This study aimed to evaluate the prognostic value of preoperative systemic immune inflammatory index (SII) and prognostic nutritional index (PNI) in patients with renal cell carcinoma (RCC) undergoing surgery, and to establish a nomogram for predicting overall survival (OS).

We retrospectively analyzed clinical data from 240 RCC patients who underwent surgery. SII and PNI values were calculated, and optimal cutoff value were determined by receiver operating characteristic curves. Patients were classified into high and low SII/PNI groups. Survival outcomes were assessed using Kaplan-Meier analysis and log-rank tests. Univariate and multivariate Cox regression models were used to identify independent prognostic factors, which were incorporated into a nomogram. The model's accuracy and discrimination were evaluated by the consistency index (C-index) and calibration curves.

The 1-, 3- and 5-year survival rates were significantly higher in low SII group were (98.10%, 92.30%, and 87.20%) compared to the high SII group (90.00%, 72.90%, and 57.40%), and higher in the high PNI group (97.60%, 93.00%, and 87.60%) compared to the low PNI group (86.90%, 67.90%, and 40.80%; P < 0.001). Multivariate Cox regression model analysis showed that SII, PNI, hemoglobin, tumor necrosis, surgical method, pathological type, AJCC stage and Fuhrman grade were independent prognostic factors. The nomogram model demonstrated excellent predictive ability with a C index was 0.915.

Preoperative SII and PNI are independent predictors of postoperative prognosis in RCC patients. The constructed nomogram based on multiple factors provides accurate individualized survival predictions.

Malnutrition is a prevalent issue among older patients with hip fracture and is significantly associated with poor outcomes. The Geriatric Nutritional Risk Index (GNRI) and Prognostic Nutritional Index (PNI) are nutritional screening tools that may assist in predicting outcomes in older patients undergoing hip fracture surgery. This study aimed to evaluate the effects of GNRI and PNI on 1-year mortality after hip fracture surgery in older patients.

This retrospective study included 577 patients aged 60 years and older with hip fractures treated surgically at a single center from January 2018 to December 2021. Nutritional status was evaluated using GNRI and PNI. The primary outcomes were 180-day and 1-year mortality, while secondary outcomes included short-term postoperative complications and length of stay. Univariate and multivariate analyses were performed to identify independent risk factors for 1-year mortality. Subgroup analysis was employed to identify potential population heterogeneity.

Patients with low GNRI and low PNI had significantly higher 1-year mortality rates and short-term postoperative complication rates compared to those with higher scores. Low GNRI was an independent risk factor for one-year mortality (95% CI 1.09 - 3.25, P = 0.022). Subgroup analyses revealed significant heterogeneity, with males patients and patients with ASA III-IV showing higher hazard ratios for 1-year mortality associated with low GNRI. Pulmonary infections and older age were also identified as independent risk factors for one-year mortality.

This study demonstrated that low GNRI was the risk factor for 1-year mortality after hip fracture surgery in older patients.

Nutritional management in neurosurgical patients with brain neoplasms is critical, as optimal nutritional status is potentially associated with improved clinical outcomes. This systematic review aimed to analyze the impact of pre- and postoperative nutritional assessment and effect of prepost interventions on the clinical outcomes.

A systematic review was conducted using the PubMed, Cochrane Library, Embase, and CINAHL databases, complemented by a search of grey literature. Study quality was assessed using the Joanna Briggs Institute framework, and the certainty of evidence was graded according to the Oxford Centre for Evidence-Based Medicine levels.

Fourteen studies, encompassing a total of 11,224 adult patients with brain neoplasms, were included. Many of these studies were retrospective, had small sample sizes, and examined diverse nutritional protocols. Preoperative nutritional status assessment, including clinical parameters such as albumin (p < 0.001), Controlling Nutritional Status score (p = 0.001), and Prognostic Nutritional Index (p < 0.010), combined with postoperative oral nutritional supplements (p < 0.001), was significantly associated with postoperative clinical outcomes. Additionally, personalized nutritional counseling contributed to a reduction in complications and facilitated more effective functional recovery.

Nutritional care is vital in managing neurosurgical patients with brain neoplasms, reducing complications and enhancing postoperative recovery and overall clinical outcomes. A multidisciplinary team is key to optimal outcomes. Future research should aim to standardize protocols for broader applicability.

Gastric cancer (GC) is a common malignant tumor of the digestive tract. Accumulating studies suggest that inflammation is linked with the pathogenesis of GC. The study delves into novel hematological inflammatory markers, such as systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and prognostic nutritional index (PNI), to explore their potential applications in early diagnosis of GC.

From October 2020 and August 2024, 1339 GC patients admitted to our hospital were enrolled in this study. The pre-treatment SII, SIRI, and PNI was calculated from peripheral blood samples. Univariate and multivariate logistic regression analyses were utilized to verify independent risk factors for patients, and constructed the nomograms. The correlation between hematological indicators and tumor-node-metastasis (TNM) stage was assessed through Spearman's analysis.

Eligible patients and healthy controls were grouped by gender. The diagnostic ability of PNI was significantly superior to other indicators to diagnose male GC (area under the curve [AUC]=0.908, 95% CI: 0.892-0.925) and female GC (AUC=0.890, 95% CI: 0.865-0.914). Besides, the combination of hematological indicators is more effective in diagnosing GC patients, especially for male patients (AUC=0.916, 95% CI: 0.901-0.932, sensitivity: 84.98%, specificity: 84.29%). The C-statistic of Nomogram model was 0.917 for males and 0.875 for females. In both male and female cohorts, CEA, SII, and SIRI were positively correlated with TNM stage, while PNI was negatively correlated. The AUC of CEA, SII, SIRI, and PNI combined for the diagnosis in the early stage of male GC patients was 0.897 (95% CI: 0.875-0.918, sensitivity: 86.57%, specificity: 80.30%) is higher than that of in the advanced stage (AUC: 0.745, 95% CI: 0.710-0.780, sensitivity: 56.53%, specificity: 82.86%).

The combined CEA, SII, PNI, and SIRI could be used as screening biomarkers in diagnosing GC, especially in the early stage of male GC patients.

