Geriatric Nutrition Index Influences Survival Outcomes in Gastric Carcinoma Patients Undergoing Radical Surgery

Sugawara, Katsuhiko; Yamashita, Hiroharu; Urabe, Masayuki; Okumura, Yasuhiro; Yagi, Koichi; Aikou, Susumu; Seto, Yasuyuki

doi:10.1002/jpen.1978

Cited by 28 publications

(52 citation statements)

References 48 publications

(117 reference statements)

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“…and Sugawara et al . also found the same result of GNRI for OS in GC 25,33 . The study by Tang et al .…”

Section: Discussionsupporting

confidence: 74%

“…also found the same result of GNRI for OS in GC. 25 , 33 The study by Tang et al . showed that the GNRI is an effective tool for predicting the long‐term prognosis and provides a scientific basis for early nutrition interventions of elderly CRC patients.…”

Section: Discussionmentioning

confidence: 99%

“…The accumulated evidence supports the harmful effects of malnutrition of various malignant tumours on patients' survival time 20 . Recent studies have evaluated the role of GNRI in elderly patients with various cancers, including lung cancer, 19 prostate cancer, 21 head and neck cancer, 22 and gastrointestinal cancer 23–25 . However, the prognostic value of GNRI in EPCC has not been thoroughly clarified, so this study aims to investigate the potential prognostic value and clinical outcome prediction ability of GNRI in EPCC.…”

Section: Introductionmentioning

confidence: 99%

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Geriatric Nutrition Risk Index: Prognostic factor related to inflammation in elderly patients with cancer cachexia

Ruan

Zhang

et al. 2021

J cachexia sarcopenia muscle

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Background Systemic inflammation and cachexia are associated with adverse clinical outcomes in elderly patients with cancer. The Geriatric Nutritional Risk Index (GNRI) is a simple and useful tool to assess these conditions, but its predictive ability for elderly patients with cancer cachexia (EPCC) is unknown. Methods This multicentre cohort study included 746 EPCC with an average age of 72.00 ± 5.24 years, of whom 489 (65.5%) were male. The patients were divided into two groups (high GNRI group ≥91.959 vs. low GNRI group <91.959) according to the optimal cut‐off value of the ROC curve. The calibration curves were performed to analyse the prognostic, predictive ability of GNRI. Comprehensive survival analyses were utilized to explore the relationship between GNRI and the overall survival (OS) of EPCC. Interaction analysis was used to investigate the comprehensive effects of low GNRI and subgroup parameters on the OS of EPCC. Results In this study, a total of 2560 patients were diagnosed with cancer cachexia, including 746 cases of EPCC. During the 3.6 year median follow‐up, we observed 403 deaths. The overall mortality rate for EPCC at 12 months was 34.3% (95% CI: 62.3% to 69.2%), and resulting in rate of 278 events per 1000 patient‐years. The GNRI score of EPCC was significantly lower than those of young patients with cancer cachexia (P < 0.001). The 1, 3, and 5 year calibration curves showed that the GNRI score had good survival prediction in the OS of EPCC. The GNRI could predict the OS of EPCC, whether as a continuous variable or a categorical variable. Particularly, we also found that low GNRI score (<91.959) of EPCC had a worse prognosis than those with a high GNRI score (≥91.959, P = 0.001, HR = 1.728, 95% CI: 1.244–2.401). Consistent results were observed in the tumour subgroups of gastric cancer and colorectal cancer. Notably, similar results were observed in the sensitivity analysis. In the subgroup analysis, the low GNRI has a combined effect with age (<70 years) on poor OS of EPCC. The results of the prognostic risk model found that the lower the GNRI score, the greater the prognostic risk score, and the greater the risk of death in EPCC. Conclusions For the first time, this study found that the GNRI score can serve as an independent prognostic factor for the OS of EPCC.

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“…and Sugawara et al . also found the same result of GNRI for OS in GC 25,33 . The study by Tang et al .…”

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Geriatric Nutrition Risk Index: Prognostic factor related to inflammation in elderly patients with cancer cachexia

Ruan

Zhang

et al. 2021

J cachexia sarcopenia muscle

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“…GNRI is a modification of the Nutritional Risk Index (NRI) because NRI requires current weight divided by previous weight, but since many elderly or other patients do not weigh themselves often or forget their previous weight, the authors further corrected NRI by calculating ideal weight instead of previous weight, so GNRI is more accurate and convenient in practice. GNRI serves as a valid predictor which has been reported to be a prognostic factor of many cancers, such as pancreatic cancer ( 48 ), advanced non-small cell lung cancer ( 49 ), large B cell lymphoma ( 50 ), gastric carcinomas ( 51 ), and so on. But there is no relevant research in GIST.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Systemic Inflammation and Nutritional Indicators in Predicting Recurrence-Free Survival After Surgical Resection of Gastrointestinal Stromal Tumors

Cao

et al. 2021

Front. Oncol.

