Research Information System
Healthcare (Switzerland), vol.13, no.23, 2025 (SCI-Expanded, SSCI, Scopus)
Highlights: What are the main findings? Nutritional optimization before surgery might improve outcomes. More careful selection or tailoring of adjuvant therapy may be needed, possibly supported by enhanced supportive care. What are the implications of the main findings? Enhanced postoperative monitoring and follow-up may help detect complications early or manage recurrence risk more promptly. Discussions with patients about prognosis and treatment trade-offs could incorporate PNI as part of personalized risk communication. Background: The Prognostic Nutritional Index (PNI), calculated from serum albumin and lymphocyte count, indicates nutritional and immunological status. Its prognostic significance in colorectal cancer (CRC) is still being assessed. Methods: This retrospective study examined 489 patients who received curative resection for colorectal cancer (CRC). According to ROC analysis, patients were split into two groups: those with low PNI (<47.5) and those with high PNI (≥47.5). We compared the clinicopathological features, postoperative outcomes, and survival rates. Kaplan–Meier and Cox regression models were used to look at overall survival (OS) and disease-free survival (DFS). Results: A low PNI was strongly related to older age, having a lower BMI, hemoglobin, albumin, and lymphocyte levels (all p < 0.001). The low-PNI group had a higher early hospital mortality (4% vs. 1%, p = 0.031). Patients with low PNI had a significantly lower five-year OS and DFS (both p < 0.001). In multivariate analysis, low PNI independently predicted poor OS (HR = 0.640, p = 0.016) and DFS (HR = 0.570, p = 0.037), in addition to pathological stage, age, and perineural invasion. Conclusions: Preoperative PNI serves as an independent prognostic marker for survival in CRC. A low PNI demonstrates that a patient has low nutritional and immune reserves, which means they are more likely to have worse early and long-term outcomes. Including PNI in preoperative evaluation may help with personalized treatment plans.