Geriatric nutritional risk index as a potential prognostic marker for patients with resectable pancreatic cancer: a single-center, retrospective cohort study

Abstract

In pancreatic cancer, postoperative complications (POCs) are associated with disease outcomes. The geriatric nutritional risk index (GNRI) is known to predict POCs after pancreatoduodenectomy (PD) or distal pancreatectomy (DP) in patients with hepatobiliary pancreatic tumors, including pancreatic cancer. Through POC occurrence risk, we aimed to determine whether GNRI could predict prognosis in patients who underwent PD or DP for resectable pancreatic cancer. This retrospective study examined 139 patients who underwent radical pancreatectomy for resectable pancreatic cancer at Ehime University. All patients were subjected to nutritional screening using GNRI and were followed up for POC diagnosis and patient outcomes such as overall survival (OS). Patients were divided based on the GNRI value of 99 (Low group: N = 74, GNRI < 99; High group: N = 65, GNRI ≥ 99), which was determined by receiver operating characteristic curve analysis. Multivariate analysis showed that GNRI < 99 was statistically correlated with POCs after curative pancreatic resection (p = 0.02). Univariate and multivariate analyses confirmed that GNRI < 99 was significantly associated with long OS (p = 0.04). GNRI could be a potential prognostic marker for resectable pancreatic cancer after curative pancreatic resection despite being a simple and noninvasive approach.

Prognostic Value of KRAS Exon-specific Mutations in Patients With Colorectal Cancer

“…

Background/Aim: The clinical significance of many RAS-family mutations in colorectal cancer (CRC) remains unclear. The purpose of this study was to investigate the relationship of RAS mutations on an exon basis (i.e., mutations in KRAS exons 2,3, and 4 and in NRAS) with clinicopathological features and prognosis in CRC. Patients and Methods: We performed a retrospective cohort study of the medical records and frozen tissue samples of 268 consecutive patients with stage I-III CRC who underwent curative resection at a single institution between 2014 and 2018.

…”

The Prognostic Value of the GNRI in Patients with Stomach Cancer Undergoing Surgery

“…Next, the GNRI was proposed and was used as an age-specific indicator to assess the nutritional status of elderly patients. Surprisingly, recent research has suggested that the GNRI may have better predictive value than nutritional assessment in many diseases, such as heart failure [ 38 , 39 ], hemodialysis [ 40 ], and patients undergoing surgery for various malignancies (for example, colorectal cancer [ 41 ], pancreatic cancer [ 42 ], gallbladder cancer [ 43 ], hepatocellular carcinoma [ 44 ], and esophageal cancer [ 45 ]). A recent study by Chen et al also revealed that the GNRI can be used as a promising alternative to the Global Leadership Initiative on Malnutrition (GLIM) and is the best option for the perioperative management of patients with rectal cancer [ 46 ].…”

Preoperative C-Reactive Protein-to-Albumin Ratio Predicts Postoperative Pancreatic Fistula following Pancreatoduodenectomy: A Single-Center, Retrospective Study

“…For such occasions, several POPF predictive scores, including inflammatory and/or nutritional status, have been developed, such as the GNRI [ 4 , 5 ], controlling nutritional status score [ 20 ], and prognostic nutritional index [ 22 ] to detect POPF at an earlier phase and with more precision. In addition, those scores using inflammatory or nutritional status, such as GNRI [ 23 ], the platelet-to-lymphocyte ratio [ 24 ], and neutrophil-to-lymphocyte ratio (NLR) [ 25 , 26 ], have been designed as prognostic factors in several types of cancers. Moreover, more recent reports have revealed that NLR, CRP-to-lymphocyte ratio (CLR), CAR, and GNRI play a critical predictive role in the incidence of POCs in pancreatic cancer [ 27 , 28 ].…”