Background/Aim: Recent evidence suggests that preoperative malnutrition may lead to poor survival in cancer patients. This study aimed to determine the ability of the prognostic nutritional index (PNI) to predict survival in gastric cancer patients. Patients and Methods: Two hundred and eighteen patients who had undergone laparoscopic gastrectomy were retrospectively reviewed via propensity score-matched analysis. Results: In multivariate analysis of overall patients, pTNM stage, carcinoembryonic antigen, and PNI were independent predictors of overall survival (OS), and pTNM stage and PNI were independent predictors of cancer-specific survival (CSS). Among the 92 non-elderly patients, pTNM stage and PNI were independent predictors of OS, and pTNM stage, PNI, and adjuvant chemotherapy were independent predictors of CSS in multivariate analysis. On the other hand, among the 126 elderly patients, low PNI value was identified as a significant predictor of shorter OS in univariate analysis. Conclusion: PNI is associated with OS and CSS in gastric cancer patients, especially non-elderly patients.
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