SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Gynecological Oncology
Prognostic value of prognostic nutritional index in patients with ovarian cancer: a systematic review and meta-analysis
Provisionally accepted
- 1Guangxi University of Chinese Medicine, Nanning, China
- 2First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, China
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Background: Accumulating evidence indicates an association between the prognostic nutritional index (PNI) and prognosis in patients with ovarian cancer (OC). However, the conclusions drawn from current studies remain controversial. Methods: We performed a systematic literature search in PubMed, Embase, Web of Science, and the Cochrane Library, covering the period from each database's inception up to July 8, 2025, to identify studies investigating the relationship between PNI and clinical outcomes. Eligible studies were identified and selected based on predefined inclusion and exclusion criteria. Primary outcomes included progression-free survival (PFS), overall survival (OS), cancer-specific survival (CSS), and disease-specific survival (DSS), which were quantified using hazard ratios (HR) with their respective 95% confidence intervals (CI). Results: We analyzed thirteen cohort studies involving 5,129 patients. Meta-analysis findings demonstrated an association between reduced PNI and poorer PFS (HR=1.59, 95% CI: 1.24–2.03; p=0.0002) and curtailed OS (HR=1.72, 95% CI: 1.36– 2.18; p<0.00001), whereas no such correlation was observed in the DSS (HR=1.88, 95% CI: 0.70–5.10; p=0.21) and CSS (HR=1.91, 95% CI: 0.81–4.52; p=0.14) analyses. Conclusion: A low PNI is associated with shortened OS and PFS in OC patients. PNI thus serves as a robust biomarker for prognostic evaluation in this patient population, providing meaningful implications to guide clinical decision-making in the context of OC.
Keywords: Meta-analysis, ovarian cancer, overall survival, prognostic value ofsurvival, Progression-free survival, the prognostic nutritional index
Received: 28 Aug 2025; Accepted: 15 Dec 2025.
Copyright: © 2025 Zang, Huang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qinggao Wang
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