Preoperative prognostic nutritional index and albumin levels are associated with cancer staging in patients undergoing gastrectomy.

[BACKGROUND] Gastric cancer often is diagnosed at an advanced stage and is associated with severe malnutrition. Existing data suggest systemic inflammation and malnutrition impact prognosis. This study aimed to evaluate the correlation between malnutrition and inflammation as well as whether preoperative assessments of laboratory tests or inflammation-based biomarkers can serve as prognostic factors for cancer staging.

[METHODS] A single-center retrospective study was conducted on patients who underwent gastrectomy between January 2017 and December 2021. Nutritional status was assessed using weight loss, body mass index, and the Global Leadership Initiative on Malnutrition criteria. Inflammatory markers included albumin, C-reactive protein, and biomarkers such as prognostic nutritional index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index. We analyzed their association with malnutrition and postoperative staging.

[RESULTS] Data from 178 patients (64.6% women, 35.4% men) showed severe malnutrition in 55.1%, with a median weight loss of 9.26%. Albumin correlated with weight loss (ρ = -0.257, P = .034) but not with body mass index (ρ = 0.189, P = .053). Total protein correlated with body mass index (ρ = 0.232, P = .020). Inflammatory biomarkers (neutrophil-to-lymphocyte ratio, prognostic nutritional index, systemic immune-inflammation index , platelet-to-lymphocyte ratio) and C-reactive protein did not correlate with nutritional status. Multivariate analysis showed that prognostic nutritional index (odds ratio, 0.88, P = .004) and low albumin (odds ratio, 4.34, P = .008) were significantly associated with advanced cancer staging.

[CONCLUSION] Low levels of albumin and prognostic nutritional index were associated with cancer staging. Systemic inflammation did not correlate with the nutritional status of patients.