Previous studies have demonstrated that PNI can predict the prognosis of gastric cancer (GC) patients. However, few studies have focused on the auxiliary role of miRNA in predicting the prognosis of GC.

This research seeks to clarify the role of the combined use of miR-132-3p and PNI in predicting the prognosis of GC patients.

The qRT-PCR was used to assess the expression of miR-132-3p in tumor and adjacent normal tissues with GC patients. The predictive value of miR-132-3p and PNI for postoperative prognosis, and the relationships between miR-132-3p, PNI, and preoperative clinical characteristics, were assessed using ROC, χ², Kaplan-Meier survival analysis, and Cox regression analysis.

miR-132-3p was found to be downregulated in GC tumor tissues and significantly positively correlated with PNI. Both miR-132-3p and PNI were significantly associated with TNM stage and lymph node metastasis. Postoperative GC patients with low miR-132-3p expression and low PNI had lower survival rates, and both were independent risk factors for poor prognosis. The combination of miR-132-3p and PNI demonstrated better sensitivity and specificity in predicting postoperative prognosis than either indicator alone.

The combination of miR-132-3p and PNI can effectively improve the predictive value of postoperative prognosis in GC patients.

Microsatellite instability high (MSI-H) and/or mismatch repair deficient (dMMR) status is the strongest predictive factor for immune checkpoint inhibitors (ICIs) benefit in patients with metastatic gastroesophageal cancer (mGC). Primary resistance to ICIs is a relevant issue, but prognostic and predictive factors are lacking.

In this multinational, retrospective cohort of patients with MSI-H/dMMR mGC treated with ICIs without chemotherapy we collected baseline laboratory values to establish the prognostic nutritional index (PNI). We evaluated the association between baseline PNI with the activity and efficacy of ICIs.

At a median follow-up of 31.6 months, median progression-free survival (PFS) and 2-year PFS rate were not reached and 73.6 % in the PNI-high subgroup versus 6.3 months and 38.3 % in the PNI-low one (HR 0.32, 95 % CI: 0.16-0.61, p < .001). Median overall survival (OS) and 2-year OS rate were not reached and 81.9 % in the PNI-high subgroup versus 24.4 months and 50.5 % in the PNI-low one (HR 0.26, 95 % CI: 0.12-0.56, p < .001). In multivariable models, high PNI was associated with longer PFS and OS (HR 0.30, 95 % CI: 0.15-0.61, p <0.001 and 0.37, 95 % CI: 0.15-0.91, p = .031).

High PNI is associated with longer PFS and OS, in patients with MSI-H mGC receiving ICIs. Patients with low baseline PNI may benefit from intensive therapeutic approaches.

Background and Objectives: The HALP (Haemoglobin, Albumin, Lymphocyte and Platelet) score is used to predict the prognosis of different types of cancer. This study aimed to investigate the role of the HALP score in predicting pathological response in early-stage gastric cancer patients. Materials and Methods: This retrospective cohort study was conducted on 118 patients diagnosed with early-stage gastric cancer and subjected to perioperative (FLOT) treatment between 2018 and 2023. The role of the HALP score in predicting the pathological response to perioperative treatment in patients was investigated. Results: The mean age of the 118 patients included in the study was 61.3 ± 11.1 (min = 23; max = 86). In the ROC analysis, the optimum cut-off value for the HALP score in pathological response classification was found to be 28.9 (AUC = 0.710, sensitivity = 56.7%, specificity = 80%, PPV = 86.79%, NPV = 46.15%). The pathological response rate was 69% in all patients, 87% in patients with a HALP score ≥ 28.9, and 52% in patients with a HALP score < 28.9 (p < 0.001). The probability of pathological response is 6.5 times higher in patients with a HALP score ≥ 28.9. In the Fagan nomogram, when the HALP score was ≥28.9, our pathological response probability estimate (post-test response probability) was found to increase to 64.8% (Positive Likelihood Ratio = 3, Negative Likelihood Ratio = 0.53). In patients with HALP scores ≥ 28.9 and <28.9, progression rates were 16.7% and 47.8%, respectively (p < 0.001), and median survival times were 45.4 and 30.6 months (p < 0.001). Conclusions: The HALP score is a useful and easily accessible score for determining pathological responses in patients with locally advanced gastric cancer.

The prognostic nutritional index (PNI) has been used to assess the immunonutritional status of cancer patients and can predict the prognosis of various solid cancers, and the serum alanine transaminase (ALT)/aspartate transaminase (AST) ratio (LSR) is considered a good predictor of liver injury. A retrospective cohort analysis was conducted to investigate the relationship between the prognosis of esophageal squamous cell carcinoma (ESCC) patients and LSR or PNI, as well as to combine these two indicators (LSR-PNI) for further prognostic analysis in ESCC patients undergoing radiotherapy (RT).

In this study, 134 patients with esophageal cancer were retrospectively analyzed. The Chi-square test was utilized to compare count data, and univariate and multivariate Cox proportional hazards models were employed to identify independent risk and prognostic factors. Additionally, the combination of LSR and PNI (LSR-PNI) was analyzed.

This study included a cohort of 134 patients, comprising 105 males with a mean age of 70.7 years and 29 females with a mean age of 76.3 years. Pathological examination categorized 41 cases as stage I-II and 93 cases as stage III-IV. The predominant treatment modality administered was intensity-modulated radiotherapy (IMRT) for esophageal cancer. Of these patients, 96 received radiation doses ≤ 54 Gy, while 38 were administered doses > 54 Gy. Radiation-induced adverse effects were observed in 67 patients, with the remaining 67 showing no such effects. Kaplan-Meier survival analysis revealed that elevated levels of the lymphocyte-to-serum ratio (LSR) and prognostic nutritional index (PNI) were significantly correlated with improved progression-free survival (PFS) and overall survival (OS). The high-LSR group demonstrated longer PFS (14.4 vs. 9.3 months, p = 0.0469) and OS (19.9 vs. 13.7 months, p = 0.0315) compared to the low-LSR group, with respective 3-year survival rates of 18.4% vs. 12.7%. Similarly, patients in the high-PNI group exhibited superior PFS (13.9 vs. 8.9 months, p = 0.0071) and OS (19.0 vs. 13.5 months, p = 0.0002) compared to the low-PNI group, with 3-year survival rates of 19.6% vs. 11.3%. Stratification based on combined LSR and PNI levels categorized patients into low-, intermediate-, and high-risk groups. The low-risk group demonstrated significantly better PFS (17.8 vs. 10.1 vs. 8.2 months) and OS (24.1 vs. 14.3 vs. 12.9 months, p < 0.0001) compared to the intermediate- and high-risk groups, with 3-year survival rates of 24%, 14%, and 10.3%, respectively.

