The prognostic nutritional index has no significant effect on the prognosis of gastrointestinal stromal tumors (GISTs), according to a new study published in the Journal of the College of Physicians and Surgeons Pakistan.

The prognostic nutritional index is calculated based on the concentration of serum albumin and peripheral blood lymphocyte count. It is used to evaluate the nutritional status of patients and is associated with prognosis in many types of cancer.

However, only a few studies investigated its prognostic value in GIST. Here, a team of researchers from the Departments of Medical Oncology and Pathology conducted a study between 2000 and 2019 at the Karadeniz Technical University Hospital in Trabzon, Turkey to investigate factors that may affect prognosis in GISTs.

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The study included 105 patients diagnosed with GISTs. The results showed that the median tumor size was larger in patients whose disease recurred compared to those whose disease did not recur. Recurrence rates were also higher with high mitosis compared to low mitosis.

Ki-67 is a cellular protein that increases before cell division and measures cell division rate. The median Ki-67 percentages were higher in patients with the recurrent disease compared to those without recurrence. Recurrence rates were also higher with necrosis and bleeding. 

The median overall survival rates were shorter in tumors with high mitotic counts compared to those with low mitotic counts, and in tumors with ulcerations compared to those without. Similarly, median disease-free survival rates were shorter with ulcerations. However, both overall survival and disease-free survival rates were similar among patients below and above the median prognostic nutritional index.

“While necrosis, bleeding, ulceration, mitosis, size, and Ki-67 significantly affect the prognosis in GIST, [prognostic nutritional index] has no significant effect,” the researchers concluded.


Yuce E, Alandag C, Cakir E, Fidan E. Prognostic factors in gastrointestinal stromal tumors (GIST): could prognostic nutritional index (PNI) be a new prognostic factor? J Coll Physicians Surg Pak. 2022; 32(1):81-85. doi:10.29271/jcpsp.2022.01.81