Geriatric Nutritional Risk Index as a prognostic factor in patients with esophageal squamous cell carcinoma –retrospective cohort study

Yamana, Ippei; Takeno, Shinsuke; Shimaoka, Hideki; Yamashita, Kanefumi; Yamada, Teppei; Shiwaku, Hironari; Hashimoto, Tatsuya; Yamashita, Yuichi; Hasegawa, Suguru

doi:10.1016/j.ijsu.2018.03.052

Cited by 64 publications

(53 citation statements)

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“…NRI is another commonly used nutritional indicators which integrated with objective measurements of nutritional status including albumin, height and weights. The study also found that lower levels of NRI was associated with poor survival in oral cancer patients, which is consistent with the previous findings in gastric cancer [17] esophageal squamous cell carcinoma [14] and liver cancer [18].…”

Section: Discussionsupporting

confidence: 92%

“…Traditional nutritional indicators such as body mass index (BMI) and serum albumin (ALB) have been widely used in clinical to assess the nutritional status of the cancer patients and have been shown to be associated with the prognosis of a variety of tumors such as rectal cancer, head neck, oral cancer and gynecologic malignancies [9][10][11][12][13]. In addition to BMI and ALB, two comprehensive indicators prognostic nutritional index (PNI) which includes albumin and lymphocyte and nutritional risk index (NRI) which combines weight, height and serum albumin levels, have also been reported as simple but sensitive methods that can objectively assess the nutritional status of cancer patients and predict their prognosis in esophageal squamous cell carcinoma, liver cancer, lung cancer, and gastric cancer et al [11,[14][15][16][17][18][19]. However, there are few studies comprehensively explored the relationship between different nutritional indicators and prognosis of oral cancer patients.…”

Section: Introductionmentioning

confidence: 99%

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Nutritional assessment and prognosis of oral cancer patients: a large-scale prospective study

et al. 2020

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Background: To evaluate and compare the prognostic performance of four nutritional indicators body mass index (BMI), serum albumin (ALB), prognostic nutritional index (PNI) and nutritional risk index (NRI) in oral cancer patients, and to predict the response to chemotherapy in patients with different nutritional status. Methods: This prospective study which involved 1395 oral cancer patients was conducted in Fujian, China from September 2007 to November 2018. The BMI, PNI and NRI were calculated according to the following formulas: BMI = weight / height 2 (kg/m 2), PNI = albumin (g/l) + 0.005 × lymphocyte (count/μl) and NRI = (1.519 × albumin, g/ l) + (41.7× present/ideal body weight), respectively. The univariate and multivariate Cox proportional hazards models were used to compare the prognostic value of BMI, ALB, PNI and NRI in overall survival (OS) in oral cancer. Results: Patients with BMI < 18.5 kg/m 2 (VS 18.5 kg/m 2 ≤ BMI < 24 kg/m 2) had a poor survival outcome (HR = 1.585; 95% CI: 1.207-2.082). ALB, PNI, NRI were inversely correlated with OS of oral cancer (HR = 0.716; 95% CI: 0.575-0.891; HR = 0.793; 95% CI: 0.633-0.992; HR = 0.588; 95% CI: 0.469-0.738, respectively). In addition, the prognostic predictive performance of NRI was superior to BMI or ALB or PNI. Interestingly, compared with patients with better nutritional status, chemotherapy was significantly associated with poorer OS in malnourished oral cancer patients. Conclusions: BMI, ALB, PNI and NRI are of prognostic value in patients with oral cancer and the prognostic performance of NRI was superior to BMI or ALB or PNI. Malnutrition (BMI < 18.5 kg/m 2 or ALB< 40 g/l or PNI < 49.3 or NRI < 97.5) could predict an unfavorable response to chemotherapy in oral cancer patients.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Nutritional assessment and prognosis of oral cancer patients: a large-scale prospective study

et al. 2020

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“…In addition, study has shown that GNRI is a favorable predictor of muscle function in renal transplant recipients [52]. Besides, GNRI was now considerd as a novel prognostic factor for cancer patients [53,54]. These results indicate that GNRI can be a powerful predictor for clinical outcome in different diseases and may be widely used in clinical practice.…”

Section: Discussionmentioning

confidence: 95%

Association of Geriatric Nutritional Risk Index with Mortality in Hemodialysis Patients: A Meta-Analysis of Cohort Studies

