Prognostic Value of the Geriatric Nutritional Risk Index in Non-Small Cell Lung Cancer Patients: A Systematic Review and Meta-Analysis

Wang, Haoyu; Cui, Li; Yang, Ruiyuan; Jin, Jing; Liu, Dan; Liu, Weimin

doi:10.3389/fonc.2021.794862

Cited by 16 publications

(16 citation statements)

References 36 publications

(36 reference statements)

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“…Better survival outcomes in patients with higher GNRIs have been reported in various types of solid tumors (e.g., lung cancer, hepatoma, esophageal cancer, kidney cancer, prostate cancer, and diffuse large B-cell lymphoma) [8,20]. However, the underlying mechanism that enables GNRI to determine survival outcomes has not been completely elucidated.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Clinical Value of the Geriatric Nutritional Risk Index and Prognostic Nutritional Index as Determinants of Survival Outcome in Patients with Gastric Cancer

An¹,

Eo²,

Lee³

2022

J. Cancer

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Background:The geriatric nutritional risk index (GNRI) is an important determinant of overall survival (OS) in patients with stage I-III gastric cancer (GC) across all ages; however, its value as a determinant of disease-free survival (DFS) is unclear. Moreover, the prognostic values between the GNRI and prognostic nutritional index (PNI) remains unclear. Methods: We retrospectively evaluated the value of the GNRI and PNI as determinants of OS and DFS in patients with stage I-III GC who underwent curative-intent gastrectomy. Cox regression analysis was used for evaluating the determinants of survival outcomes. The discriminative capacity of the prognostic model was determined using the concordance index (C-index), and then C-indices of related models were compared. Results: Data from 450 patients were analyzed. The median patient age was 60 years (range: 26-92 years). In total, 276 (61.3%) patients had stage I cancer, 83 (18.4%) had stage II cancer, and 91 (20.2%) had stage III cancer. Multivariate Cox regression analysis revealed that age, type of gastrectomy (TOG), T stage, tumor-node-metastasis (TNM) stage, and GNRI were determinants of OS. These five covariates constituted the GNRI model for the OS. In addition, multivariate analysis revealed that age, TOG, TNM stage, and GNRI were determinants of DFS. These four covariates constituted the GNRI model for DFS. When constructing the PNI model for OS (comprising age, TOG, T stage, TNM stage, and PNI), and PNI model for DFS (including age, TOG, TNM stage, and PNI), the C-indices of the GNRI and PNI models were nearly equal for OS (0.818 and 0.818, respectively; p=0.909) and DFS (0.805 and 0.808, respectively; p=0.653). Using the GNRI models, nomograms for predicting OS and DFS were established. When validating the nomograms using calibration curves, the predicted survival closely matched the actual survival rate. Conclusion:The GNRI and PNI were important determinants of both OS and DFS in patients with GC across all ages. In addition, the effects of the GNRI model on OS and DFS were similar to those of the PNI model.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Clinical Value of the Geriatric Nutritional Risk Index and Prognostic Nutritional Index as Determinants of Survival Outcome in Patients with Gastric Cancer

An¹,

Eo²,

Lee³

2022

J. Cancer

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“…This is necessary because the course and the treatment of the malignancy could be very different in patients with different cancers, which may cause significant heterogeneity. During the preparation of our manuscript, two mea-analyses regarding the association between GNRI and outcomes of patients with lung cancer were published [ 43,44]. One study included eight retrospective cohort studies in NSCLC patients and showed that GNRI may be a prognostic factor of NSCLC [43].…”

Section: Discussionmentioning

confidence: 99%

“…During the preparation of our manuscript, two mea-analyses regarding the association between GNRI and outcomes of patients with lung cancer were published [ 43,44]. One study included eight retrospective cohort studies in NSCLC patients and showed that GNRI may be a prognostic factor of NSCLC [43]. However, probably due to the relative number of studies included, no subgroup analyses were performed according to the therapy of the patients (surgery, chemotherapy, or immunotherapy) [43].…”

Section: Discussionmentioning

confidence: 99%

“…One study included eight retrospective cohort studies in NSCLC patients and showed that GNRI may be a prognostic factor of NSCLC [43]. However, probably due to the relative number of studies included, no subgroup analyses were performed according to the therapy of the patients (surgery, chemotherapy, or immunotherapy) [43]. The other meta-analysis included patients with NSCLC and SCLC [44].…”