Pretreatment LSR and PNI can serve as independent prognostic predictors for patients, with higher values of both being associated with improved progression-free survival and overall survival. Additionally, the combined LSR-PNI score effectively stratifies patients into distinct risk groups, offering a robust tool for predicting outcomes in clinical practice.

The aim of the study was to analyze and discuss the value of preoperative systemic immune inflammation index (SII) and prognostic nutritional index (PNI) in predicting the prognosis of patients with renal cell carcinoma (RCC) after operation, and to establish a nomogram prediction model for patients with RCC after operation based on SII and PNI. From January 2014 to December 2018, 210 patients with RCC who underwent surgical treatment at the Xuzhou Central Hospital were selected as the research object. The receiver operating characteristic curve (ROC) was used to determine the optimal cut-off value for preoperative SII, PNI, LMR, PLR, NLR and the patients were divided into groups according to the optimal cutoff values. The survival rate of patients was evaluated. The risk factors that affect the prognosis of patients with RCC were determined by LASSO and Cox regression analysis, and a prognostic nomogram was constructed based on this result. The bootstrap method was used for internal verification of the nomogram model. The prediction efficiency and discrimination of the nomogram model were evaluated by the calibration curve and index of concordance (C-index), respectively. The average overall survival (OS) of all patients was 75.385 months, and the 1-, 2-and 3-year survival rates were 95.5%, 86.6% and 77.2%, respectively. The survival curve showed that the 5-year OS rate of low SII group was significantly higher than that of high SII group (89.0% vs. 64.5%; P < 0.05), and low PNI group was significantly lower than those in high PNI group (43.4% vs. 87.9%; p < 0.05). There were significant differences between preoperative SII and CRP, NLR, PLR, LMR, postoperative recurrence, pathological type and AJCC stage (P < 0.05). There were significant differences between preoperative PNI and BMI, platelet, NLR, PLR, LMR, postoperative recurrence, surgical mode and Fuhrman grade (P < 0.05). The ROC curve analysis showed that the AUC of PNI (AUC = 0.736) was higher than that of other inflammatory indicators, followed by the AUC of SII (0.718), and the difference in AUC area between groups was statistically significant (P < 0.05). The results from multivariate Cox regression analysis showed that SII, PNI, tumor size, tumor necrosis, surgical mode, pathological type, CRP, AJCC stage and Fuhrman grade were independent risk factors for postoperative death of patients with RCC. According to the results of Cox regression analysis, a prediction model for the prognosis of RCC patients was established, and the C-index (0.918) showed that the model had good calibration and discrimination. The subject's operating characteristic curve indicates that the nomogram has good prediction efficiency (the AUC = 0.953). Preoperative SII and PNI, tumor size, tumor necrosis, surgical mode, pathological type, CRP, AJCC stage and Fuhrman grade are closely related to the postoperative prognosis of patients with renal cell carcinoma. The nomogram model based on SII, PNI, tumor size, tumor necrosis, surgical mode, pathological type, CRP, AJCC stage and Fuhrman grade has good accuracy, discrimination and clinical prediction efficiency.

Adjuvant chemotherapy is crucial for the treatment of advanced gastric cancer. However, various factors negatively impact chemoadherence, with malnutrition after gastrectomy being a critical determinant. This study aims to analyze the impact of malnutrition, assessed through the Global Leadership Initiative on Malnutrition (GLIM) and other immunonutritional indices, on chemoadherence and its subsequent effect on survival.

This retrospective study included 116 patients who underwent curative gastrectomy and received oxaliplatin and capecitabine (XELOX). Preoperative nutritional status was assessed using the GLIM criteria along with other immunonutritional indices, such as the prognostic nutritional index (PNI), C-reactive protein-to-albumin ratio (CAR), neutrophil-lymphocyte ratio (NLR), controlling nutritional status (CONUT) score, and modified Glasgow Prognostic Score (mGPS). Chemotherapy adherence was measured using relative dose intensity (RDI). Statistical analyses included least absolute shrinkage and selection operator (LASSO) regression to identify the key predictors of RDI and Cox proportional hazards models and assess the impact on survival.

Overall, 116 patients were included in this analysis. In the multivariate analysis using LASSO regression, higher GLIM severity was independently associated with a lower RDI (coefficient = -0.0216; p < 0.01). Other significant factors influencing RDI included older age (p < 0.01), female sex (p = 0.02), higher mGPS (p = 0.03), higher CONUT score (p = 0.04), and higher CAR (p = 0.05), all of which were associated with a lower RDI. The Cox proportional hazards analysis revealed that higher RDI was significantly associated with better survival (hazard ratio [HR] = 0.06; p < 0.005).

This study highlights the critical role of immunonutritional status, particularly as measured using the GLIM criteria, in maintaining adherence to chemotherapy and improving survival outcomes in patients with gastric cancer. Routine preoperative nutritional assessments using GLIM can help identify high-risk patients, and early nutritional interventions may improve chemotherapy adherence and outcomes. These findings support the integration of nutritional strategies, specifically targeting those identified by the GLIM, into standard care to enhance the efficacy and survival of chemotherapy.

