The recurrence-free survival and overall survival of patients with gastrointestinal stromal tumor (GIST) who have a lower prognostic nutritional index are inferior, according to a new study published in the journal BMJ Open. A low prognostic nutritional index may also be associated with a higher risk of tumor recurrence.

To determine the prognostic and clinicopathological significance of the prognostic nutritional index in GIST, a team of researchers from China led by Sihui Zheng from the Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, in Hangzhou conducted a literature review and meta-analysis.

The team analyzed 8 studies that included a total of 2307 patients.

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The results showed that a low prognostic nutritional index was significantly associated with worse recurrence-free survival and overall survival in patients with GIST. 

Moreover, a low prognostic nutritional index was significantly associated with a tumor size of 5 cm or larger and the primary tumor site in the small intestine, colorectum, or extra-GISTs.

“Our meta-analysis demonstrated that patients with GISTs with lower [prognostic nutritional index] had inferior [recurrence-free survival] and [overall survival],” the researchers wrote. “Due to some limitations, including a small sample size and diverse cut-off values of [prognostic nutritional index], further prospective studies are required to validate our results.”

The prognostic nutritional index is calculated by multiplying serum albumin levels by 10 and adding this to the total number of lymphocytes in peripheral blood times 0.005. It is used to evaluate the nutritional status of patients undergoing surgery.

The index may help evaluate the effect of different treatments and predict survival in patients with different types of solid tumors such as gastric, esophageal, nasopharyngeal, and colorectal cancers. The prognostic potential of the index in GIST is less clear.


Kang N, Gu H, Ni Y, Wei X, Zheng S. Prognostic and clinicopathological significance of the Prognostic Nutritional Index in patients with gastrointestinal stromal tumours undergoing surgery: a meta-analysis. BMJ Open. Published online December 1, 2022s. doi:10.1136/bmjopen-2022-064577