The prognostic nutritional index is prognostic factor of gynecological cancer: A systematic review and meta-analysis

Background and aims: Many reports have shown that the prognostic nutritional index (PNI) is associated with the progression of malignant tumors. We comprehensively evaluated the prognostic significance of the PNI in patients with gynecological cancer. Methods: We identified relevant studies by searching PubMed, Embase, the Cochrane Library, and the Web of Science. The hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI) were used to explore the correlation between PNI and overall survival (OS), progression-free survival (PFS), and the characteristics of gynecological cancer. All analyses were performed using Review Manager ver. 5.2 software. Results: We included nine studies with 2373 patients. The PNI correlated closely with the OS and PFS of gynecological cancer; the pooled HRs were respectively 2.66 (95% CI 1.56-4.55) and 2.43 (95% CI 2.07-2.86) on univariate analysis (UVA) and 1.88 (95% CI 1.10-3.20) and 1.92 (95% CI 1.52-2.44) on multivariate analysis (MVA). Conclusions: The PNI is significantly associated with the prognosis of patients with gynecological cancer, and may, in fact, be independently prognostic.