The role of pretreatment prognostic nutritional index in esophageal cancer: A meta‐analysis

Clinicopathological characteristics and prognosis of esophageal cancer (EC) patients with decreased prognostic nutritional index (PNI) have not been well investigated. So, we conducted this meta-analysis. We performed comprehensive research in PubMed, Embase, and Cochrane databases. The effect size was hazard ratio (HR) with 95% confidence interval (CI) for overall survival (OS) and cancer-specific survival (CSS). The pooled odds ratio (OR) with 95% CI were used to assess the association between PNI and clinicopathological features. A total of 3,425 EC patients were included in the present meta-analysis. Male patients, advanced age, higher tumor stage, and lymph node metastases were associated with reduced PNI level (OR=1.40, 95% CI: 1.10-1.79; OR=1.35, 95% CI: 1.10-1.66; OR=2.37, 95% CI: 1.91-2.94; OR=1.63, 95% CI: 1.04-2.56). And, the EC patients with decreased PNI held a worse OS and CSS compared with those who carried a higher PNI (HR=1.29, 95% CI: 1.10-1.50; HR=2.53, 95% CI: 1.15-5.57). This meta-analysis demonstrated PNI level was associated with tumor stage and lymph nodes metastases and was an independent prognostic factor in EC.