Liver cancer represents a grave hepatic condition and constitutes a significant global health concern. Surgical resection remains the principal therapeutic modality for liver cancer. Nevertheless, perioperative malnutrition exerts a notable impact on patients with liver cancer, emerging as an independent risk factor for disease mortality and adverse outcomes. Hence, precise nutritional diagnosis and timely nutritional support hold the potential to enhance therapeutic efficacy and quality of life for liver cancer patients. This study represents a meticulous foray into the literature, extracting data from PubMed, Web of Science, and EMBASE databases, with a focus on the past 5 years. It scrutinizes the impact of malnutrition on patients undergoing liver cancer surgery, the etiological underpinnings of malnutrition within this patient cohort, the critical assessment of perioperative nutritional status, and the strategic approaches to nutritional support. Utilizing rigorous inclusion and exclusion criteria, the amassed scholarly works are meticulously synthesized, methodically organized, and categorically elaborated upon. Ultimately, the authors propose the incorporation of a multidisciplinary nutrition management team during the perioperative period, comprising nutritionists, pharmacists, physicians, nurses, psychologists, and rehabilitation therapists, among other specialized professionals. Together, they collaborate to devise and implement personalized nutritional support plans, monitor patients' nutritional status, and make necessary adjustments as required. Through comprehensive management and intervention, improvements in the nutritional status of liver cancer patients can be achieved, thereby enhancing surgical success rates and facilitating postoperative recovery. It is believed that this manuscript will offer valuable insights to advance the nutritional management during the perioperative phase of liver cancer, aiding in ameliorating patients' nutritional status and treatment outcomes.

Postoperative recurrence and metastasis of gastric cancer (GC) are primary factors that contribute to poor prognosis. GC recurs at a rate of approximately 70%-80% within 2 years after local treatment and approximately 90% within 5 years. "Yang-deficient toxic node" is the core pathogenesis of GC recurrence and metastasis. The Yiqi Wenyang Jiedu prescription (YWJP), a form of complementary and alternative medicine in China, is an empirical remedy to prevent postoperative recurrence and metastasis of GC. Taking the main therapeutic principles of "nourishing Qi and warming Yang, strengthening Zhengqi, and detoxifying" can aid in preventing the recurrence and metastasis of GC in patients during the watchful waiting period after surgery and adjuvant chemotherapy. This approach aims to enhance the quality of life of patients. However, high-quality evidence to support this hypothesis is lacking. This study will aim to investigate the efficacy and safety of YWJP to prevent and treat postoperative metastasis and GC recurrence.

The study will be a multicenter, randomized, double-blind, placebo-parallel-controlled clinical trial. A total of 212 patients who completed adjuvant chemotherapy within 8 months of radical gastrectomy will be enrolled. Patients in the intervention group will receive the YWJP, whereas those in the control group will receive a placebo. The main outcome was the disease-free survival (DFS) rate 2 years after surgery. The secondary outcomes included DFS time, overall survival, annual cumulative recurrence and rate of metastasis after 1-3 years, cumulative annual survival after 1-3 years, fat distribution-related indicators, tumor markers, peripheral blood inflammatory indicators, prognostic nutritional index, symptoms and quality of life evaluation, medication compliance, and adverse reaction rate.

There is a lack of effective therapy after the completion of adjuvant therapy during the postoperative period of watchful waiting. This study will be the first randomized clinical trial to evaluate whether complementary and alternative medical interventions can effectively prevent recurrence and metastasis during the watchful waiting period after GC surgery and to provide evidence for surveillance treatment management after GC surgery.

ClinicalTrials.gov, identifier NCT05229809.

In this study, We aim to explore the association between the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), lymphocyte to monocyte ratio (LMR) and prognostic nutritional index (PNI) and distant metastasis of gastric cancer and develop an efficient nomogram for screening patients with distant metastasis. A total of 1281 inpatients with gastric cancer were enrolled and divided into the training and validation set.Univariate, Lasso regression and Multivariate Logistic Regression Analysis was used to identify the risk factors of distant metastasis. The independent predictive factors were then enrolled in the nomogram model. The nomogram's predictive perform and clinical practicality was evaluated by receiver operating characteristics (ROC) curves, calibration curves and decision curve analysis. Multivariate Logistic Regression Analysis identified D-dimer, CA199, CA125, NLR and PNI as independent predictive factors. The area under the curve of our nomogram based on these factors was 0.838 in the training cohort and 0.811 in the validation cohort. The calibration plots and decision curves demonstrated the nomogram's good predictive performance and clinical practicality in both training and validation cohort. Therefore,our nomogram could be an important tool for clinicians in screening gastric cancer patients with distant metastasis.

Inflammatory factors have increasingly become a more cost-effective prognostic indicator for gastric cancer (GC). The goal of this study was to develop a prognostic score system for gastric cancer patients based on inflammatory indicators.

Patients' baseline characteristics and anthropometric measures were used as predictors, and independently screened by multiple machine learning(ML) algorithms. We constructed risk scores to predict overall survival in the training cohort and tested risk scores in the validation. The predictors selected by the model were used in multivariate Cox regression analysis and developed a nomogram to predict the individual survival of GC patients.

A 13-variable adaptive boost machine (ADA) model mainly comprising tumor stage and inflammation indices was selected in a wide variety of machine learning models. The ADA model performed well in predicting survival in the validation set (AUC = 0.751; 95% CI: 0.698, 0.803). Patients in the study were split into two sets - "high-risk" and "low-risk" based on 0.42, the cut-off value of the risk score. We plotted the survival curves using Kaplan-Meier analysis.

The proposed model performed well in predicting the prognosis of GC patients and could help clinicians apply management strategies for better prognostic outcomes for patients.

Delirium is a serious and complex problem facing critically ill patients. This retrospective study aimed to explore the association between prognostic nutrition index (PNI) and delirium in critically ill patients in the intensive care unit (ICU). This study was based on the Medical Information Mart Intensive Care IV (MIMIC IV) database. Patients over 18 years of age were enrolled. Univariate and multivariate logistic regression analyses were performed to explore the association between PNI and delirium. Tendency analysis, subgroups analysis, and restricted cubic spline (RCS) were selected to further certify the association. The receiver operating characteristic curve (ROC) was adopted to assess the predictability of PNI to delirium. Propensity score matching (PSM) was used to reduce the interference of confounders. A total of 3,105 patients participated in this study. As the grade of malnutrition increases, the incidence of delirium increases in all models. The odds ratios (OR) of delirium in the fully adjusted model were 1.00 (reference), 1.04 (0.80, 1.36), 1.53 (1.17, 1.99), and 1.93 (1.44, 2.59). Strong U-shaped curves were found with RCS analysis between delirium and PNI in the subgroups of patients over 60 years of age and patients with chronic obstructive pulmonary disease (COPD). After PSM, the ORs of delirium were 1.44 (1.16, 1.79) and 1.53 (1.22, 1.93), respectively, in the univariate and multivariate logistic regression models. PNI is negatively associated with the prevalence of delirium in critically ill adults in the ICU. PNI is an independent risk factor for the incidence of delirium in adults in the ICU.

