Development of a novel prognostic nutrition-inflammation scoring system to predict long-term prognosis in patients with pancreatic cancer after radical surgery

doi:10.3877/cma.j.issn.1674-0793.2026.02.003

Abstract

Abstract:

Objective

Toinvestigate the prognostic values of nutrition-and inflammation-related indicators in pancreatic cancer and construct a personalized predictive model.

Methods

Clinical data from 158 patients with pancreatic cancer who underwent radical resection in Peking Union Medical College Hospital and Qilu Hospital of Shandong University from January 2016 to September 2021 were retrospectively analyzed. Cox regression was used to identify markers associated with overall survival (OS) and disease-free survival (DFS). The prognostic nutritional inflammation score (PNIS) system and PNIS-nomogram were developed using the ‘rms’ package and evaluated via time-dependent receiver operating characteristic curves, calibration curves, and decision curve analysis (DCA).

Results

The PNIS formula, based on prognostic nutritional index, neutrophil-to-lymphocyte ratio, alanine aminotransferase, and high-sensitivity C-reactive protein, stratified patients into low- and high-risk groups, with high-risk patients showing significantly shorter OS (P<0.001) and DFS (P<0.001). The PNIS-nomogram, incorporating pathological grade, N stage, chemotherapy, and smoking history, demonstrated excellent predictive performance for 1-, 2-, and 3-year OS (AUC: 0.896, 0.782, 0.783) and DFS (AUC: 0.775, 0.766, 0.784), with favorable calibration and DCA results.

Conclusion

The PNIS-nomogram serves as a reliable tool for effectively predicting long-term postoperative outcomes in pancreatic cancer patients and may provide new insights into the role of abnormal inflammatory responses and malnutrition in pancreatic cancer.

Key words: Pancreatic neoplasms, Nutrition/inflammation, Long-term prognosis, Nomogram

Zhe Cao, Guihu Weng, Tao Liu, Menggang Zhang, Gang Yang, Hao Chen, Jiangdong Qiu, Jianwei Xu, Taiping Zhang. Development of a novel prognostic nutrition-inflammation scoring system to predict long-term prognosis in patients with pancreatic cancer after radical surgery[J]. Chinese Archives of General Surgery(Electronic Edition), 2026, 20(02): 85-90.

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URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2026.02.003

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2026/V20/I02/85

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References 22

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