Prognostic value of the prognostic nutritional index in colorectal cancer: a systematic review and meta-analysis.
[BACKGROUND] This meta-analysis evaluates the prognostic significance of the Prognostic Nutritional Index (PNI) in colorectal cancer (CRC) patients, focusing on overall survival (OS), disease-free sur
- 95% CI 1.70–2.10
- 연구 설계 meta-analysis
APA
Xu YB, Huang YS, et al. (2026). Prognostic value of the prognostic nutritional index in colorectal cancer: a systematic review and meta-analysis.. BMC gastroenterology, 26(1). https://doi.org/10.1186/s12876-026-04702-y
MLA
Xu YB, et al.. "Prognostic value of the prognostic nutritional index in colorectal cancer: a systematic review and meta-analysis.." BMC gastroenterology, vol. 26, no. 1, 2026.
PMID
41731387
Abstract
[BACKGROUND] This meta-analysis evaluates the prognostic significance of the Prognostic Nutritional Index (PNI) in colorectal cancer (CRC) patients, focusing on overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS).
[METHODS] We conducted a comprehensive literature search across PubMed, Embase, Web of Science, and CNKI. Observational studies reporting hazard ratios (HRs) with 95% confidence intervals (CIs) for survival outcomes based on PNI were included. Pooled HRs were calculated using random-effects models. Heterogeneity, sensitivity, and publication bias were evaluated, and subgroup analyses were performed by region, follow-up duration, and tumor stage.
[RESULTS] A total of 43 studies comprising 19,214 CRC patients were included the meta-analysis. 36 studies with 18,231 patients reported the prognostic value of PNI on the OS of CRC, and the pooled HR was 1.89 (95% CI: 1.70–2.10, < 0.001). This association remained robust across sensitivity analyses, suggesting PNI as a reliable biomarker for risk stratification. Moderate heterogeneity (I = 32.9%) was observed, which subgroup analyses attributed to study region, follow-up duration, and inclusion criteria for CRC stages. Non-Asian cohorts, studies with shorter follow-up or partial staging and high cut-off value of PNI exhibited reduced heterogeneity. Eleven studies with 5,181 patients reported the prognostic value for DFS, and the pooled HR was 1.31 (95% CI: 0.84–2.03). Nine studies with 2,856 patients were for PFS, and the pooled HR was 1.15 (95% CI: 0.78–1.72), neither reaching statistical significance. Significant heterogeneity was noted for both DFS and PFS across the studies.
[CONCLUSIONS] This meta-analysis demonstrates that a low PNI is a robust predictor of poor overall survival in colorectal cancer, particularly in Asian populations and across diverse disease stages. While its prognostic value for DFS and PFS remains uncertain.
[SUPPLEMENTARY INFORMATION] The online version contains supplementary material available at 10.1186/s12876-026-04702-y.
[METHODS] We conducted a comprehensive literature search across PubMed, Embase, Web of Science, and CNKI. Observational studies reporting hazard ratios (HRs) with 95% confidence intervals (CIs) for survival outcomes based on PNI were included. Pooled HRs were calculated using random-effects models. Heterogeneity, sensitivity, and publication bias were evaluated, and subgroup analyses were performed by region, follow-up duration, and tumor stage.
[RESULTS] A total of 43 studies comprising 19,214 CRC patients were included the meta-analysis. 36 studies with 18,231 patients reported the prognostic value of PNI on the OS of CRC, and the pooled HR was 1.89 (95% CI: 1.70–2.10, < 0.001). This association remained robust across sensitivity analyses, suggesting PNI as a reliable biomarker for risk stratification. Moderate heterogeneity (I = 32.9%) was observed, which subgroup analyses attributed to study region, follow-up duration, and inclusion criteria for CRC stages. Non-Asian cohorts, studies with shorter follow-up or partial staging and high cut-off value of PNI exhibited reduced heterogeneity. Eleven studies with 5,181 patients reported the prognostic value for DFS, and the pooled HR was 1.31 (95% CI: 0.84–2.03). Nine studies with 2,856 patients were for PFS, and the pooled HR was 1.15 (95% CI: 0.78–1.72), neither reaching statistical significance. Significant heterogeneity was noted for both DFS and PFS across the studies.
[CONCLUSIONS] This meta-analysis demonstrates that a low PNI is a robust predictor of poor overall survival in colorectal cancer, particularly in Asian populations and across diverse disease stages. While its prognostic value for DFS and PFS remains uncertain.
[SUPPLEMENTARY INFORMATION] The online version contains supplementary material available at 10.1186/s12876-026-04702-y.