (1.487-1.908)	< 0.001
pN0	124	71.8
pN1	58	46.6
pN2	83	36.1
pN3	121	12.4
TNM stage			78.584	< 0.001
I	39	84.6
II	100	63.0
III	247	26.3
Postoperative complications			15.175	< 0.001	1.453 (1.079-1.956)	0.014
Yes	83	22.9
No	303	46.9
Chemotherapy			2.750	0.097
Yes	224	48.1
No	162	37.1
PNI					2.074 (1.581-2.722)	< 0.001
High	245	54.1	60.703	< 0.001
Low	141	21.1

PNI: Prognostic nutritional index; BMI: Body mass index.