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20.05.2016 | Gastrointestinal Oncology | Ausgabe 11/2016

Annals of Surgical Oncology 11/2016

Low Preoperative Prognostic Nutritional Index Predicts Poor Survival Post-gastrectomy in Elderly Patients with Gastric Cancer

Annals of Surgical Oncology > Ausgabe 11/2016
MD, PhD Katsunobu Sakurai, MD, PhD Tatsuro Tamura, MD, PhD Takahiro Toyokawa, MD, PhD Ryosuke Amano, MD, PhD Naoshi Kubo, MD, PhD Hiroaki Tanaka, MD, PhD Kazuya Muguruma, MD, PhD Masakazu Yashiro, MD, PhD Kiyoshi Maeda, MD, PhD Masaichi Ohira, MD, PhD Kosei Hirakawa
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1245/​s10434-016-5272-6) contains supplementary material, which is available to authorized users.



Preoperative nutritional status may predict short- and long-term outcomes of patients with cancer.


The aim of this study was to clarify the impact of preoperative nutritional status on outcomes of elderly patients who have undergone gastrectomy for gastric cancer (GC).


A review examining 147 patients treated for GC by gastrectomy at our institution between January 2004 and December 2011 was conducted. Onodera’s prognostic nutritional index (PNI) was invoked, using an optimal cutpoint to stratify patients by high (PNI > 43.8; n = 84) or low (PNI ≤ 43.8; n = 63) nutritional status. Clinicopathologic features and short- and long-term outcomes, including the cause of death, were compared.


In multivariate analysis, low PNI was identified as an independent correlate of poor 5-year overall survival (OS). In subgroup analysis, 5-year OS rates for patients with stage 1 GC were significantly worse in the low PNI (vs. high PNI) patient subset, which also posed a significantly higher risk of death from other disease; however, 5-year cancer-specific survival and PNI were unrelated. Deaths from recurrence in both groups were statistically similar, and morbidity rates did not differ significantly by group.


PNI is useful in predicting long-term outcomes of elderly patients surgically treated for GC, helping to identify those at high risk of death from other disease. In an effort to improve patient outcomes, nutritional status and oncologic staging merit attention.

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Cancer-specific survival curve. Supplementary material 1 (PDF 78 kb)
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