Section: Discussionmentioning

confidence: 99%

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

Yang

Liu

et al. 2022

Horm Metab Res

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Geriatric nutritional risk index (GNRI), a newly developed indicator of nutritional status retrieved by serum albumin concentration and ideal body weight, has been suggested as a prognostic factor for various malignancies. The aim of the study was to summarize the prognostic role of GNRI for patients with non-small cell lung cancer (NSCLC) in a meta-analysis. Cohort studies evaluating the relationship between GNRI at baseline and survival OF NSCLC were retrieved by search of PubMed, Embase, and Web of Science databases from inception to January 12, 2022. A conservative random-effect model incorporating the possible influence of between-study heterogeneity was used to pool the results. Eleven cohorts including 2865 patients with NSCLC were included. Compared to those with higher GNRI, NSCLC patients with lower GNRI were associated with poorer overall survival [OS, hazard ratio (HR): 2.39, 95% CI: 1.97–2.91, p<0.001; I2=29%), progression-free survival (HR: 1.94, 95% CI: 1.52–2.47, p<0.001; I2=29%), and cancer-specific survival (HR: 2.59, 95% CI: 1.55–4.35, p<0.001; I2=0%). Subgroup analyses showed that the significant association between lower GNRI and worse OS in patients with NSCLC was not affected by study characteristics including study location, design, cancer stage, treatment, or follow-up durations (p for subgroup effects all<0.001). In conclusion, a lower GNRI in patients with NSCLC may be a predictor of poor survival. Nutritional status indicated by GNRI may be important for the prognostic prediction of patients with NSCLC.

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“…Further studies in oncology showed that GNRI may also be applied as an effective prognostic index in patients with various malignancies, not limited to elderly patients ( 28 ). Indeed, a lower GNRI has been associated with poor prognosis in patients with various malignancies, such as those with esophageal cancer ( 29 ), renal cell carcinomas ( 30 ), and non-small cell lung cancer ( 31 ). However, the influences of GNRI on survival outcomes in patients with CRC, particularly of patients with different cancer stages, remain not comprehensively evaluated.…”

Section: Introductionmentioning

confidence: 99%

Geriatric Nutritional Risk Index and Survival of Patients With Colorectal Cancer: A Meta-Analysis

et al. 2022

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BackgroundGeriatric nutritional risk index (GNRI) is an indicator of nutritional status derived by serum albumin level and ideal body weight, which has been proposed as a predictor of prognosis for elderly population with various clinical conditions. The objective of the meta-analysis was to comprehensively evaluate the association between baseline GNRI and survival of patients with colorectal cancer (CRC).MethodsCohort studies were identified by search of PubMed, Embase, and Web of Science databases from inception to January 05, 2022 according to the aim of the meta-analysis. A random-effect model incorporating the potential between-study heterogeneity was adopted to pool the results.ResultsNine studies including 3658 patients with CRC contributed to the meta-analysis. Results showed that CRC patients with lower GNRI at baseline had worse overall survival (OS, hazard ratio [HR] 2.39, 95% confidence interval [CI] 1.78-3.23, p<0.001; I2 = 60%) and progression-free survival (PFS, HR 1.77, 95% CI 1.38-2.26, p<0.001; I2 = 33%). The results were consistent in sensitivity analyses limited to elderly patients (HR for OS 2.25, p<0.001; HR for PFS 1.65, p=0.003). Subgroup analyses showed consistent results in patents with different cancer stages, and in studies with median follow-up < and ≥ 5 years (p for subgroup effects all < 0.05).ConclusionA lower GNRI at baseline may be independent associated with poor survival outcomes of patients with CRC. Evaluating the nutritional status using GNRI may be important for risk stratification of patients with CRC.

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Prognostic Value of the Geriatric Nutritional Risk Index in Non-Small Cell Lung Cancer Patients: A Systematic Review and Meta-Analysis

Cited by 16 publications

References 36 publications

Comparison of the Clinical Value of the Geriatric Nutritional Risk Index and Prognostic Nutritional Index as Determinants of Survival Outcome in Patients with Gastric Cancer

Comparison of the Clinical Value of the Geriatric Nutritional Risk Index and Prognostic Nutritional Index as Determinants of Survival Outcome in Patients with Gastric Cancer

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

Geriatric Nutritional Risk Index and Survival of Patients With Colorectal Cancer: A Meta-Analysis

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