CLINICAL NUTRITION, vol.63, no.1057, pp.979-1311, 2024 (SCI-Expanded)
Rationale: Recognizing immunonutritional risk factors holds significant
importance in enhancing treatment efficacy and reducing mortality rates
especially in geriatric cancer patients. We aimed to compare the utility of
pretreatment immunonutritional indexes for predicting mortality in
elderly patients with gastric cancer treated with perioperative FLOT.
Methods: We conducted a retrospective enrollment (January 2013 - July
2023) of 69 locally advanced gastric cancer patients aged over 65 years
who were treated with perioperative FLOT regimen. We compared the
prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI),
platelet/lymphocyte ratio, lymphocyte/monocyte ratio, neutrophil/
lymphocyte ratio, platelet/hemoglobin ratio, CRP/albumin ratio, ferritin/
lymphocyte ratio (FLR), and ferritin/albumin ratio (FAR) for predicting
postoperative mortality in these patients.
Results: We determined that pretreatment PNI values were statistically
significantly lower in patients who died during their follow-up (33.9±6.41
vs. 36.7±4.04; p¼0.036). Multivariable analysis identified only PNI as being
associated with overall survival (HR, 0.884; 95% confidence interval,
0.782e0.999; p ¼ 0.048). The Cox regression model revealed that each
one-unit increase (1%) in PNI caused an approximately 13% reduction in
the risk of mortality.
Conclusion: In conclusion, our results suggest that the PNI is a good
pretreatment predictor of overall survival for elderly patients with gastric
cancer treated with neoadjuvant FLOT