Combined analysis of the preoperative and postoperative prognostic nutritional index offers a precise predictor of the prognosis of patients with gastric cancer

Purpose: The prognostic nutritional index (PNI) is considered useful for predicting the prognosis of patients with gastric cancer (GC). This retrospective study investigated the relationship between both the pre- and postoperative PNI and the prognosis of GC patients. Methods: The subjects of this study were 254 patients who underwent curative surgery for histopathologically diagnosed GC. Results: Patients were divided according to their pre- and postoperative PNI as follows: preoperative PNI of ≥ 52 (pre-PNI^High), preoperative PNI of < 52 (pre-PNI^Low), postoperative PNI of ≥ 49 (post-PNI^High), and postoperative PNI of < 49 (pre-PNI^Low). Both pre- and postoperative PNI were significantly associated with GC prognosis. Patients were then divided as follows: group A, patients with pre-PNI^High and post-PNI^High; group B, patients with either pre-PNI^High and post-PNI^Low or pre-PNI^Low and post-PNI^High; and group C, patients with pre-PNI^Low and post-PNI^Low. The 5-year survival rates were 100.0, 83.0, and 67.1% for groups A, B, and C, respectively. Multivariate analysis indicated that the combination of pre- and postoperative PNI was an independent prognostic indicator. Conclusions: Combined analysis of the pre- and postoperative PNI offers accurate information about the prognosis of patients with GC.