Comparative Prognostic Value of the Preoperative Prognostic Nutritional Index and Gustave Roussy Immune Score After Curative-Intent Gastrectomy for Gastric Cancer.
- 1Department of General Surgery, Bağcılar Training and Research Hospital, University of Health Sciences, 34200 Istanbul, Türkiye.
- 2Department of General Surgery, Istanbul Aydın University, 34295 Istanbul, Türkiye.
Abstract
Background/objectives
We compared the prognostic performance of preoperative prognostic nutritional index (PNI) and Gustave Roussy Immune Score (GRIm-s) after curative-intent gastrectomy.Methods
This retrospective cohort included 168 patients, including five postoperative in-hospital deaths. Continuous PNI and ordinal GRIm-s were compared using censoring-adjusted time-dependent AUC and concordance, with paired bootstrap confidence intervals. Preoperative prediction models underwent bootstrap internal validation; restricted mean survival time and time-varying Cox analyses addressed non-proportional hazards.Results
There were 92 deaths and 107 disease-free survival (DFS) events. At 36 months, overall survival (OS) AUC was 0.659 for PNI and 0.527 for GRIm-s (difference 0.132, 95% CI 0.039-0.226); corresponding DFS values were 0.650 and 0.516 (difference 0.134, 95% CI 0.035-0.228). After optimism correction, preoperative PNI-model AUCs were 0.610 for OS and 0.595 for DFS. PNI associations weakened over time. The cohort-derived 49.6 threshold was used only in secondary exploratory analyses.Conclusions
PNI showed better unadjusted discrimination than GRIm-s at three years, but modest internally validated model performance limits clinical interpretation. These findings do not establish clinical utility, a validated cutoff, or a substitute for pathological assessment. External validation is required.
Related
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BibTeX
@article{ergin2026comparative,
title = {{Comparative Prognostic Value of the Preoperative Prognostic Nutritional Index and Gustave Roussy Immune Score After Curative-Intent Gastrectomy for Gastric Cancer.}},
author = {Ahmet Sencer Ergin and Mustafa Can Alıklı and Ali Karabulut and Alparslan Saylar and Nihat Buğdaycı and Turan Pehlivan and Serhat Meriç and Ali Naki Yücesoy and Erkan Yavuz and Osman Bilgin Gülçiçek},
journal = {Current oncology (Toronto, Ont.)},
year = {2026},
month = oct,
doi = {10.3390/curroncol33100610},
url = {https://europepmc.org/article/MED/42930177},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative Prognostic Value of the Preoperative Prognostic Nutritional Index and Gustave Roussy Immune Score After Curative-Intent Gastrectomy for Gastric Cancer.
AU - Ahmet Sencer Ergin
AU - Mustafa Can Alıklı
AU - Ali Karabulut
AU - Alparslan Saylar
AU - Nihat Buğdaycı
AU - Turan Pehlivan
AU - Serhat Meriç
AU - Ali Naki Yücesoy
AU - Erkan Yavuz
AU - Osman Bilgin Gülçiçek
PY - 2026
DA - 2026/10/10
JO - Current oncology (Toronto, Ont.)
DO - 10.3390/curroncol33100610
UR - https://europepmc.org/article/MED/42930177
AB - Background/objectives We compared the prognostic performance of preoperative prognostic nutritional index (PNI) and Gustave Roussy Immune Score (GRIm-s) after curative-intent gastrectomy.Methods This retrospective cohort included 168 patients, including five postoperative in-hospital deaths. Continuous PNI and ordinal GRIm-s were compared using censoring-adjusted time-dependent AUC and concordance, with paired bootstrap confidence intervals. Preoperative prediction models underwent bootstrap internal validation; restricted mean survival time and time-varying Cox analyses addressed non-proportional hazards.Results There were 92 deaths and 107 disease-free survival (DFS) events. At 36 months, overall survival (OS) AUC was 0.659 for PNI and 0.527 for GRIm-s (difference 0.132, 95% CI 0.039-0.226); corresponding DFS values were 0.650 and 0.516 (difference 0.134, 95% CI 0.035-0.228). After optimism correction, preoperative PNI-model AUCs were 0.610 for OS and 0.595 for DFS. PNI associations weakened over time. The cohort-derived 49.6 threshold was used only in secondary exploratory analyses.Conclusions PNI showed better unadjusted discrimination than GRIm-s at three years, but modest internally validated model performance limits clinical interpretation. These findings do not establish clinical utility, a validated cutoff, or a substitute for pathological assessment. External validation is required.
SN - 1198-0052
SN - 1718-7729
ER -