Malnutrition is a risk factor of adverse clinical outcome in patients with
cancer. Recent studies suggest that geriatric nutritional risk index (GNRI)
could reflect the nutritional status in patients with various clinical
conditions. The aim of the systematic review and meta-analysis was to evaluate
the association between GNRI and survival of patients with hepatocellular
carcinoma (HCC). Observational studies evaluating the association between
pretreatment GNRI and survival of patients with HCC were obtained by search of
PubMed, Web of Science, Embase, Wanfang, and CNKI databases. A random-effects
model was used to pool the results after incorporating the potential influence
of heterogeneity. Seven cohort studies including 2636 patients with HCC
contributed to the meta-analysis. Pooled results showed that HCC patients with
low pretreatment GNRI were associated with poor overall survival [hazard ratio
(HR): 1.77, 95% confidence interval (CI): 1.32 to 2.37, p<0.001;
I2=66%) and progression-free survival (HR: 1.62, 95% CI:
1.39 to 1.89, p<0.001; I2=0%) as compared to those with
normal GNRI. Sensitivity analyses by excluding one study at a time showed
similar results (p all<0.05). Subgroup analyses showed that the
association between low pretreatment GNRI and poor survival of patients with HCC
was not significantly affected by age of the patients, main treatment, cutoff of
GNRI, or the follow-up durations. In conclusion, malnutrition indicated by a low
pretreatment GNRI may be a risk factor of poor survival of patients with
HCC.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.