The development and improved response to chemotherapy has resulted in a survival benefit of conversion surgery (CS) for advanced gastric cancer (GC). However, this benefit is limited in some cases, such as in those with very early recurrence (VER). This study investigated the relationship between outcome and clinicopathological characteristics after CS for stage IV GC, and the risk factors for VER after CS.

We retrospectively studied 184 patients with stage IV GC who initially underwent chemotherapy, including 36 patients who underwent CS between May 2007 and January 2022. We evaluated the long-term outcome after CS for stage IV GC and the clinicopathological characteristics of the patients who underwent CS.

Median survival times (MSTs) in the chemotherapy alone and CS groups were 13.4 and 36.5 months, respectively (p < 0.0001). Of the 27 patients who underwent R0 resection, 22 remained free of early recurrence and five experienced VER. MSTs in the VER and free of early recurrence groups were 15.2 and 44.1 months, respectively (p < 0.0001). Significantly more patients had liver metastasis before initial treatment in the VER group than in the FER group (p = 0.016). There were more patients with preoperative PNI <40 in the VER group (p = 0.046).

CS is an effective treatment for stage IV GC, but VER is associated with poor prognosis. We need to carefully consider the indications for CS, especially for patients with poor nutritional status and liver metastases.

This study explored the potential association between the Prognostic Nutritional Index (PNI) and the incidence of non-alcoholic fatty liver disease (NAFLD) and advanced liver fibrosis (AF) in the adult population of the United States.

Information on 6409 participants ≥18 years old was downloaded from the U.S. National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. Multivariate analysis was combined with demographic factors to assess the relationships between PNI, NAFLD, and AF. A restricted cubic spline (RCS) was used to characterise the nonlinear association between the PNI and NAFLD and AF.

Patients without NAFLD had substantially lower mean values for parameters such as age, lymphocyte count, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), total cholesterol, triglycerides, HbA1c, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) than patients with NAFLD. Interestingly, non-NAFLD patients showed a pronounced increase in serum albumin levels compared to their NAFLD counterparts. In the subset without AF, there were discernibly lower measures of NLR, age, AST, ALT, γ-glutamyl transferase, triglycerides, neutrophil count, and body mass index (BMI) than in patients with AF. It was evident that those without AF had markedly elevated mean albumin and PNI levels in comparison to AF-affected individuals. In the comprehensive multivariable framework, a direct correlation was observed between PNI and NAFLD (adjusted odds ratio[aOR] = 1.07, 95% confidence interval [CI]: 1.05-1.09; p < 0.001), whereas PNI and AF were inversely correlated (aOR = 0.92; 95% CI: 0.88-0.96; p < 0.001). Within the RCS model, a swift ascendancy was noted in the relationship between the PNI and NAFLD, peaking at approximately 52. Conversely, a non-linear inverse association was observed between PNI and AF.

Our analytical results indicate that elevated PNI levels are positively associated with an increased risk of NAFLD, but inversely related to the risk of AF. For robust validation of these observations, further research is required.

With the advancements in cancer prevention and diagnosis, the proportion of newly diagnosed early-stage cervical cancers has increased. Adjuvant therapies based on high-risk postoperative histopathological factors significantly increase the morbidity of treatment complications and seriously affect patients' quality of life.

Our study aimed to establish a diagnostic nomogram for vaginal invasion (VI) among early-stage cervical cancer (CC) that can be used to reduce the occurrence of positive or close vaginal surgical margins.

We assembled the medical data of early-stage CC patients between January 2013 and December 2021 from the Fujian Cancer Hospital. Data on demographics, laboratory tests, MRI features, physical examination (PE), and pathological outcomes were collected. Univariate and multivariate logistic regression analyses were employed to estimate the diagnostic variables for VI in the training set. Finally, the statistically significant factors were used to construct an integrated nomogram.

In this retrospective study, 540 CC patients were randomly divided into training and validation cohorts according to a 7:3 ratio. Multivariate logistic analyses showed that age [odds ratio (OR) = 2.41, 95% confidence interval (CI), 1.29-4.50, P = 0.006], prognostic nutritional index (OR = 0.18, 95% CI, 0.04-0.77, P = 0.021), histological type (OR = 0.28, 95% CI, 0.08-0.94, P = 0.039), and VI based on PE (OR = 3.12, 95% CI, 1.52-6.45, P = 0.002) were independent diagnostic factors of VI. The diagnostic nomogram had a robust ability to predict VI in the training [area under the receiver operating characteristic curve (AUC) = 0.76, 95% CI: 0.70-0.82] and validation (AUC = 0.70, 95% CI: 0.58-0.83) cohorts, and the calibration curves, decision curve analysis, and confusion matrix showed good prediction power.

Our diagnostic nomograms could help gynaecologists quantify individual preoperative VI risk, thereby optimizing treatment options, and minimizing the incidence of multimodality treatment-related complications and the economic burden.

The aim of this study was to identify the predictive factors for adverse clinical events after surgery in patients with acute type A aortic dissection (AAAD), and to explore the predictive value of preoperative prognostic nutritional index (PNI) combined with D-dimer for these events.

This study was a retrospective analysis of clinical data of 153 patients with AAAD who underwent emergency surgery at our center from January 2019 to January 2022. Patients were divided into adverse event group and non-adverse event group based on whether they experienced adverse clinical events after surgery. Univariate and multivariable logistic regression analyses were performed to identify the risk factors for adverse events, and the predictive efficacy was evaluated by the area under the receiver operating characteristic curve (ROC-AUC).

