The effect of preoperative cholesterol-modified prognostic nutritional index on postoperative long-term prognosis of borderline resectable pancreatic cancer
Objective To investigate the effect of cholesterol-modified prognostic nutritional index(cPNI)on postoperative long-term prognosis of the borderline resectable pancreatic cancer(BRPC).Methods Clinical data of 173 patients with BRPC admitted to the Department of Hepatobiliary and Pancre-aticosplenic Surgery,Beijing Chaoyang Hospital,Capital Medical University from January 2011 to September 2023 were retrospectively analyzed,including 90 males and 83 females,aged(61.7±9.8)years.The re-ceiver operating curve(ROC)of preoperative cPNI predicting 1-year postoperative survival was drawn and the optimal cut-off value in predicting 1-year survival was 77.36.Patients were divided into low cPNI(n=83,cPNI ≤77.36)and high cPNI group(n=90,cPNI＞77.36).Kaplan-Meier method was used for sur-vival analysis,log-rank test was used for univariate analysis,and Cox proportion hazard model was used for multivariate analysis to reveal the effect of cPNI on postoperative long-term survival in patients with BRPC.Results The cumulative survival rates at 1,2 and 3 years after surgery in low cPNI group and high cPNI group were 70.6％,40.3％,21.8％,and 48.3％,21.5％,9.5％,respectively(x2=8.49,P=0.004).Univariate analysis showed that preoperative cPNI,length of portal vein invasion,tumor differentia-tion degree,tumor TNM stage,tumor diameter,lymph node metastasis,and postoperative chemotherapy were correlated with long-term survival of BRPC patients(all P＜0.05).Multivariate analysis showed that BRPC patients with preoperative cPNI＞77.36(HR=1.452,95％CI:1.026-2.053,P=0.035)had a increased risk of postoperative death,while patients with length of portal venous invasion＞3.0 cm,poorer tumor differentiation,lymph node metastasis and no postoperative chemotherapy had an increased risk of postoperative death.Conclusion Preoperative cPNI＞77.36 is a risk factor for long-term survival in BRPC patients.
Nutrition assessmentPrognosisRisk factorsBorderline resectable pancreatic cancer
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