Introduction/Background An accurate, objective prognostic index based on disease pathology has not been established for gynaecologic cancer. Therefore, many cases have been treated aimlessly and highly invasively, rapidly aggravating patients' general condition and eventually causing death. Recently, the Prognostic Nutritional Index (PNI), an indicator of nutritional status, has shown to be related to cancer prognosis. In this study, we aimed to verify if the PNI is an useful prognostic predictor in terminal-stage gynaecologic cancer.

Methodology The study cohort consisted of 104 patients who died of gynaecologic cancer at related facilities, including our hospital, between January 2013 and September 2018. We retrospectively analyzed the correlation between prognosis and trends in PNI in cases of cervical, endometrial, and ovarian cancers by using laboratory data obtained during the initial examination and during the last 6 months before death. We investigated whether initiating chemotherapy when the patient's PNI was lower than the cutoff value could improve prognosis.

Results For all cancer types, PNI decreased significantly 2 months before death. The PNI values that indicated 2-month survival were 36.9, 30.2, and 33.6 for cervical, endometrial, and ovarian cancers, respectively. There was no difference in the prognosis between chemotherapy group and best supportive care group after when the PNI became lower than the each cutoff value.

Conclusion For terminal-stage gyneacologic cancer patients, the PNI was useful for predicting prognosis. Since initiating chemotherapy when the PNI was below the cutoff value did not improve prognosis, the cutoff PNI could instead be used as the basis for a switch to palliative care.

Disclosure Nothing to disclose