A total of 153 AAAD patients were included in the study, and were divided into the adverse event group (n = 46) and the non-adverse events group (n = 107) based on whether or not they experienced clinical adverse events after surgery. The optimal cutoff value was determined using ROC curves, and multivariate logistic regression analysis was performed. Ultimately, it was found that preoperative PNI < 42.45 and D-dimer > 15.05 were independent predictors of postoperative clinical adverse events in AAAD patients. The odd ratios (OR) value for preoperative PNI < 42.45 is 3.596 [95% Confidence Interval (CI): 1.508-8.923, p = 0.004], while the OR value for D-dimer > 15.05 is 7.572 [95% CI: 3.094-20.220, p < 0.001]. The combination of these two indicators has a high predictive value (AUC = 0.843, 95% CI: 0.774-0.912, p < 0.001) and is superior to using either variable alone.

Preoperative PNI < 42.45 and D-dimer > 15.05 are independent predictive factors for postoperative adverse events during hospitalization in patients with AAAD. The combination of these two indicators can improve the predictive accuracy, which is superior to using either variable alone.

The adverse effects of chemotherapy are more apparent in elderly patients and lead to worse prognosis and mortality. Identifying immunonutritional risk factors is of great importance in terms of treatment effectiveness, prognosis, and mortality in geriatric oncology. The modified Glasgow prognostic score (mGPS) is an immunonutritional index based on serum CRP and albumin levels. In this study, we aimed to investigate the role of mGPS in predicting prognosis and survival in elderly patients with gastric cancer receiving perioperative FLOT treatment. We retrospectively enrolled 71 patients aged over 65 years and grouped them according to their pretreatment mGPS score. Kaplan-Meier and Cox regression analysis showed overall survival was significantly worse in the mGPS 1 and mGPS 2 groups than in the mGPS 0 group (p = 0.005 and p < 0.001, respectively). Compared to the mGPS 0 group, the mGPS 1 group had a 6.25 times greater risk of death (95% CI: 1.61-24.28, p = 0.008), and the mGPS 2 group had a 6.59 times greater risk of death (95% CI: 2.08-20.85, p = 0.001). High BMI was identified as a significant risk factor for being in the mGPS 2 group (OR: 1.20, 95% CI: 1.018-1.425, p = 0.030). In conclusion, elevated pretreatment mGPS was associated with poor overall survival in elderly patients with gastric cancer treated with perioperative FLOT therapy. As such, pretreatment mGPS can be a simple and useful tool to predict mortality in this specific patient group.

Previous reports have not reached consistent results regarding the prognostic significance of the controlling nutritional status (CONUT) score in biliary tract cancer (BTC). Therefore, the present meta-analysis was conducted to investigate the precise role of the CONUT score in predicting the prognosis of BTC.

Electronic platforms including Web of Science, PubMed, Cochrane Library, and Embase were comprehensively searched up to May 2, 2023. We also determined combined hazard ratios (HRs) and 95% confidence intervals (CIs) to estimate the role of the CONUT score in predicting the prognosis of patients with BTC.

Ten studies involving 1,441 patients were included in the present study. Nine studies treated patients with surgical resection, and one study used percutaneous transhepatic biliary stenting (PTBS) plus 125I seed intracavitary irradiation. Based on the combined data, a higher CONUT score significantly predicted dismal overall survival (OS) (HR = 1.94, 95%CI = 1.41-2.66, p < 0.001), inferior recurrence-free survival (RFS) (HR = 1.79, 95%CI = 1.48-2.17, p < 0.001) in BTC, and low differentiation (OR = 1.57, 95%CI = 1.15-2.14, p = 0.004). Nonetheless, the CONUT score was not related to sex, lymph node metastasis, microvascular invasion, perineural invasion, distant metastasis, TNM stage, or tumor number in patients with BTC.

Higher CONUT scores significantly predicted worse OS and RFS in patients with BTC. Moreover, BTC patients with high CONUT scores tended to have poor tumor differentiation. The CONUT score could help clinicians stratify high-risk patients with BTC and devise individualized treatment plans.

Immunotherapy offers survival benefits for patients with advanced gastric cancer, but not all populations can benefit from immunotherapy. Good nutritional status is fundamental to a patient's immune function and may have an impact on the efficacy of immunotherapy. The present study aimed to investigate changes in prognostic nutritional index (PNI), advanced lung cancer inflammation index (ALI) and albumin-globulin ratio (AGR) values before and after immunotherapy in patients with advanced gastric cancer. The study also aimed to determine the potential association of the aforementioned values with patient outcomes and prognosis. Body mass index (BMI), serum albumin, total protein, peripheral blood lymphocyte, neutrophil, carcinoembryonic antigen (CEA), carbohydrate antigen19-9 (CA19-9) and a-fetoprotein (AFP) data were collected from 195 patients with advanced gastric cancer who underwent immunotherapy from January 2020 to October 2021. In addition, PNI, ALI and AGR values were calculated based on variables in blood collected from the patients within 3 days prior to immunotherapy and 3 weeks after immunotherapy. The results demonstrated that low PNI was associated with elevated CEA levels. Moreover, low ALI levels were associated with reduced BMI levels, elevated AFP levels, PD-L1 negative and first-line treatment. Comparison of responding and non-responding groups revealed that patients who responded to immunotherapy had higher PNI and AGR values than patients who did not respond, both before and after treatment, but had lower CEA and CA19-9 levels after treatment. Furthermore, in the non-responding group, PNI and AGR values were decreased and CEA values were increased following treatment compared with those prior to treatment. The objective response and disease control rates were higher in the high PNI and AGR groups compared with the low PNI and AGR groups, respectively. Moreover, PNI and AGR were found to be independent predictors of the short-term efficacy of immunotherapy for advanced gastric cancer, with cut-off values of 47.18 and 1.29, respectively. Univariate analysis revealed that ALI was associated with the progression-free survival (PFS) of patients, while multivariate analysis demonstrated that baseline PNI and AGR were independent predictors of PFS. In conclusion, tumor progression leads to a decline in the nutritional level of patients, and the present study indicated that effective immunotherapy may alleviate this deterioration to a certain extent. Furthermore, PNI and AGR exhibit potential in predicting the efficacy of immunotherapy and the prognosis of patients with advanced gastric cancer, and may exhibit potential as biomarkers in clinical practice.

