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Risk Stratification According to the Prognostic Nutritional Index for Predicting Postoperative Complications After Lung Cancer Surgery

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The prognostic nutritional index (PNI), an immune nutritional marker based on serum albumin levels and total lymphocyte count, predicts postoperative complications in various types of malignancies. However, the clinical significance of the PNI for postoperative complications following lung cancer surgery is uncertain.

Methods

Patients with resected non-small cell lung cancer (n = 515) were retrospectively analyzed and the relationship between the preoperative PNI and postoperative complications was evaluated.

Results

Multivariate logistic regression analysis revealed that a preoperative low PNI was a significant independent predictor of postoperative complications of Clavien–Dindo Grade ≥ II (odds ratio: 1.06 per unit decrease, 95.0% confidence interval 1.01–1.11). Patients were divided into three groups according to the preoperative PNI: normal (≥ 50; n = 324), mildly low (< 50, ≥ 45; n = 134), and severely low (< 45; n = 57). The incidence of postoperative complications of Grade ≥ II and Grade ≥ III in the normal, mildly low, and severely low PNI groups was 22.2, 39.6, and 42.1% and 7.1, 16.4, and 22.8%, respectively. The incidence of postoperative complications of Grade ≥ II and Grade ≥ III was significantly higher in the mildly low and severely low PNI groups than in the normal PNI group (p < 0.001 and p < 0.001, respectively). The incidence of air leak, pneumonia, and extrapulmonary infection, but not arrhythmia, was significantly higher in the mildly low and severely low PNI groups than in the normal PNI group.

Conclusions

The PNI could be a useful marker to predict the risk of postoperative complications after lung cancer surgery.

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Acknowledgements

The authors thank Editage (www.editage.jp) for English language editing.

Funding

None.

Disclosures

The authors declare that there are no conflicts of interest to disclose.

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Authors and Affiliations

  1. Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Satoru Okada MD, Junichi Shimada MD, PhD, Daishiro Kato MD, PhD, Hiroaki Tsunezuka MD, PhD, Naoko Miyata MD, Shunta Ishihara MD, Tatsuo Furuya MD, Chiaki Nakazono MD, Narumi Ishikawa MD & Masayoshi Inoue MD, PhD

  2. Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Satoshi Teramukai PhD

Authors
  1. Satoru Okada MD
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  2. Junichi Shimada MD, PhD
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  3. Satoshi Teramukai PhD
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  4. Daishiro Kato MD, PhD
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  5. Hiroaki Tsunezuka MD, PhD
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  11. Masayoshi Inoue MD, PhD
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Correspondence to Masayoshi Inoue MD, PhD.

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Okada, S., Shimada, J., Teramukai, S. et al. Risk Stratification According to the Prognostic Nutritional Index for Predicting Postoperative Complications After Lung Cancer Surgery. Ann Surg Oncol 25, 1254–1261 (2018). https://doi.org/10.1245/s10434-018-6368-y

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  • DOI: https://doi.org/10.1245/s10434-018-6368-y

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