Prognostic significance of prognostic nutritional index (PNI) and body composition in advanced gastric cancer patients

Dai Yuhong; Luo Yan

doi:10.16689/j.cnki.cn11-9349/r.2026.02.010

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Electronic Journal of Metabolism and Nutrition of Cancer ›› 2026, Vol. 13 ›› Issue (2) : 243-250. DOI: 10.16689/j.cnki.cn11-9349/r.2026.02.010

Original Articles

Prognostic significance of prognostic nutritional index (PNI) and body composition in advanced gastric cancer patients

¹Dai Yuhong, ²Luo Yan

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Abstract

Object Based on post-hoc analysis of a prospective study, we analyzed the prognostic significance of inflammatory and nutritional markers in patients with advanced gastric cancer. Methods 76 patients with advanced gastric cancer were enrolled in the GAPSO study. Pretreatment lymphocyte count and serum albumin level were also recorded. Skeletal muscle mass at the third lumbar vertebral level was measured using computed tomography before and after two cycles of chemotherapy. Results X-tile was used to calculate the cut-off value of prognostic nutritional index (PNI) as 49.45, and the patients were divided into PNI-high and PNI-low groups. Compared with the PNI-low group, the progression-free survival (PFS, 12.4 vs 5.3 months, P<0.001) and overall survival (OS, 27.6 vs 11.7 months, P=0.008) of first-line chemotherapy in the PNI-high group were significantly longer. The skeletal muscle index (SMIs) values of males and females were 40.8 cm²/m² and 34.9 cm²/m², respectively, and the patients were divided into SMI-high and SMI-low groups, and there were no significant differences in PFS and OS between groups. Patients with a 3.56% decrease in SMI after two cycles of chemotherapy tended to have a shorter OS. Compared with PNI-low patients, PNI-high patients tended to have fewer adverse chemotherapy reactions and a significantly lower incidence of thrombocytopenia. Multivariate analysis showed that ECOG performance status and PNI were independent prognostic factors for OS. Conclusion PNI-high is a positive prognostic factor for long-term survival in patients with advanced gastric cancer and is associated with a lower incidence of adverse chemotherapy reactions. Patients with skeletal muscle loss after chemotherapy exhibited a trend toward worse outcomes.

Key words

Gastric cancer / Chemotherapy / Prognostic nutritional index / Skeletal muscle index / Adverse reactions / body composition / Progression-free survival / Overall survival

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Dai Yuhong, Luo Yan. Prognostic significance of prognostic nutritional index (PNI) and body composition in advanced gastric cancer patients[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(2): 243-250 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.02.010

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