This study aimed to investigate and analyze the clinical application value of thoracoscopic segmentectomy and lobectomy in patients with invasive pulmonary adenocarcinoma.

286 patients with invasive pulmonary adenocarcinoma who underwent segmentectomy or lobectomy at the First Hospital of Jiaxing City from January 2018 to June 2020 were retrospectively analyzed. Patients were divided into a thoracoscopic segmentectomy group(n=97) and a lobectomy group (n=189). Patients were compared after obtaining 1:1 propensity score-matched cohorts. Outcome indicators included surgery-related indicators, immune-inflammation-related indicators, postoperative complications, recurrence, and metastasis.

After 1:1 propensity score matching, 93 patients were included in each group. We found that the volume of intraoperative blood loss in the segmentectomy group was significantly less than in the lobectomy group (P=0.014). The duration of postoperative drainage (P = 0.005) and hospitalization (P=0.002) in the segmentectomy group were significantly shorter than in the lobectomy group. In terms of immunoinflammatory response, compared with the lobectomy group, white blood cells, neutrophils, SII, and NLR in the segmentectomy group were significantly lower than in the lobectomy group (P< 0.05). The recurrence-free survival (RFS) rates in the segmentectomy and lobectomy were 80.5% and 88.2% at 1 year and 35.1% and 52.6% at 3 years, respectively, and the difference was statistically significant (P<0.05). The segmentectomy group achieved similar outcomes to the lobectomy group at 1 year and 3 years (P > 0.05). Multivariate COX regression analysis showed that CAR was an independent risk factor for RFS in patients undergoing invasive adenocarcinoma surgery.

Compared with lobectomy, thoracoscopic segmentectomy can effectively reduce the postoperative inflammatory response in patients with early invasive lung adenocarcinoma and promote patient recovery. Although segmentectomy is associated with a higher recurrence rate in the short term for patients with early invasive lung adenocarcinoma, the associated survival rate is similar to the lobectomy group. Segmentectomy should be considered in the treatment of early invasive lung adenocarcinoma. Meanwhile, postoperative CAR represents an independent risk factor for early postoperative recurrence in patients with IAC.

This study evaluated the value of PNI to predicting relapse-free survival (RFS) and overall survival (OS) in patients with resectable gastroesophageal junction adenocarcinoma (AGE).

Between 2016 and 2020, there were 236 resectable AGE patients underwent a retrospective review via propensity score matched (PSM) analysis. The PNI values were computed for each patient prior to surgery [PNI= 10×albumin (gr/dL) + 0.005×total lymphocyte count (mm3)]. By using disease progression and mortality as the end points, a receiver operating characteristic(ROC) curve was plotted to identify the PNI cut-off value. Kaplan-Meier curves and Cox proportional hazard models were used for survival analysis.

The ROC curve indicated that the ideal cutoff value was 45.60. After propensity score matching, there were 143 patients in our retrospective study, which included 58 patients in the low-PNI group and 85 patients in the high-PNI group. When compared to the low PNI group, the high PNI group substantially increased RFS and OS (p<0.001, p=0.003, respectively) according to the Kaplan-Meier analysis and Log rank test. Advanced pathological N stage (p=0.011) and poor PNI (p=0.004) were also significant risk factors for a shorter OS, according to a univariate analysis. Multivariate analysis revealed that the N0 plus N1 group had an endpoint mortality risk that was 0.39 times lower than the N2 plus N3 group's (p=0.008). In comparison to the high PNI group, the hazard of endpoint mortality was 2.442 times greater in the low PNI group (p = 0.003).

PNI is a simplistic and practical predictive predictor of the RFS and OS time in patients with resectable AGE.

Although the survival rate of patients who undergo surgery for gastric cancer has greatly improved, still many patients have a poor prognosis. This retrospective study aimed to investigate the predictive ability of the PNI-IgM score, a combined prognostic nutritional index (PNI), and immunoglobulin M (IgM), on the prognosis of patients undergoing surgery for gastric cancer.

340 patients with gastric cancer who underwent surgery from January 2016 to December 2017 were selected. The PNI-IgM score ranged from 1 to 3: score of 1, low PNI (< 48.45) and low IgM (< 0.87); score of 2, low PNI and high IgM, or high PNI and low IgM; score of 3, high PNI and high IgM. We compared the differences in disease-free survival (DFS) and overall survival (OS) among the three groups, while univariate and multivariate analyses calculated prognostic factors for DFS and OS. In addition, the nomograms were constructed based on the results of multivariate analysis to estimate the 1-, 3- and 5-year survival probability.

There were 67 cases in the PNI-IgM score 1 group, 160 cases in the PNI-IgM score 2 group, and 113 cases in the PNI-IgM score 3 group. The median survival times of DFS in the PNI-IgM score group 1, the PNI-IgM score group 2, and the PNI-IgM score group 3 were 62.20 months, not reached, and not reached, and 67.57 months vs. not reached vs. not reached in three groups for OS. Patients in the PNI-IgM score group 1 had a lower DFS than the PNI-IgM score group 2 (HR = 0.648, 95% CI: 0.418-1.006, P = 0.053) and the PNI-IgM score group 3 (HR = 0.337, 95% CI: 0.194-0.585, P < 0.001). In stratified analysis, PNI-IgM score 1 had a worse prognosis in the age < 60 years group and CA724 < 2.11 U/m group.

PNI-IgM score is a novel combination of nutritional and immunological markers that can be used as a sensitive biological marker for patients with gastric cancer who undergo surgery. The lower the PNI-IgM score, the worse the prognosis.

Cancer cachexia, a complex multifactorial syndrome associated with sarcopenia, negatively affects the quality of life and survival in patients with several cancers. We aimed to develop a new score for cachexia assessment and evaluate its effectiveness in the classification of patients undergoing radical resection for colorectal cancer.

This study included 396 patients who underwent radical resection for Stage I-III colorectal cancer. To develop the Cancer Cachexia Score (CCS), we analyzed predictive factors of cachexia status related to the development of sarcopenia and incorporated significant factors into the score. We then evaluated the relationship between CCS and survival after radical resection for colorectal cancer.

