Erschienen in:
24.01.2019 | Original Article
Impact of the preoperative prognostic nutritional index on postoperative and survival outcomes in colorectal cancer patients who underwent primary tumor resection: a systematic review and meta-analysis
verfasst von:
Guangwei Sun, Yalun Li, Yangjie Peng, Dapeng Lu, Fuqiang Zhang, Xueyang Cui, Qingyue Zhang, Zhuang Li
Erschienen in:
International Journal of Colorectal Disease
|
Ausgabe 4/2019
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Abstract
Purpose
We aimed to explore whether the preoperative prognostic nutritional index (PNI) could be an indicator of prognostic outcomes in colorectal cancer (CRC) patients.
Methods
A systematic review and meta-analysis was conducted using the PubMed, Embase, and Web of Science databases. All original comparative studies published in English that were related to a high PNI versus a low PNI in CRC patients were included.
Results
A total of 10 studies involving 6372 patients were included in our meta-analysis. Our overall analysis indicated that the low-PNI group had a significantly reduced overall survival (OS) (HR = 1.87, 95% CI = 1.45–2.42, P < 0.01), cancer-specific survival (HR = 1.53, 95% CI = 1.07–2.19, P = 0.02), and disease-free survival (HR = 1.67, 95% CI = 1.23–2.26, P < 0.01) compared with the high-PNI group. Furthermore, our subgroup results indicated that a high PNI could be a significant indicator of improved OS in TNM stage II (HR = 1.93, 95% CI = 1.29–2.90, P < 0.01) and III (HR = 1.71, 95% CI = 1.25–2.34, P < 0.01), and a similar trend in TNM stage I or IV could also be observed though without statistical significance. Regarding postoperative complications, our pooled results indicated that the low-PNI group had a significantly increased incidence of total and severe postoperative complications.
Conclusions
Our findings indicated that CRC patients with a preoperative high PNI had a significantly improved OS. However, almost only Asian CRC patients were included based on current issue.