Correspondence regarding “Is the prognostic nutritional index (PNI) a useful predictive marker for postoperative complications after lung surgery?” by Dr. X Li and J Chen

We thank Drs. Xin Li and Jun Chen and read with great interest their editorial comment on “Is the prognostic nutritional index (PNI) a useful predictive marker for postoperative complications after lung surgery?” Lung cancer is a leading cause of death that was estimated to have caused 1.76 million deaths worldwide in 2018 (1). Several factors for predicting prognosis have been reported so far. In addition to stage, including lymph node involvement, pleural invasion, or serum tumor markers, nutritional status has also recently been reported to be an important prognostic factor (2-4). It is a somewhat new concept that a clinical characteristic of a patient, not a tumor characteristic, could affect the outcome, while nutrition might be affected by tumor progression with inflammation.