123P - The clinical value of prognostic nutritional index in esophagogastric junctional adenocarcinoma patients with anastomotic leakage after surgery

Background

To study the relationship between prognostic nutritional index (PNI) and clinicopathological factors in gastroesophageal junction cancer patients with postoperative anastomotic leakage and the clinical significance of PNI in predicting the survival of patients with postoperative anastomotic leakage.

Methods

Clinicopathological and follow-up data of 115 gastroesophageal junction cancer patients with anastomotic leakage after radical surgery in the Department of Thoracic Surgery, the 4th Hospital of Hebei Medical University from January 1 2004 to December 31 2013 were retrospectively analyzed. PNI values were calculated [PNI = absolute lymphocyte count (10⁹/L) x 5 + serum albumin (g/L)], and was grouped according to the PNI mean value. Relationships of PNI with patient gender, age, tumor stage, tumor differentiation, tumor location, lymph node metastasis were analyzed. For survival analysis, log-rank method was used for univariate analysis, and Cox method was used for multivariate analysis.

Results

The mean PNI of patients with anastomotic leakage was 48.51 (43.25∼56.25). The 5-year survival rate of patients with PNI ≤48.51 was 58.9%, and the 5-year survival rate for patients with PNI>48.51 was 59.3%. There was no significant difference between the two groups (χ2=0.127, P=0.722). Univariate and multivariate analysis showed that N stage is an independent risk factor for the prognosis of patients with PNI≤48.51. Postoperative adjuvant treatment is an independent risk factor for the survival of patients with PNI>48.51. P for interaction between PNI and treatment modality: P=0.037.

Conclusions

The independent prognostic factors of patients with esophagogastric junction adenocarcinoma combined with anastomotic leakage are N stage and adjuvant treatment for PNI≤48.51 and PNI>48.51 group, respectively. For patients with esophagogastric junction adenocarcinoma combined with anastomotic leakage, PNI is an important factor for guiding the selection of appropriate postoperative treatment.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The Fourth Hospital of Hebei Medical University.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.