A novel integrated nutrition-combined prognostic index for predicting overall survival after radical gastrectomy

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Abstract
Objective: The objectives of this study were to integrate the Prognostic Nutritional Index, Controlling Nutritional Status, and Nutritional Risk Index, into a novel Nutrition-combined Prognostic Index (NCPI), and to develop and validate a nomogram to predict overall survival (OS) in patients with gastric cancer (GC).Materials and methods: Data from 609 patients with GC, collected between January 1, 2017, and April 30, 2023, were retrospectively analyzed. Optimal cut-off values for nutritional parameters were determined using X-Tile software, and the Kaplan–Meier method applied for survival analysis. Univariate, least absolute shrinkage and selection operator, and multivariate Cox regression analyses were conducted, and a nomogram for predicting OS in patients with GC constructed and validated.Results: Inferior nutritional status was strongly correlated with worse clinicopathologic features and prognosis of patients with GC. NCPI, body mass index, American Joint Committee on Cancer T stage, and lymph node ratio were identified as independent risk factors for OS. A nomogram including these factors predicted 1-, 3-, and 5-year OS, with training and validation set C-index values of 0.716 and 0.77, respectively. Calibration curves demonstrated that the predicted outcomes closely matched the actual results, and decision curve analysis highlighted the high practical value of the model.Conclusion: The novel nutritional marker, NCPI, is closely associated with the clinicopathologic features and OS of patients with GC. The practical value of the NCPI-based nomogram was demonstrated and a web-based calculator developed.

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