Abstract
BackgroundThe main aim of this study was to validate the potential association between the preoperative prognostic nutritional index (PNI) and survival of patients with ovarian cancer (OC).MethodsWe systematically searched multiple databases (PubMed, EMBASE, and Web of Science) for publications up to June 30, 2019, to identify observational studies evaluating the PNI in relation to survival. Two reviewers independently extracted data and assessed the quality of each study using the Newcastle-Ottawa Scale (NOS). Summary hazard ratios (HR) and 95% confidence intervals (CI) were calculated with the aid of a random-effects model. The potential for publication bias was explored using Funnel plots as well as Begg’s and Egger’s tests.ResultsAmong the 15,000 studies selected for selection, 5 retrospective cohort studies (4 from China and one from Japan) comprising 1964 OC patients met the inclusion criteria. All studies were graded as ‘low risk of bias’ according to NOS. A low preoperative PNI was associated with poor overall survival (HR = 1.69, 95% CI = 1.16–2.46; I2 = 83.8%) and progression-free survival (HR = 1.86, 95% CI = 1.39–2.51; I2 = 29.7%) of OC patients. No significant publication bias was detected.ConclusionsCollective data from the present systematic review and meta-analysis suggest that a low preoperative PNI is associated with poor survival in OC. Further prospective studies are required to confirm these findings.
The prognostic nutritional index is prognostic factor of gynecological cancer: A systematic review and meta-analysis
