A Low Geriatric Nutritional Risk Index is Associated with Aggressive Pathologic Characteristics and Poor Survival after Nephrectomy in Clear Renal Cell Carcinoma: A Multicenter Retrospective Study

Kang, Ho Won; Seo, Sung Pil; Kim, Dong-Won; Yun, Seok Joong; Lee, Sang Cheol; Kim, Wun-Jae; Hwang, Eu Chang; Kang, Seok Ho; Hong, Sung Hoo; Chung, Jinsoo; Kwon, Tae Gyun; Kim, Hyeon Hoe; Kwak, Cheol; Byun, Seok Soo; Kim, Yong June

doi:10.1080/01635581.2019.1621357

Cited by 21 publications

(32 citation statements)

References 29 publications

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“…However, an easy tool to assess the nutritional status is still needed. The GNRI, a simplified nutritional assessment tool, has been recognized to have prognostic value for several types of cancer, including colorectal cancer (14)(15)(16)(17). This report provides the first evidence of a correlation between the GNRI and the prognosis of patients with CRLM.…”

Section: Discussionmentioning

confidence: 75%

Prognostic Impact of Geriatric Nutritional Risk Index in Patients With Synchronous Colorectal Liver Metastasis

et al. 2020

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Background/Aim: The Geriatric Nutritional Risk Index (GNRI) is a prognostic indicator for several cancers; however, the association between the GNRI and colorectal liver metastasis (CRLM) remains unknown. Patients and Methods: Eighty patients who underwent hepatectomy for synchronous CRLM were divided into two groups based on the GNRI. Results: The preoperative CA19-9 levels were significantly higher in the low (GNRI ≤98; n=30) than the normal GNRI group (GNRI >98; n=50). Patients in the low GNRI group had poorer outcomes than those in the normal GNRI group. A low GNRI was an independent prognostic factor for recurrence-free survival and overall survival. Among 50 patients who experienced recurrence, only 16 of 22 patients (72.7%) in the low GNRI group could receive intensive treatment and 27 of 28 patients (96.4%) in the normal GNRI group. Conclusion: The GNRI is a simplified prognostic factor for patients with CRLM.Colorectal cancer is the third most common neoplasm worldwide and the second leading cause of cancer mortality (1). The liver is the most common site of colorectal cancer metastasis, and 15% to 25% of patients have colorectal liver metastasis (CRLM) at the time of diagnosis (2). Surgical resection of CRLM has been shown to significantly improve survival, with a reported 5-year survival rate of approximately 50% (3, 4); however, the incidence of postoperative recurrence remains high (5). Therefore, identification of relevant prognostic factors after hepatectomy for CRLM has become important.Metastatic cancers are associated with poor nutrition, which occurs in 37% of patients with metastatic digestive cancer (6). Cancer-associated malnutrition, termed cachexia, is associated with an impaired immune response, performance status, muscle function, quality of life, and tolerance of and response to chemotherapy, leading to a poor prognosis (7). Implementation of nutritional treatment is therefore warranted to improve the clinical outcome (8, 9), and more attention has been given to the correlation between cancer and the nutritional status.Several studies have shown a relationship between poor prognosis and several preoperative nutritional status markers, such as the neutrophil-to-lymphocyte ratio, modified Glasgow prognostic score, and prognostic nutritional index, in patients with CRLM (10-12). However, these nutritional status markers are directly affected by inflammatory markers. The Geriatric Nutritional Risk Index (GNRI) has been established to predict the risk of malnutrition-related morbidity and mortality in advanced age patients (13) and has been reportedly associated with a poor outcome in many diseases, including cancer (14-18). The GNRI is a wellestablished, simplified tool that is used to assess the nutritional status. This index combines only two nutritional indicators: the serum albumin level and the actual weight compared with the ideal weight. To date, however, the influence of the GNRI on outcomes after hepatectomy for CRLM has not been described. Thus, the present study was performed to ...

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Section: Discussionmentioning

confidence: 75%

Prognostic Impact of Geriatric Nutritional Risk Index in Patients With Synchronous Colorectal Liver Metastasis

et al. 2020

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“…Five studies were based on patients with hematological malignant tumors [15–19], 4 studies were based on esophageal cancers [20–23], 2 studies were based on renal cell carcinoma [24, 25], and 4 studies were based on hepatocellular carcinoma, prostate cancer, pancreatic cancer, and lung cancer respectively [26–29]. Among these studies, two studies reported HRs for prognosis by two subsets in each study [23, 27]. On the basis of population origin, all the studies were based on Asian countries (1 in Korea, 9 in Japan, and 5 in China).…”

Section: Resultsmentioning

confidence: 99%

Geriatric Nutritional Risk Index Predicts Adverse Outcomes in Human Malignancy: A Meta-Analysis

