Prognostic nutritional index in predicting survival of patients with gastric or gastroesophageal junction adenocarcinoma: A systematic review

Table 5 Prognostic nutritional index cut-off value calculation method, threshold value and range, follow-up, and survival of the patients

Ref.	PNI calculation	PNI cut-off value and groups	PNI range	Follow up (months)	Outcome
Hashimoto et al[21]	ROC curve analysis	44.2. PNI > 44.2 (n = 72), PNI < 44.2 (n = 37)	NS	23.9 (0.4-81.9)	The 30-d, 180-d, 1-yr, and 3-yr cumulative OS rates were 100%, 97.0%, 91.6%, and 74.7%, respectively
Hirahara et al[31]	ROC curve analysis	44.3. PNI < 44.3 (n = 109), PNI > 44.3, n = 109	NS	Observation period from date of surgery till day of death	5-yr OS: Low PNI, 50.9%; high PNI, 73.6% (P < 0.001). In elderly patients (age > 70) 5-yr OS: Low PNI 52.5%, high PNI 82.5%. Non elderly patients (age < 70), 5-yr OS: Low PNI 46.6%, high PNI 54.7%
Hirahara et al[22]	ROC curve analysis	44.5. PNI < 44.5 n = 114, PNI > 44.5, n = 254	NS	NS	NS
Ishiguro et al[23]	Set according to previous reports	47. PNI < 47 (n = 75), PNI > 47 (n = 183)	NS	NS	5-yr OS: A: 44.7%; B: 77.2% (P < 0.001)
Kudou et al[12]	ROC curve analysis	44.7. PNI < 44.7 (n = 167, 81.1%), PNI > 44.7 (n = 39, 18.9%)	NS	60	Worse 5-year OS rates were associated with PNI < 44.7 (vs > 44.7) (OS: 41.7% vs 84.5%, HR = 5.460, P < 0.0001). In subgroup analysis PNI < 44.7 (vs > 44.7) was significantly associated with poor prognosis in patients with stages II and III disease
Lee et al[13]	ROC curve analysis	46.7. PNI < 46,7 (n = 779), PNI > 46,7, n = 7002	54.2 ± 5.9	60	The low PNI group had a poor prognosis for all stages of disease (for all stages and stages I, II, and III: P < 0.001)
Lin et al[15]	Set according to previous reports	46. PNI ≤ 46 (n = 1348, (61.8%), PNI > 46 (n = 834, 38.2%)	NS	52 (1-118)	Low PNI 5-yr OS = 55.5%, high PNI 5-yr OS = 75.4%
Liu et al[24]	Set according to previous reports	45. Low PNI group PNI < 45. Number of patients NS		35 (range 1-179). Final follow-up June 2015, 806 patients were alive by then	NS
Murakami et al[1]	ROC curve analysis	Preoperative PNI of ≥ 52 (pre-PNIhigh) n = 82, preoperative PNI < 52 (pre-PNIlow) n = 172, postoperative PNI ≥ 49 (post-PNIhigh) n = 95, postoperative PNI < 49 (pre-PNIlow) n = 159. Group A, patients with pre-PNIhigh and post-PNIhigh; group B, patients with either pre-PNIhigh and post-PNIlow or pre-PNIlow and post-PNIhigh; group C, patients with pre-PNIlow and post-PNIlow	Preoperative PNI range 30.6-63.6. Postoperative range 24.2-61.7	NS	5-yr OS prePNIhigh 95.8%, prePNIlow 70% (P < 0.0001). 5-yr OS postPNIhigh 91.4%, postPNIlow 70.1% (P < 0.0001). 5-yr OS prePNIlow and postPNIhigh 80.1%, prePNIlow and postPNIlow 67.1% (P = 0.031). 5-yr OS prePNIhigh and postPNIhigh 100%, prePNIhigh and postPNIlow 83.4% (P = 0.0021)
Saito et al[25]	ROC curve analysis	46.7. PNI ≥ 46.7 (n = 265, 58.5%) and PNI < 46.7 (PNIlow, n = 188, 41.5%)	Range 27.7-63.6	NS	5-yr OS PNIlow 59.5%, PNIhigh 88.2% (P < 0.0001)
Shen et al[26]	X-tile 3.6.1 software1 (Yale University, New Haven, CT, United States)	45.39. Training set low PNI n = 48 (13.01%), high PNI 321 (86.99%), validation set low PNI n = 29 (18.59%), high PNI n = 127 (81.41%). Patients were randomly divided into the training set and the validation set at a 7:3 ratio	NS	41 (range 2-102) training set and 38 (range 1-101) validation set	3-yr and 5-yr OS rates were 80.9% and 74.8% in the training set, and 81.6% and 73.5% in the validation set
Takechi et al[17]	Set according to previous reports	45. PNI < 45 (n = 97), PNI ≥ 45 (n = 85)	NS	39 (range, 1-72)	NS
Toyokawa et al[27]	ROC curve analysis	49.2. PNI ≤ 49.2 (n = 136), PNI > 49.2) (n = 104)	NS	100.5 (70.0-136.8)	The 5-yr OS rate for the entire study population was 78.8%
Toyokawa et al[28]	ROC curve analysis	45.6. PNI ≤ 45.6 (n = 90, 40%), PNI > 45.6 (n = 135, 60%)	46.8 (IQR: 42.5-49.9)	Median 80 (69-124)	The 5-yr OS rate for the entire study population was 48.7%.
Wu et al[29]	ROC curve analysis	42.3. Low PNI group PNI < 42.3. Number of patients NS	NS	Shortest 30, longest 64	3-yr OS low PNI group < 40%, high PNI group > 60%. Exact number NS (only survival curves available)
Xu et al[30]	ROC curve analysis	45.6. Propensity matching patients. PNI < 45.6 (n = 58), PNI > 45.6 (n = 85)	NS	Every 3 months first 2 yr, every 12 months for 3rd-5th yr, once per year after that. Final follow-up December 2022	Low PNI group had a 5-yr OS rate of 46.9%, high PNI group had a 5-yr OS rate of 71.30%

¹A bioinformatics tool for biomarker assessment and outcome-based cut-point optimization designed by Yale University.

PNI: Prognostic nutritional index; OS: Overall survival; ROC: Receiver operating characteristic; NS: Not stated; IQR: Interquartile range; HR: Hazard ratio.