Prognostic Nutritional Index Is Associated With Gastrointestinal Symptom Severity in Patients Receiving Chemotherapy for Gastrointestinal Cancer: A Cross-Sectional Study.

Objective

This study aimed to investigate the relationship between the Prognostic Nutritional Index (PNI) and chemotherapy-related gastrointestinal (GI) symptom severity in patients with GI cancer.

Methods

This observational cross-sectional study included 262 adult patients with GI cancer receiving chemotherapy at a research hospital in eastern Türkiye. Nutritional status was assessed using the Prognostic Nutritional Index, calculated from serum albumin levels and lymphocyte counts obtained prior to chemotherapy cycles. Gastrointestinal symptom burden was evaluated using the Gastrointestinal Symptom Rating Scale (GSRS). Descriptive statistics, group comparisons, and correlation analyses were performed to evaluate associations between clinical variables, PNI, and GSRS scores. RESULT The mean PNI score was 39.34 ± 12.31, and nearly half of the participants were classified as at risk for malnutrition based on sample-specific cut-off values. The mean total GSRS score was 36.23 ± 12.06, indicating mild-to-moderate symptom severity. GSRS scores were significantly higher among patients with advanced disease stages and lower PNI values. Correlation analysis revealed a statistically significant negative association between PNI and GSRS scores (r = -0.239, p < 0.05), demonstrating that poorer nutritional status was associated with greater gastrointestinal symptom severity. In the multiple linear regression analysis, it was determined that cancer stage and chemotherapy protocol had significant effects on PNI and GSRS scores (p<0.05).

Conclusion

This study demonstrates that lower PNI is linked to greater gastrointestinal symptom severity, underscoring the need to integrate routine nutritional evaluation with gastrointestinal symptom monitoring in GI cancer care.