Assessing the role of prognostic nutritional index in predicting outcomes for rectal cancer surgery.

Autor:	Silva ACR; Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária 'Zeferino Vaz', 13083-887, Campinas, SP, Brazil., Antunes-Correa LM; Universidade Estadual de Campinas (UNICAMP), Escola de Educação Física, Érico Veríssimo Avenue, 701 - Barão Geraldo, 13083-851, Campinas, SP, Brazil., Juliani FL; Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária 'Zeferino Vaz', 13083-887, Campinas, SP, Brazil., Carrilho LAO; Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária 'Zeferino Vaz', 13083-887, Campinas, SP, Brazil., Costa FO; Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária 'Zeferino Vaz', 13083-887, Campinas, SP, Brazil., Martinez CAR; Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária 'Zeferino Vaz', 13083-887, Campinas, SP, Brazil., Mendes MCS; Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária 'Zeferino Vaz', 13083-887, Campinas, SP, Brazil., Carvalheira JBC; Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária 'Zeferino Vaz', 13083-887, Campinas, SP, Brazil. Electronic address: jbcc@unicamp.br.
Jazyk:	angličtina
Zdroj:	Clinical nutrition ESPEN [Clin Nutr ESPEN] 2024 Oct; Vol. 63, pp. 644-650. Date of Electronic Publication: 2024 Jul 31.
DOI:	10.1016/j.clnesp.2024.07.1058
Abstrakt:	Background & Aims: The association of Prognostic Nutritional Index (PNI) with prognosis has been established for various cancer types, including rectal cancer. However, the precise relationship between PNI and body composition characteristics in patients with non-metastatic rectal cancer remain unclear. This study aimed to investigate the impact of PNI on overall survival and disease-free survival in non-metastatic rectal cancer patients undergoing total surgical resection. Additionally, it sought to assess the inflammatory status and body composition in patients across different PNI levels. Methods: Patients with non-metastatic rectal cancer who underwent total surgical resection, were consecutively enrolled. PNI was calculated using the formula: PNI = (10 × serum albumin [g/dl]) + (0.005 × lymphocytes/μL). Body composition was assessed using CT-derived measurements and laboratory tests performed at diagnosis were used to calculate inflammatory indices. Univariate and multivariate logistic regression analyses as well as Kaplan-Meier curves were used to determine prognostic values. Results: A total of 298 patients were included. Patients with low PNI demonstrated significantly reduced overall survival and disease-free survival compared to those with high PNI (Hazard ratio [HR] 1.85; Confidence interval [CI] 1.30-2 0.62; p = 0.001). Moreover, patients with low PNI exhibited heightened systemic inflammatory status and reduced skeletal muscle index, increased muscle radiodensity, as well as a decrease in subcutaneous adipose tissue area, subcutaneous fat index, and low attenuation of both subcutaneous and visceral adipose tissue. Conclusion: The PNI, assessed prior to treatment initiation, serves as a prognostic biomarker for non-metastatic rectal cancer patients undergoing total surgical resection and is linked with both inflammation and alterations in body composition. Competing Interests: Declaration of competing interest The authors declare no conflict of interest. (Copyright © 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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