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BackgroundRecent studies have shown that the systemic inflammation and nutritional indicators are prognostic for a variety of malignancies. However, only limited data have so far demonstrated their usefulness in gastrointestinal mesenchymal tumors (GIST).MethodsWe retrospectively analyzed the data of GIST patients who underwent radical surgery in Beijing hospital from October 2004 to July 2018. The area under the receiver operating characteristic curve (AUC) was used to compare several commonly used inflammatory and nutritional indicators. The indicators with largest AUC were further analysis. Optimal cut-off values of those indicators in predicting recurrence-free survival (RFS) were determined. Kaplan-Meier curve and the time-dependent receiver operating characteristic (ROC) curve were used to assess the prognostic values. We then used univariate and multivariate Cox regression analyses to identify prognostic factors that were associated with RFS.ResultsIn total, 160 patients who underwent surgery for GIST were included in the study. The median survival time was 34.5 months, with 1-, 3-, and 5-year RFS rates of 96.1%, 84.7%, and 80.8%, respectively. The inflammatory and nutritional indicators with largest AUC were Systemic immunoinflammatory Index (SII) and Geriatric Nutrition Risk Index (GNRI), reached 0.650 and 0.713, respectively. The optimal cutoff of GNRI and SII were 98.3, and 820.0, respectively. Univariate analysis showed that GNRI, SII, KI67, surgery method, tumor location, tumor size, and mitotic index were all significant prognostic indicators of RFS. After multivariate Cox analysis, independent prognostic factors for RFS in GIST included tumor location, mitotic index, tumor size, and GNRI (HR=2.802,95% CI: 1.045 to 7.515, p = 0.041). Besides, SII also tended to be associated with RFS (HR = 2.970, 95% CI: 0.946 to 9.326, p = 0.062).ConclusionsHigh GNRI is an independent prognostic factor for RFS in GIST, while SII can be considered as a prognostic factor. GNRI and SII can be used as tools to evaluate the prognosis of patients before surgery, helping doctors to better treat high-risk patients.

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“…Among various nutritional indicators, the geriatric nutritional risk index (GNRI) consisting of serum albumin level and patient height and body weight was originally developed to assess the risks of mortality and morbidity in older hospitalized patients [1]. However, in the last decade, the GNRI has gained attention as a simple nutritional indicator to predict the prognosis of patients with cancer and several studies with a cohort including not only older patients but also non-older patients reported that the GNRI was a useful prognostic factor in lung cancer, esophageal cancer, gastric cancer, and pancreatic cancer [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Modified Geriatric Nutritional Risk Index in Patients with Pancreatic Cancer

Sakamoto

Sunaguchi

Goto

et al. 2022

Preprint

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Background: The geriatric nutritional risk index (GNRI) was recently reported not as a nutritional assessment tool but as a useful index for predicting prognosis in various diseases including malignancies. The modified nutritional geriatric risk index (mGNRI), incorporating C-reactive protein instead of albumin, was developed as a novel index and provides a more appropriate prognostic index than the original GNRI. This study aimed to establish the prognostic significance of the mGNRI compared with the GNRI in patients with pancreatic cancer.Methods: This retrospective study included 137 patients who had undergone pancreatectomy for pancreatic cancer. The enrolled patients were grouped as high mGNRI (≥ 85.3) or low mGNRI (< 85.3), and high GNRI (≥ 92) or low GNRI (< 92) for prognostic analysis based on cutoff values.Results: The 5-year overall survival and recurrence-free survival of patients in the high mGNRI group were significantly longer than those in the low mGNRI group. Similarly, the 5-year overall survival and recurrence-free survival of patients in the high GNRI group were significantly longer than those in the low GNRI group. The concordance index of the mGNRI to predict the 5-year overall survival was greater than that of the GNRI. Multivariate analysis revealed that the mGNRI was an independent prognostic factor for patients with pancreatic cancer (P = 0.004).Conclusions: The mGNRI might be a useful prognostic factor for patients with pancreatic cancer and might predict prognostic outcomes more accurately than the GNRI.

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Geriatric Nutrition Index Influences Survival Outcomes in Gastric Carcinoma Patients Undergoing Radical Surgery

Cited by 28 publications

References 48 publications

Geriatric Nutrition Risk Index: Prognostic factor related to inflammation in elderly patients with cancer cachexia

Geriatric Nutrition Risk Index: Prognostic factor related to inflammation in elderly patients with cancer cachexia

Assessment of Systemic Inflammation and Nutritional Indicators in Predicting Recurrence-Free Survival After Surgical Resection of Gastrointestinal Stromal Tumors

Modified Geriatric Nutritional Risk Index in Patients with Pancreatic Cancer

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