{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T03:29:25Z","timestamp":1786418965203,"version":"build-2736575974"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The prognostic nutritional index (PNI), derived from serum albumin levels and lymphocyte counts, reflects both nutritional and immunologic status. This study aimed to evaluate the association between preoperative PNI and long\u2010term oncologic outcomes and postoperative complications in patients undergoing curative resection for colorectal cancer (CRC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter retrospective analysis was conducted on 3045 patients with stage I\u2013III CRC who underwent curative surgery at five Hallym University\u2010affiliated hospitals between 2012 and 2023. Preoperative PNI, lymphocyte\u2010to\u2010monocyte ratio (LMR), neutrophil\u2010to\u2010lymphocyte ratio (NLR), and platelet\u2010to\u2010lymphocyte ratio (PLR) were calculated using laboratory values within 2\u2009weeks prior to surgery. The optimal PNI cutoff for overall survival (OS) was determined by receiver operating characteristic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The optimal preoperative PNI cutoff was 43.4 (area under the curve\u2009=\u20090.643, sensitivity\u2009=\u200960.4%, specificity\u2009=\u200959.4%). Patients with low PNI (&lt;\u200943.4) exhibited significantly poorer 5\u2010year OS (59.0% vs. 80.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and recurrence\u2010free survival (RFS) (51.4% vs. 73.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to the high PNI group. These associations remained consistent across all cancer stages. In multivariate analysis, low PNI was independently associated with OS (hazard ratio [HR]\u2009=\u20091.535,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and RFS (HR\u2009=\u20091.519,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), as well as increased risk of severe complications (odds ratio\u2009=\u20092.503,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). PNI showed better predictive performance than LMR, NLR, and PLR for these outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperative PNI is an independent predictor of oncologic outcomes and perioperative risk in CRC patients and may serve as a practical biomarker for preoperative risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72088","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:06:49Z","timestamp":1784866009000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Preoperative Prognostic Nutritional Index on Long\u2010Term Outcomes and Postoperative Complications of Stage I\u2013\n                    <scp>III<\/scp>\n                    Colorectal Cancer"],"prefix":"10.1002","volume":"15","author":[{"given":"Eui Myung","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Surgery, Dongtan Sacred Heart Hospital Hallym University College of Medicine  Hwaseong\u2010Si Gyeonggi\u2010Do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hyun","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dongtan Sacred Heart Hospital Hallym University College of Medicine  Hwaseong\u2010Si Gyeonggi\u2010Do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minsung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hallym Sacred Heart Hospital Hallym University College of Medicine  Anyang Si Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Nam","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kangnam Sacred Heart Hospital Hallym University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Jeong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kangdong Sacred Heart Hospital Hallym University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4120-4213","authenticated-orcid":false,"given":"Jin Won","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Chun Cheon Sacred Heart Hospital Hallym University College of Medicine  Chuncheon Si Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7335-764X","authenticated-orcid":false,"given":"Jong Wan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dongtan Sacred Heart Hospital Hallym University College of Medicine  Hwaseong\u2010Si Gyeonggi\u2010Do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2022.179"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21708"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.05.063"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40780-016-0064-5"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13277-015-3667-9"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1602540"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22158002"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6805"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001743"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000441396"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/1354750X.2012.656705"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.21873\/invivo.13265"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1694587"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-025-15165-x"},{"issue":"9","key":"e_1_2_12_16_1","first-page":"1001","article-title":"Prognostic Nutritional Index in Gastrointestinal Surgery of Malnourished Cancer Patients","volume":"85","author":"Onodera T.","year":"1984","journal-title":"Nihon Geka Gakkai Zasshi"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-017-1599-2"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2015.07.022"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2014.08.005"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/01635581.2015.1032430"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-020-02050-2"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/01635581.2017.1285038"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-017-2366-x"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000458"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-013-2156-9"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-011-0061-0"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-014-1799-8"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-013-2386-x"},{"issue":"10","key":"e_1_2_12_29_1","first-page":"4947","article-title":"Clinical Impact of Postoperative Prognostic Nutritional Index in Colorectal Cancer Patients Undergoing Adjuvant Chemotherapy","volume":"11","author":"Tamai M.","year":"2021","journal-title":"American Journal of Cancer Research"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12826"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6462-1"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1081\/IMM-120022979"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-08-3845"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-200608000-00006"},{"issue":"8","key":"e_1_2_12_36_1","first-page":"2553","article-title":"Spontaneous Apoptosis of Circulating T Lymphocytes in Patients With Head and Neck Cancer and Its Clinical Importance","volume":"8","author":"Hoffmann T. K.","year":"2002","journal-title":"Clinical Cancer Research"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-011-1610-3"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-019-01910-w"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40880-017-0260-1"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.11445"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.72088","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.72088","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.72088","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T02:55:41Z","timestamp":1786416941000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.72088"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":39,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/cam4.72088"],"URL":"https:\/\/doi.org\/10.1002\/cam4.72088","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-08-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72088"}}