Sun

2019

Disease Markers

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Background Geriatric Nutritional Risk Index (GNRI) has been widely used to assess the nutritional status in a variety of human pathological conditions, but the prognostic value of the GNRI in malignancies has not been evinced. Methods Relevant studies updated on Jul 27, 2019, were retrieved in available databases, including PubMed, Web of Science, Cochrane library, Chinese CNKI, and Chinese Wan-fang. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted and pooled by using STATA 14. Results A total of 15 studies involving 8,046 subjects were included in this meta-analysis. Meta-analysis results evinced that low GNRI was associated with poor OS (HR = 1.95, 95% CI: 1.49-2.56, p ≤ 0.001), poor CSS (HR = 1.81, 95% CI: 1.49-2.19, p ≤ 0.001), poor DFS (HR = 1.67, 95% CI: 1.28-2.17, p ≤ 0.001), and poor PFS (HR = 1.68, 95% CI: 1.28-2.21, p ≤ 0.001), and the correlation of GNRI with OS was not changed when stratified by possible confounding factors, suggesting that malignancy patients with low GNRI would suffer from reduced survival rate and increased recurrence rate. Moreover, low GNRI was also associated with postoperative complications in malignancies. Conclusions In summary, GNRI is associated poor prognosis in human malignancies, and GNRI should be used as a predictive indicator of adverse outcomes during malignancy treatment.

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“…As demonstrated in previous studies, one of the indexes under the NRI umbrella that could appraise forecasting risk of malnutrition-related incidence rate and mortality in advanced-age patients was the Geriatric Nutritional Risk Index (GNRI) (45). GNRI has been associated with poor treatment outcomes in many diseases, including cancer (46)(47)(48)(49)(50). Moreover, previous research also illustrated that in patients with new metastatic gastric adenocarcinoma and esophageal adenocarcinoma, pretreatment NRI and change of NRI in that were significant prognostic factors for OS.…”

Section: Discussionmentioning

confidence: 99%

Nutritional Risk Index Predicts Survival in Patients With Breast Cancer Treated With Neoadjuvant Chemotherapy

Chen

Kong

et al. 2022

Front. Nutr.

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Nutritional risk index (NRI) is an index based on ideal body weight that aims to present body weight and serum albumin levels. It has been utilized to discriminate patients at risk of postoperative complications and predict the postoperative outcome of major surgeries. However, this index remains limited for breast cancer patients treated with neoadjuvant chemotherapy (NACT). The research explores the clinical and prognostic significance of NRI in breast cancer patients. This study included 785 breast cancer patients (477 cases received NACT and 308 cases did not) were enrolled in this retrospective study. The optimal NRI cutoff value was evaluated by receiver operating characteristic (ROC) curve, then reclassified as low NRI group (<112) and high NRI group (≥112). The results demonstrated that NRI independently predicted survival on disease-free survival (DFS) and overall survival (OS) by univariate and multivariate Cox regression survival analyses [P = 0.019, hazard ratio (HR): 1.521, 95% CI: 1.071–2.161 and P = 0.004, HR: 1.415, 95% CI: 1.119–1.789; and P = 0.026, HR:1.500, 95% CI: 1.051–2.143 and P < 0.001, HR: 1.547, 95% CI: 1.221–1.959]. According to the optimal cutoff value of NRI, the high NRI value patients had longer mean DFS and OS time in contrast to those with low NRI value patients (63.47 vs. 40.50 months; 71.50 vs. 56.39 months). Furthermore, the results demonstrated that the high NRI score patients had significantly longer mean DFS and OS time than those with low NRI score patients in early-stage breast cancer (χ2 = 9.0510, P = 0.0026 and χ2 = 9.2140, P = 0.0024) and advanced breast cancer (χ2 = 6.2500, P = 0.0124 and χ2 = 5.8880, P = 0.0152). The mean DFS and OS values in patients with high NRI scores were significantly longer in contrast to those with low NRI scores in different molecular subtypes. The common toxicities after NACT were hematologic and gastrointestinal reactions, and the NRI had no statistically significant effects on toxicities, except in nausea (χ2 = 9.2413, P = 0.0024), mouth ulcers (χ2 = 4.8133, P = 0.0282), anemia (χ2 = 8.5441, P = 0.0140), and leukopenia (χ2 = 11.0951, P = 0.0039). NRI serves as a minimally invasive, easily accessible and convenient prognostic tool for evaluating breast cancer prognoses and treatment efficacy, and may help doctors in terms of selecting measures of greater efficiency or appropriateness to better treat breast cancer.

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A Low Geriatric Nutritional Risk Index is Associated with Aggressive Pathologic Characteristics and Poor Survival after Nephrectomy in Clear Renal Cell Carcinoma: A Multicenter Retrospective Study

Cited by 21 publications

References 29 publications

Prognostic Impact of Geriatric Nutritional Risk Index in Patients With Synchronous Colorectal Liver Metastasis

Prognostic Impact of Geriatric Nutritional Risk Index in Patients With Synchronous Colorectal Liver Metastasis

Geriatric Nutritional Risk Index Predicts Adverse Outcomes in Human Malignancy: A Meta-Analysis

Nutritional Risk Index Predicts Survival in Patients With Breast Cancer Treated With Neoadjuvant Chemotherapy

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