Abstract
Objective: Although the prognostic immune and nutritional index (PINI) has attracted increasing attention as a prognostic marker for various cancers, its clinical significance in older patients has not been fully clarified. This retrospective single-center study aimed to investigate the association among PINI, long-term prognosis, and postoperative complications in older patients with colorectal cancer (CRC).
Methods: We analyzed 181 patients aged ≥75 years with pathological stage I–III CRC who underwent curative surgery at our institution between 2015 and 2023.
Results: Overall survival (OS) (p < 0.001) and cancer-specific survival (CSS) (p < 0.001) rates in patients with low PINI were significantly worse than those in their counterparts. Low PINI was an independent prognostic factor for OS (hazard ratio [HR] = 5.22, 95% confidence interval [CI]: 2.45–11.1, p < 0.001) and CSS (HR = 2.94, 95% CI: 1.03–8.36, p = 0.042). Moreover, low PINI was an independent risk factor for postoperative complications (odds ratio = 2.90, 95% CI: 1.10-7.82, p = 0.030). Additionally, patients with low PINI had a significantly higher recurrence rate for locoregional metastasis than those with high PINI (2.79% vs. 22.6%, p < 0.001); no significant differences were observed in the recurrence rates for other patterns.
Conclusions: Low PINI was an independent risk factor for postoperative complications and poor prognosis in older patients with CRC. Preoperative inflammatory and immunonutritional assessments using the PINI may contribute to comprehensive risk stratification and individualized perioperative management in this vulnerable population.
