Abstract: Objective To investigate the effect of prognostic nutritional index （PNI） on postoperative complications and 3-year survival rates for patients with advanced gastric （AGC） cancer. Methods The data of 106 AGC patients were extracted and analyzed between October 2015 and September 2017 in our hospital. The PNI value was calculated based on the peripheral blood lymphocyte count and albumin value,and the optimal cut-off value of PNI was calculated by a receiver operating characteristic（ROC）curve. The mean PNI of all patients was calculated. Patients were divided into high PNI group and low PNI group according to the mean PNI. The clinicopathological characteristics and overall survival rate（OS）were compared between two groups. Logistic regression analysis and Cox proportional hazard model were used to analyze the relationship between PNI and postoperative complications and long-term survival rate. Results The optimal cut-off value of PNI was 46.The mean PNI was 45.6. Sixty-nine cases were classified in high PNI group and 37 cases were in low PNI group. There were significant differences in age（χ²=4.049,P=0.044）,BMI（χ²=4.381,P=0.036）,lymph node metastasis（χ²=5.110,P=0.024）,serosal invasion（χ²=20.856,P<0.001）and postoperative complications（χ²=5.384, P=0.020） between two groups. There was significant difference in OS between two groups（χ²=15.232,P<0.001）. Unconditional binary logistic regression analysis showed that PNI<46（OR=2.256,P<0.001）and serosal invasion（OR=2.038,P<0.001） were independent risk factors for postoperative complications. In multivariate analysis,age≥60 years（HR=2.963,P=0.012）,PNI<46（HR=10.430,P<0.001）,lymph node metastasis（HR=3.600,P=0.025） and postoperative complications（HR=4.056,P=0.039）were independent predictors of overall survival. Conclusion Many factors affect postoperative complications and survival rate of AGC patients. PNI can be used not only to assess the increased risk for postoperative complications, but also to predict short-term survival rate after surgery. It should be included in a routine evaluation and strengthen the perioperative management of gastric cancer patients.

Key words: Prognostic nutritional index, Gastric cancer, Operation, Complication, Overall survival rate