Geriatric Nutritional Risk Index as a Prognostic Factor of Patients
                    with Non-Small Cell Lung Cancer: A Meta-Analysis

BackgroundPrevious studies have explored the relationship between the geriatric nutritional risk index (GNRI) and survival outcomes of diffuse large B-cell lymphoma (DLBCL) cases, but the results were inconsistent. Consequently, the present meta-analysis was conducted to investigate how GNRI affects DLBCL and its function in terms of prognosis.MethodsThe Web of Science, PubMed, Embase, and Cochrane Library databases were thoroughly searched until January 18, 2023. We calculated combined hazard ratios (HRs) and 95% confidence intervals (CIs) to estimate the relationship between the GNRI and survival outcomes of patients with DLBCL.ResultsThis meta-analysis included seven articles involving 2,353 cases. A lower level of GNRI predicted dismal overall survival (HR=1.40, 95% CI=1.25–1.56, p<0.001) and inferior progression-free survival (HR=1.46, 95% CI=1.19-1.80, p<0.001) of DLBCL patients. Moreover, a low GNRI was significantly related to Eastern Cooperative Oncology Group Performance Status ≥2 (odds ratio [OR]=4.55, 95% CI=2.75–7.54, p<0.001), Ann Arbor stage III–IV (OR=2.91, 95% CI=2.38–3.57, p<0.001), B symptoms (OR=3.51, 95% CI=2.34–5.29, p<0.001), and extranodal disease (OR=2.90, 95% CI=2.32–3.63, p<0.001).ConclusionA lower GNRI level predicted poorer short- and long-term prognosis in patients with DLBCL. A low GNRI was correlated with clinical factors of disease progression in DLBCL patients.

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“…Recent meta-analyses have reported that the GNRI significantly predicts cancer prognosis (34)(35)(36)(37)(38). Zhang et al conducted a meta-…”

Section: Discussionmentioning

confidence: 99%

Prognostic and clinicopathological role of geriatric nutritional risk index in patients with diffuse large B-cell lymphoma: A meta-analysis

Cao

Zhang

2023

Front. Oncol.

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“…Moreover, it can also be used as a parameter for determining drug discontinuation and other reductions in treatment efficiency. In contrast, neutrophilto-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI) have been reported to affect TKI survival and adverse effects (10)(11)(12)(13). Therefore, appropriate nutritional assessment is important for therapy continuation.…”

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confidence: 99%

The Relationship Between Efficacy and Safety of Osimertinib Blood Concentration in Patients With EGFR Mutation-positive Lung Cancer: A Prospective Observational Study

HASHINO,

HATSUYAMA,

IWAYAMA

et al. 2023

In Vivo

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Background/Aim: Osimertinib blood levels and their impact on treatment continuation in patients with EGFR mutation-positive lung cancer is not known. This study investigated the drug blood levels and risk factors affecting treatment continuation. Patients and Methods: Fifty-six patients with recurrent and inoperable epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer who received Osimertinib (80 mg once daily, daily dose) between October 1, 2016, and August 31, 2021, were included. Patients were classified into two groups using a cutoff blood level of 155 ng/ml. The primary endpoint was the relationship between Osimertinib exposure and efficacy, and secondary endpoints were the relationship between Osimertinib exposure and side effects, and the effect of covariates on efficacy and blood levels. Results: The median progression-free survival (PFS) for evaluable patients in the steady-state trough concentration (C min ss ) ≥155 ng/ml and C min ss <155 ng/ml groups was 18.7 months and 31.2 months. Serum albumin (Alb) levels were 3.73±0.40 g/dl and 3.93±0.28 g/dl (p=0.030), respectively, and in multivariate analysis, Alb <3.7 g/dl was associated with a hazard ratio of p=0.013), indicating that Alb <3.7 g/dl significantly shortened PFS. Conclusion: Free blood concentration of Osimertinib may have been increased by a combination of factors, including decreased hepatic metabolic function and decreased albumin production caused by systemic inflammation in patients with cancer. However, there was no effect of Osimertinib C min ss on PFS.

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“…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)(64)(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.…”

Section: Discussionmentioning

confidence: 99%

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

Hung,

Kao,

Hsu

et al. 2024

Front. Nutr.

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BackgroundThis meta-analysis aimed to synthesize current evidence on the association between the Geriatric Nutritional Risk Index (GNRI) and long-term outcomes in patients undergoing hemodialysis.MethodsElectronic databases were systematically searched for relevant studies that investigated the association between GNRI and long-term outcomes in hemodialysis patients until November 2023. The primary outcome was the association between the GNRI (i.e., low versus high) and overall mortality risk, while the secondary outcome was the relationship between the GNRI and cardiovascular mortality risk.ResultsThirty cohort studies involving 55,864 patients were included. A low GNRI was found to be significantly associated with increased overall mortality (hazard ratio [HR]: 2.42, 95% confidence interval [CIs]: 2.10–2.79, p < 0.00001, I2 = 65%). Each unit increase in GNRI corresponded to a 5% reduction in mortality risk (HR: 0.95, 95% CI: 0.93–0.96, p < 0.00001, I2 = 79%). The association remained consistent across Asian (HR = 2.45, 95% CI: 2.08–2.88, p < 0.00001, I2 = 70%) and non-Asian subgroups (HR = 2.3, 95% CI: 1.72–3.06, p < 0.00001, I2 = 23%). Meta-regression analysis of patient age (coefficient: −0.002; p = 0.896), male proportion (coefficient: 0.002; p = 0.875), percentage of diabetes mellitus (coefficient: −0.003; p = 0.605), and follow-up duration (coefficient: −0.003; p = 0.431) revealed that these moderator variables did not significantly influence the association between GNRI and overall mortality risk. Cardiovascular mortality risk also increased with low GNRI (HR, 1.93; 95%CI: 1.51–2.45, p < 0.00001; I2 = 2%). Similarly, an inverse association was observed between the GNRI values and cardiovascular mortality risk (HR, 0.94; 95% CI: 0.91–0.97; p < 0.0001; I2 = 65%) (per unit increase).ConclusionThe GNRI is a simple nutritional screening tool that can be used to effectively stratify patients undergoing hemodialysis globally. Further studies are warranted to determine whether nutrition optimization based on the GNRI improves long-term outcomes.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, CRD42023483729.

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Geriatric Nutritional Risk Index as a Prognostic Factor of Patients with Non-Small Cell Lung Cancer: A Meta-Analysis

Cited by 6 publications

References 60 publications

Prognostic and clinicopathological role of geriatric nutritional risk index in patients with diffuse large B-cell lymphoma: A meta-analysis

Prognostic and clinicopathological role of geriatric nutritional risk index in patients with diffuse large B-cell lymphoma: A meta-analysis

The Relationship Between Efficacy and Safety of Osimertinib Blood Concentration in Patients With EGFR Mutation-positive Lung Cancer: A Prospective Observational Study

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

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