Efficacy of the Geriatric Nutritional Risk Index for Predicting Overall Survival in Patients with Head and Neck Cancer: A Meta-Analysis

Abstract

Head and neck cancer (HNC) is a prevalent malignancy with a poor prognosis, necessitating the identification of prognostic biomarkers to guide management. The geriatric nutritional risk index (GNRI), calculated from serum albumin and body weight, may predict survival in patients with HNC. We performed a systematic review and meta-analysis to clarify this relationship. Databases were searched for studies examining the association between pretreatment GNRI and overall survival in patients with HNC. Ten studies with 2793 patients were included. Meta-analysis demonstrated that low GNRI was associated with significantly worse overall survival compared to high GNRI (hazard ratio [HR]:2.84, 95% CI 2.07–3.91, p < 0.00001). Older age (HR:1.73; 95% CI, 1.35–2.22; p < 0.0001), male sex (HR:1.7; 95% CI, 1.12–2.6; p = 0.01), advanced tumor stage (HR: 2.5; 95% CI, 1.72–3.63; p < 0.00001), and higher T-/N-stage (HR = 1.69 and 1.98, respectively) were also predictive of unfavorable outcomes. The GNRI had the highest HR, suggesting potent predictive ability. Despite limitations, including retrospective design and potential publication bias, our study indicates that low pretreatment GNRI predicts poor overall survival in patients with HNC. The GNRI is an inexpensive, routinely available biomarker that could improve prognostication and guide management decisions. Additional research is warranted to validate these findings.

Comparison of three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer

“…The initial aim of GNRI was to evaluate the morbidity and mortality risk in elderly patients during hospitalization, with cut-off values of 98 established for identifying nutrition-related risks 8 . Subsequent studies have demonstrated that GNRI can effectively serve as a prognostic tool in patients with different types of cancers, including gastrointestinal cancer 23 , rectal cancer 24 , head and neck cancer 25 , and lung cancer 26 . However, the association between GNRI and GLIM-de ned malnutrition remains unclear.…”

Impact of the geriatric nutritional risk index on long-term outcomes in patients undergoing hemodialysis: a meta-analysis of observational studies

“…For elderly patients with heart failure, a meta-analysis of nine studies involving 7,659 patients revealed that low GNRI was predictive of all-cause mortality (HR: 1.56) compared to high GNRI ( 62 ). In addition, low GNRI values have been associated with an increased overall mortality risk in patients with head and neck, gastrointestinal, or lung cancer, with HRs ranging from 2.39 2.84 ( 63 – 65 ). Considering our findings and previous research, it appears that using the GNRI as a prognostic tool in patients on hemodialysis or suffering from cancer is more beneficial than in other clinical situations.…”

Comment on effect of massage therapy on sleep quality in critically ill patients

“…To further assess the robustness of the finding (Fang et al, 2023) in light of heterogeneity, we conducted a prediction interval based on the raw data from the originally published metaanalysis (Fang et al, 2023). All analyses were conducted using Comprehensive Meta-Analysis (version 4; Biostat, Englewood, NJ, USA) as previously reported (Yiu et al, 2023). As shown in Figure 1, the 95% prediction interval was −1.7 to 3.73 (red line).…”