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Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels: a propensity score matching analysis
BACKGROUND: An ideal tumor marker should be capable of being detected at any stage of the disease. However, gastric cancer patients do not always have elevated serum carcinoembryonic antigen (CEA) levels, even in advanced cases. Recently, several studies have investigated the associations between pr...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850976/ https://www.ncbi.nlm.nih.gov/pubmed/29534689 http://dx.doi.org/10.1186/s12885-018-4201-4 |
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author | Hirahara, Noriyuki Tajima, Yoshitsugu Fujii, Yusuke Kaji, Shunsuke Yamamoto, Tetsu Hyakudomi, Ryoji Taniura, Takahito Kawabata, Yasunari |
author_facet | Hirahara, Noriyuki Tajima, Yoshitsugu Fujii, Yusuke Kaji, Shunsuke Yamamoto, Tetsu Hyakudomi, Ryoji Taniura, Takahito Kawabata, Yasunari |
author_sort | Hirahara, Noriyuki |
collection | PubMed |
description | BACKGROUND: An ideal tumor marker should be capable of being detected at any stage of the disease. However, gastric cancer patients do not always have elevated serum carcinoembryonic antigen (CEA) levels, even in advanced cases. Recently, several studies have investigated the associations between preoperative PNI and postoperative long-term outcomes. In this study, we focused on the significance of the prognostic nutritional index (PNI) as a potential predictor of survival in resectable gastric cancer patients with normal preoperative serum CEA levels. METHODS: We retrospectively conducted cohort study to evaluate the PNI as a predictor of survival in 368 resectable gastric cancer patients who underwent potentially curative gastrectomy at our institute between January 2010 and December 2016. We selected 218 patients by propensity score matching to reduce biases due to the different distributions of co-variables among the comparable groups. RESULTS: In the multivariate analysis, pStage (hazard ratio [HR]: 14.003, 95% confidence interval [CI]: 5.033–44.487; p < 0.001), PNI (HR: 2.794, 95% CI: 1.352–6.039; p < 0.001) were identified as independent prognostic factors of CSS in 218 propensity matched gastric cancer patients. The Kaplan-Meier analysis demonstrated that low PNI patients had a significantly poorer cancer specific survival (CSS) than high PNI patients (p = 0.008). Among 166 propensity matched gastric cancer patients with normal preoperative serum CEA levels, multivariate analysis demonstrated that pStage (HR: 7.803, 95% CI: 3.015–24.041; p < 0.001) and PNI (HR: 3.078, 95% CI: 1.232–8.707; p = 0.016) were identified as independent prognostic factors of CSS. And Kaplan-Meier analysis demonstrated that low PNI had a significantly poorer CSS than high PNI value (p = 0.011). CONCLUSIONS: This study demonstrates that a low preoperative PNI value is a potential independent risk factor for poorer CSS in patients with gastric cancer, even in those with normal serum CEA levels. |
format | Online Article Text |
id | pubmed-5850976 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-58509762018-03-21 Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels: a propensity score matching analysis Hirahara, Noriyuki Tajima, Yoshitsugu Fujii, Yusuke Kaji, Shunsuke Yamamoto, Tetsu Hyakudomi, Ryoji Taniura, Takahito Kawabata, Yasunari BMC Cancer Research Article BACKGROUND: An ideal tumor marker should be capable of being detected at any stage of the disease. However, gastric cancer patients do not always have elevated serum carcinoembryonic antigen (CEA) levels, even in advanced cases. Recently, several studies have investigated the associations between preoperative PNI and postoperative long-term outcomes. In this study, we focused on the significance of the prognostic nutritional index (PNI) as a potential predictor of survival in resectable gastric cancer patients with normal preoperative serum CEA levels. METHODS: We retrospectively conducted cohort study to evaluate the PNI as a predictor of survival in 368 resectable gastric cancer patients who underwent potentially curative gastrectomy at our institute between January 2010 and December 2016. We selected 218 patients by propensity score matching to reduce biases due to the different distributions of co-variables among the comparable groups. RESULTS: In the multivariate analysis, pStage (hazard ratio [HR]: 14.003, 95% confidence interval [CI]: 5.033–44.487; p < 0.001), PNI (HR: 2.794, 95% CI: 1.352–6.039; p < 0.001) were identified as independent prognostic factors of CSS in 218 propensity matched gastric cancer patients. The Kaplan-Meier analysis demonstrated that low PNI patients had a significantly poorer cancer specific survival (CSS) than high PNI patients (p = 0.008). Among 166 propensity matched gastric cancer patients with normal preoperative serum CEA levels, multivariate analysis demonstrated that pStage (HR: 7.803, 95% CI: 3.015–24.041; p < 0.001) and PNI (HR: 3.078, 95% CI: 1.232–8.707; p = 0.016) were identified as independent prognostic factors of CSS. And Kaplan-Meier analysis demonstrated that low PNI had a significantly poorer CSS than high PNI value (p = 0.011). CONCLUSIONS: This study demonstrates that a low preoperative PNI value is a potential independent risk factor for poorer CSS in patients with gastric cancer, even in those with normal serum CEA levels. BioMed Central 2018-03-13 /pmc/articles/PMC5850976/ /pubmed/29534689 http://dx.doi.org/10.1186/s12885-018-4201-4 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Hirahara, Noriyuki Tajima, Yoshitsugu Fujii, Yusuke Kaji, Shunsuke Yamamoto, Tetsu Hyakudomi, Ryoji Taniura, Takahito Kawabata, Yasunari Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels: a propensity score matching analysis |
title | Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels: a propensity score matching analysis |
title_full | Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels: a propensity score matching analysis |
title_fullStr | Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels: a propensity score matching analysis |
title_full_unstemmed | Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels: a propensity score matching analysis |
title_short | Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels: a propensity score matching analysis |
title_sort | prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels: a propensity score matching analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850976/ https://www.ncbi.nlm.nih.gov/pubmed/29534689 http://dx.doi.org/10.1186/s12885-018-4201-4 |
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