Prognostic nutritional index predicts postoperative outcome in colorectal cancer

World J Surg. 2013 Nov;37(11):2688-92. doi: 10.1007/s00268-013-2156-9.


Background: The prognostic nutritional index (PNI), which is calculated based on the serum albumin concentration and peripheral blood lymphocyte count, is a useful tool for predicting short-term and long-term postoperative outcome in patients undergoing cancer surgery. However, few studies have investigated PNI in colorectal cancer surgery. We examined the ability of PNI to predict short- and long-term outcomes in patients with colorectal cancer.

Methods: This retrospective study included 365 patients who underwent resection for colorectal cancer. The prognostic nutritional status was calculated on the basis of admission data as follows: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm(3)). The primary outcomes measured were the impact of PNI on overall survival and postoperative complications.

Results: Kaplan-Meier analysis and the log rank test revealed that low PNI was significantly associated with poor survival (P < 0.0001). In multivariate analysis for survival, preoperative low PNI was an independent prognostic factor for poor survival: odds ratio: 2.25, 95 % confidence interval 1.42-3.59). Moreover, low PNI significantly correlated with the incidence of postoperative complications, especially serious ones.

Conclusions: Preoperative PNI is a useful predictor of postoperative complications and survival in patients with colorectal cancer.

MeSH terms

  • Aged
  • Colorectal Neoplasms / surgery*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Nutritional Status*
  • Postoperative Complications / epidemiology
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin / analysis*
  • Survival Rate
  • Treatment Outcome


  • Serum Albumin