Preoperative Prognostic Nutritional Index Is a Prognostic Indicator of Cancer-Specific Survival in Patients Undergoing Endometrial Cancer Surgery

Q: What does the prognostic nutritional index (PNI) represent in this study?

PNI reflects systemic inflammation and nutritional status. It is calculated from serum albumin and total lymphocyte count measured before surgery.

Q: How was the relationship between preoperative PNI and survival evaluated?

Patients were grouped into high vs low PNI based on a cutoff value. Survival outcomes were analyzed in unadjusted data and after stabilized inverse probability of treatment weighting (IPTW), followed by multivariate Cox regression.

Q: What were the key findings regarding cancer-specific survival?

Postoperative cancer-specific survival was higher in the high PNI group than the low PNI group in both unadjusted and IPTW-adjusted cohorts. In the IPTW-adjusted multivariate Cox model, high preoperative PNI independently predicted lower cancer-specific mortality.

Sep 24, 2026

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The prognostic nutritional index (PNI) captures systemic inflammation and nutritional status and may influence cancer outcomes. A retrospective cohort study assessed whether preoperative PNI predicts postoperative cancer-specific survival in 894 endometrial cancer patients undergoing surgical resection. PNI was derived from serum albumin and total lymphocyte counts within 1 month preoperatively. High vs low PNI groups showed higher cancer-specific survival in unadjusted and IPTW-adjusted analyses, with high PNI remaining independently associated with lower postoperative cancer-specific mortality.

LanguageEnglish

CategoryHealthcare

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Pages12

Reading Time30 min

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Abstract

Background

Methods

Results

Conclusion

Introduction

J Korean Med Sci. 2023 May 29;38(21):e163 [https://doi.org/10.3346/jkms.2023.38.e163](https://doi.org/10.3346/jkms.2023.38.e163)[ ](https://doi.org/10.3346/jkms.2023.38.e163)eISSN 1598-6357·pISSN 1011-8934 Original Article Obstetrics & Gynecology Received: Dec 14, 2022 Accepted: Feb 16, 2023 Published online: Apr 28, 2023 Address for Correspondence: Sanghon Park, MD, PhD Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173-beon-gil, Bundanggu, Seongnam 13620, Republic of Korea. Email: [psh1399@snubh.org](psh1399@snubh.org) © 2023 The Korean Academy of Medical Sciences. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://](https://)[ ](https://)[creativecommons.org/licenses/by-nc/4.0/](creativecommons.org/licenses/by-nc/4.0/)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ORCID iDs Yoon Jung Kim [https://orcid.org/0000-0003-4320-2502](https://orcid.org/0000-0003-4320-2502)[ ](https://orcid.org/0000-0003-4320-2502)[Hee-Pyoung Park](Hee-Pyoung Park) [https://orcid.org/0000-0002-4772-0780](https://orcid.org/0000-0002-4772-0780)[ ](https://orcid.org/0000-0002-4772-0780)Hee Seung Kim [https://orcid.org/0000-0001-6876-8671](https://orcid.org/0000-0001-6876-8671)[ ](https://orcid.org/0000-0001-6876-8671)Sanghon Park [https://orcid.org/0000-0002-4579-9042](https://orcid.org/0000-0002-4579-9042) Preoperative Prognostic Nutritional Index Is a Prognostic Indicator of Cancer-Specific Survival in Patients Undergoing Endometrial Cancer Surgery Yoon Jung Kim ,1 Hee-Pyoung Park ,1 Hee Seung Kim ,2 and Sanghon Park 3 1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea 2Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea 3Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea ABSTRACT Background: The prognostic nutritional index (PNI) reflects systemic inflammation and nutritional status. This study aimed to evaluate the effect of preoperative PNI on postoperative cancer-specific survival in patients with endometrial cancer (EC) . Methods: Demographic, laboratory, and clinical data were retrospectively collected from 894 patients who underwent surgical resection of EC. Preoperative PNIs were determined from the serum albumin concentration and total lymphocyte count, which were measured within 1 month before surgery. Patients were classified into high PNI (n = 619) and low PNI (n = 275) groups according to the preoperative PNI cut-offvalue of 50.6. The stabilized inverse probability of treatment weighting (IPTW) method was used to reduce bias: a weighting cohort divided into high PNI (n = 615.4) and low PNI (n = 272.3) groups. The primary outcome measure was postoperative cancer-specific survival. Results: The postoperative cancer-specific survival rate was higher in the high PNI group than the low PNI group in the unadjusted cohort (93.1% vs. 81.5%; proportion difference [95% confidence interval; 95% CI], 11.6%[6.6–16.6%]; P < 0.001) and in the IPTW-adjusted cohort (91.4% vs. 86.0%; 5.4%[0.8–10.2%]; P = 0.021). In the multivariate Cox proportional hazard regression model in the IPTW-adjusted cohort, high preoperative PNI (hazard ratio [95% CI], 0.60 [0.38–0.96]; P = 0.032) was an independent determinant of postoperative cancer-specific mortality. The multivariate-adjusted restricted cubic spline curve for the Cox regression model showed a significant negative association between preoperative PNI and postoperative cancer-specific mortality (P < 0.001) . Conclusion: High preoperative PNI was associated with improved postoperative cancerspecific surviva

FAQs

What does the prognostic nutritional index (PNI) represent in this study?

PNI reflects systemic inflammation and nutritional status. It is calculated from serum albumin and total lymphocyte count measured before surgery.

How was the relationship between preoperative PNI and survival evaluated?

Patients were grouped into high vs low PNI based on a cutoff value. Survival outcomes were analyzed in unadjusted data and after stabilized inverse probability of treatment weighting (IPTW), followed by multivariate Cox regression.

What were the key findings regarding cancer-specific survival?

Postoperative cancer-specific survival was higher in the high PNI group than the low PNI group in both unadjusted and IPTW-adjusted cohorts. In the IPTW-adjusted multivariate Cox model, high preoperative PNI independently predicted lower cancer-specific mortality.

Sep 24, 2026

Uploaded by Valentina