As body mass index (P < 0.001), prognostic nutritional index (P = 0.005), and tumor volume (P < 0.001) were significantly associated with the development of sarcopenia, these factors were included in CCS. Using CCS, 221 (56%), 98 (25%), and 77 (19%) patients were diagnosed with mild, moderate, and severe cancer cachexia, respectively. In multivariate analysis, severe CCS (P < 0.001), N stage 1-2 (P < 0.001), and occurrence of postoperative complications (P = 0.007) were independent predictors of disease-free survival. Age ≥ 65 years (P = 0.009), severe CCS (P < 0.001), and N stage 1-2 (P < 0.001) were independent predictors of overall survival.

CCS may be a useful prognostic factor for predicting poor survival after radical resection in patients with Stage I-III colorectal cancer.

Kawasaki disease (KD) is a febrile disease that affects children under 5 years of age and leads to serious cardiovascular complications such as coronary artery disease. The development of markers that can predict early is important to reduce the under- and misdiagnosis of KD. The aim of this research was to develop a diagnostic predictive model to differentiate Kawasaki disease (KD) from other febrile diseases using eosinophil-to-lymphocyte ratio (ELR) and other biomarkers. We recruited a total of 190 children with KD and 1604 children with other febrile diseases. We retrospectively collected clinical information from the children, which included laboratory data on the day of admission, such as white blood cells (WBC), hemoglobin (HGB), calcitoninogen (PCT), hypersensitive c-reactive protein (CRP), snake prognostic nutritional index (PNI), peripheral blood neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and ELR. We performed analyses using univariate analysis, multivariate logistic regression, and column line plots, and evaluated the diagnostic parameters of the predictive models. ELR was significantly increased in patients with KD. After multivariate logistic regression, WBC, HGB, CRP, NLR, ELR and PNI were finally included as indicators for constructing the prediction model. The ROC curve analysis suggested that the C-index of the diagnostic prediction model was 0.921. The calibration curve showed good diagnostic performance of the columnar graph model. The cut-off value of ELR alone for KD was 0.04, the area under the ROC curve was 0.809. Kids with KD show highly expressive level of ELR compared to children with febrile disease, which can be used to diagnose KD, and column line graphs constructed together with other indicators can help pediatricians to identify KD more effectively from febrile children.

It has been shown that peripheral blood inflammatory factor ratios correlate with the prognosis of various malignancies. Although indicative of prognosis in some tumors, its value for prognosis in breast cancer patients is unclear.

The clinical data of breast cancer patients diagnosed with breast cancer in the Second Hospital of Jilin University from January 1, 2013, to December 31, 2017, were retrospectively analyzed. The prognostic nutritional index (PNI) optimal cutoff values of the subjects' operating characteristic curves divided the patients into a low PNI group (≤51.05) and a high PNI group (>51.05). Correlations between breast cancer and PNI clinicopathological variables were determined by the χ² test or Fisher exact test. Kaplan-Meier plots and log-rank tests were used to assess clinical outcomes in terms of disease-free survival (DFS). The prognostic value of PNI was analyzed by univariate and multivariate Cox proportional risk regression models.

The best cutoff value for predicting DFS by pretreatment PNI was 51.05 and the Youden index when was 0.416, with a sensitivity of 71.4% and specificity of 70.2%. Univariate analysis showed that PNI ≤ 51.05, human epidermal growth factor receptor-2 (HER-2) positivity, and the number of lymph node metastases >4 were risk factors affecting DFS in invasive breast cancer (p < 0.05). Cox multifactor analysis showed that PNI and lymph node status were the most important factors affecting the prognosis of invasive breast cancer. Neutrophils-to-lymphocytes ratio and platelets-to-lymphocytes ratio were not significantly correlated with patient prognosis (p > 0.05).

Preoperative peripheral blood PNI in patients with invasive breast cancer are independent risk factors affecting patients' prognosis, they are positively correlated with prognosis and can be used as indicators to assess prognosis. PNI, HER-2, and lymph node status had the best predictive efficacy with the area under the curve = 0.816 (95% confidence interval: 0.680-0.951, p < 0.001).

The inflammation and nutrition status are crucial factors influencing the outcome of patients with gastric cancer. This study aims to investigate the prognostic value of the preoperative prognostic nutritional index (PNI) in patients with stage I-III gastric cancer undergoing robotic radical gastrectomy combined with Enhanced Recovery after Surgery (ERAS), and further to create a clinical prognosis prediction model.

525 patients with stage I-III gastric cancer who underwent ERAS combined with RRG from July 2010 to June 2018 were included in this work, and were divided randomly into training and validating groups in a 7-to-3 ratio. The association between PNI and overall survival (OS) was assessed by Kaplan-Meier analysis and the log-rank test. Independent risk factors impacting postoperative survival were analyzed with the Cox proportional hazards regression model. A nomogram for predicting OS was constructed based on multivariate analysis, and its predictive performance was evaluated using Harrell's concordance index (C-index), calibration plots, ROC curve, decision curve analysis (DCA), and time-dependent ROC curve analysis.

Survival analyses revealed the presence of a significant correlation between low preoperative PNI and shortened postoperative survival (P = 0.001). According to multivariate analysis, postoperative complications (P < 0.001), pTNM stage (II: P = 0.007; III: P < 0.001), PNI (P = 0.048) and lymph node ratio (LNR) (P = 0.003) were independent prognostic factors in patients undergoing ERAS combined with RRG. The nomogram constructed based on PNI, pTNM stage, complications, and LNR was superior to the pTNM stage model in terms of predictive performance. The C-indexes of the nomogram model were respectively 0.765 and 0.754 in the training and testing set, while AUC values for 1-year, 3-year, and 5-year OS were 0.68, 0.71, and 0.74 in the training set and 0.60, 0.67, and 0.72 in the validation set.

Preoperative PNI is an independent prognostic factor for patients with stage I-III gastric cancer undergoing ERAS combined with robotic radical gastrectomy. Based on PNI, we constructed a nomogram for predicting postoperative outcomes of gastric cancer patients, which might be utilized clinically.