A Novel Prognostic Score, Based on Preoperative Nutritional Status, Predicts Outcomes of Patients after Curative Resection for Gastric Cancer
PURPOSE: We aimed to determine whether preoperative nutritional status (PNS) was a valuable predictor of outcome in patients with gastric cancer (GC) METHODS: We retrospectively evaluated 1320 patients with GC undergoing curative resection. The PNS score was constructed based on four objective and easily measurable criteria: prognostic nutritional index (PNI) score 1, serum albumin <35 g/L, body mass index (BMI) <18.5 kg/m2, or preoperative weight loss =5% of body weight. The PNS score was 2 for patients who met three or four criteria, 1 for those who met one or two criteria, and 0 for those who didn't meet all of these criteria. RESULTS: The overall survival (OS) rates in patients with PNS scores 0, 1, and 2 were 59.1% 42.4% and 23.4% respectively (P 0.001) Multivariate analyses revealed the PNS was an independent predictor for OS (HR for PNS 1 and PNS 2: 1.497, 95 CI: 1.230 1.820 and 2.434, 95 CI: 1.773 3.340, respectively; p 0.001) Furthermore, 5 year OS ranged from 92% (stage I) to 37% (stage III) while the combination of TNM and PNS stratified 5 year OS from 95% (TNM I, PNS 0) to 19% (TNM III, PNS 3) Of note, the prognostic significance of PNS was still maintained when stratified by TNM stage, age, sex, tumor size, anemia and adjuvant chemotherapy (All P 0.05) CONCLUSIONS: The PNS, a novel nutritional based prognostic score, is independently associated with OS in GC. Prospective studies are needed to validate its clinical utility.
Journal of Cancer