Prognostic nutritional index and postoperative outcomes in patients with colon cancer after laparoscopic surgery

Tetsuro Tominaga, Toshiya Nagasaki, Takashi Akiyoshi, Yosuke Fukunaga, Satoru Honma, Tomoyuki Nagaoka, Shinpei Matsui, Hironori Minami, Shun Miyanari, Tomohiro Yamaguchi, Masashi Ueno

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)


Purpose: The prognostic nutritional index (PNI) is calculated using the serum albumin and peripheral lymphocyte counts. We sought to assess the correlation between the preoperative PNI and postoperative outcomes in patients with colon cancer treated with laparoscopic surgery. Methods: We included 896 colon cancer patients who underwent curative laparoscopic colectomy between January 2013 and March 2016. To identify any predictors of the postoperative outcomes, we compared the clinical characteristics and immunonutritional parameters, including the PNI, between patients classified as the Clavien–Dindo grade 2 or higher (n = 99) with those classified as grade 0 or 1 (n = 797). Results: A longer surgical time and a preoperative low PNI (< 49.8) (odds ratio; 1.913, p = 0.002) were independent predictors of postoperative complications according to a multivariate analysis. A preoperative low PNI was significantly associated with an older age, a lower performance status, a lower BMI, higher CEA levels, an advanced T status, lymph node metastasis, a longer operative time, a higher blood loss, a larger tumor size, treatment with a combined resection, a longer time to bowel recovery, a longer postoperative hospital stay, and a poor overall survival. Conclusions: A preoperative low PNI was found to be significantly associated with the incidence of postoperative complications, an advanced tumor status, and a poor prognosis. Further research is needed to understand how to best clinically utilize this promising parameter.

Original languageEnglish
Pages (from-to)1633-1643
Number of pages11
JournalSurgery today
Issue number12
Publication statusPublished - 2020 Dec
Externally publishedYes


  • Laparoscopic surgery
  • Postoperative complication
  • Prognostic nutritional index

ASJC Scopus subject areas

  • Surgery


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