Clinical Research Papers:

Prognostic significance of preoperative prognostic nutritional index in colorectal cancer: results from a retrospective cohort study and a meta-analysis

Yuchong Yang, Peng Gao, Xiaowan Chen, Yongxi Song, Jinxin Shi, Junhua Zhao, Jingxu Sun, Yingying Xu and Zhenning Wang _

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Oncotarget. 2016; 7:58543-58552. https://doi.org/10.18632/oncotarget.10148

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Yuchong Yang1,*, Peng Gao1,*, Xiaowan Chen1, Yongxi Song1, Jinxin Shi1, Junhua Zhao1, Jingxu Sun1, Yingying Xu2 and Zhenning Wang1

1 Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, Shenyang City, PR China

2 Department of Breast Surgery, First Hospital of China Medical University, Shenyang City, PR China

* These authors have contributed equally to this work

Correspondence to:

Zhenning Wang, email:

Keywords: colorectal cancer, meta-analysis, prognostic nutritional index, prognosis, TNM staging

Received: April 29, 2016 Accepted: June 07, 2016 Published: June 17, 2016


The preoperative prognostic nutritional index (PNI) may forecast colorectal cancer (CRC) outcomes, but the evidence is not conclusive. Here, we retrospectively analyzed a cohort of patients from the Department of Surgical Oncology at the First Hospital of China Medical University (CMU-SO). We also conducted a meta-analysis of eleven cohort studies. Bayesian Information Criterion (BIC) was used to determine the optimal PNI cut-off values for classifying prognosis in the patients from the CMU-SO. The result from CMU-SO and meta-analysis both confirmed that low PNI was significantly associated with a poor prognosis and advanced TNM stages. Among the patients from the CMU-SO, the optimal cut-off values were “41-45-58” (PNI < 41, 41 ≤ PNI < 45, 45 ≤ PNI < 58, PNI ≥ 58), which divided patients into 4 stages. The BIC value for TNM staging combined with the PNI was smaller than that of TNM staging alone (–325.76 vs. –310.80). In conclusion, low PNI was predictive of a poor prognosis and was associated with clinicopathological features in patients with CRC, and the 41-45-58 four-stage division may be suitable for determining prognosis. PNI may thus provide an additional index for use along with the current TNM staging system to determine more accurate CRC prognoses.

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