Efficacy of the Nutritional Risk Index, Geriatric Nutritional Risk Index, BMI, and GLIM-Defined Malnutrition in Predicting Survival of Patients with Head and Neck Cancer Patients Qualified for Home Enteral Nutrition

Abstract

Malnutrition is a poor prognostic factor in cancer disease. In case of head and neck cancer, there are multiple disease symptoms and side effects of treatment that increase the risk of malnutrition. The aim of the study is to assess the association between nutritional status at the time of qualification for home enteral nutrition (HEN) and overall survival of patients with head and neck cancer (HNC), and assessment usefulness of selected nutritional indices as prognostic factors. The retrospective survival analysis involved 157 patients with HNC referred to HEN between January 2018 and October 2021. The nutritional status assessment was performed at the qualification for HEN visit. We have analyzed results of body mass index (BMI), Nutritional Risk Index (NRI) for patients <65 years, Geriatric Nutritional Risk Index (GNRI) for patients ≥65 years and malnutrition defined by Global Leadership Initiative on Malnutrition (GLIM). The mean patient survival was 44.7 weeks and the median was 23.9 weeks. Patients with low NRI and GNRI score had a higher risk of death (NRI: p = 0.0229; GNRI: p = 0.371). NRI, GNRI, and malnutrition defined by GLIM were superior to BMI as prognostic markers for survival. Results suggest that the use of NRI, GNRI, and GLIM criteria could provide useful prognostic information. The longer survival since the qualifying visit for home enteral nutrition suggests that nutritional management could be initiated earlier.

Prognostic value of the nutritional risk index in patients with newly diagnosed multiple myeloma

“…Patients in the high NRI group had a significantly better OS than those in the low NRI group. Consistent with the results of previous studies in other cancers, our results suggest that malnutrition, as assessed by the NRI, may be a predictor of poor survival in patients with NDMM [ 22 – 24 ].…”

The impact of geriatric nutritional risk index on esophageal squamous cell carcinoma patients with neoadjuvant therapy followed by esophagectomy

“…The results of our study suggested that GNRI could be utilized in clinical setting in the future for confirming ESCC patients with decreasing nutrition level and for patients who requiring nutritional support before esophagectomy. Przekop et al ( 24 ) had proved that GNRI could provide useful prognostic information in patients with head and neck cancer patients qualified for home enteral nutrition (HEN), and they had also suggested nutritional management should be also initiated earlier during the management of cancer patients. Liu et al ( 25 ) demonstrated that HEN and preoperative nutritional support was safe, and beneficial to the recovery of EC patients who had underwent esophagectomy.…”

The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer

“…HNSCC can lead to dysphagia, dysgeusia, xerostomia, and oral mucositis, which can be caused directly by the primary tumor or due to treatment side effects, particularly from radio- and chemotherapy. These symptoms can severely impair daily calorie intake and are associated with increased mortality and morbidity [ 2 , 3 ]. Since a significant proportion of HNSCC patients require food supplements and tube feeding during treatment, managing their nutrition is an integral part of therapy.…”