Xiong

Min

Zhang

et al. 2018

Kidney Blood Press Res

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Background/Aims: Geriatric nutritional risk index (GNRI) was developed as a “nutrition-related” risk index and was reported in different populations as associated with the risk of all-cause and cardiovascular morbidity and mortality. Therefore, GNRI can be used to classify patients according to a risk of complications in relation to conditions associated with protein-energy wasting (PEW). However, not all reports pointed to the prognostic ability of the GNRI. The purpose of this study was to assess the associations of GNRI with mortality in chronic hemodialysis patients. Methods: We electronically searched original articles published in peer-reviewed journals from their inception to September 2018 in The PubMed, Embase, and the Cochrane Library databases. The primary outcome was all-cause and cardiovascular mortality. We pooled unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) using Review Manager 5.3 software. Results: A total of 10,739 patients from 19 cohort studies published from 2010 to 2018 were included. A significant negative association was found between the GNRI and all-cause mortality in patients with chronic hemodialysis (OR, 0.90; 95% CI, 0.84-0.97, p=0.004) (per unit increase) and (OR, 2.15; 95% CI, 1.88-2.46, p＜0.00001) (low vs. high GNRI). Moreover, there was also a significant negative association between the GNRI (per unit increase) and cardiovascular events (OR, 0.98; 95% CI, 0.97-1.00, p=0.01), as well as cardiovascular mortality (OR, 0.89; 95% CI, 0.80-0.99, p=0.03). Conclusion: Our findings supported the hypothesis that the low GNRI is associated with an increased risk of all-cause and cardiovascular mortality in chronic hemodialysis patients. Based on our literature review, GNRI has been found to be an effective tool for identifying patients with nutrition-related risk of all-cause and cardiovascular disease.

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“…11,12 GNRI is widely used in nutritional assessment of elderly patients with chronic liver failure, chronic obstructive pulmonary disease, and cardiovascular disease. [13][14][15] Recently, many studies have found that GNRI can be used in the prognostic assessment of various malignant tumors, including renal cell carcinoma, 16,17 esophageal squamous cell carcinoma, 18 hepatocellular carcinoma, 19 and pathological stage I non-small cell lung cancer. 20 However, there is currently little research on the relationship between GNRI and outcomes in elderly CRC patients.…”

Section: Introductionmentioning

confidence: 99%

<p>The Value of Geriatric Nutritional Risk Index in Evaluating Postoperative Complication Risk and Long-Term Prognosis in Elderly Colorectal Cancer Patients</p>

Tang¹,

Xie²,

Kuang³

et al. 2020

CMAR

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The geriatric nutritional risk index (GNRI) has been reported as a useful tool for predicting the prognosis of many diseases; however, there is currently little research on the relationship between GNRI and outcomes in elderly colorectal cancer (CRC) patients. This study aimed to explore the value of GNRI in evaluating postoperative complication risk and long-term prognosis in elderly CRC patients. Patients and Methods: The medical records of 230 CRC patients aged≥65 years who underwent surgery between January 2012 and December 2014 were retrospectively analyzed. Patients were divided into abnormal and normal GNRI groups by modified binary classification. Logistic regression analysis was used to evaluate the correlation between GNRI and complication risk. The Kaplan-Meier method with log-rank test was used to construct survival curves. The Cox proportional hazard model was used for univariate, multivariate and subgroup survival analyses to assess the relationship between GNRI and long-term prognosis. Results: Multivariate logistic regression analysis showed that GNRI (p = 0.009, HR 2.280, 95% CI: 1.224-4.247) was an independent risk factor for postoperative complications in elderly CRC patients. Kaplan-Meier survival curves revealed that the abnormal GNRI group had significantly lower disease-free survival (DFS; p = 0.005) and overall survival (OS; p=0.007) than the normal GNRI group had, especially in TNM I stage. In multivariate survival analysis, GNRI was an independent prognostic factor for DFS (p = 0.003, HR 1.842, 95% CI: 1.229-2.760) and OS (p = 0.003, HR 1.852, 95% CI: 1.231-2.787). Conclusion: GNRI is a simple and effective tool for predicting the risk of postoperative complications and the long-term prognosis of postoperative elderly CRC patients and can provide a scientific basis for early nutrition interventions in elderly CRC patients.

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Geriatric Nutritional Risk Index as a prognostic factor in patients with esophageal squamous cell carcinoma –retrospective cohort study

Abstract: GNRI is considered to be a useful prognostic factor in patients with ESCC undergoing esophagectomy.

Cited by 64 publications

References 28 publications

Nutritional assessment and prognosis of oral cancer patients: a large-scale prospective study

Nutritional assessment and prognosis of oral cancer patients: a large-scale prospective study

Association of Geriatric Nutritional Risk Index with Mortality in Hemodialysis Patients: A Meta-Analysis of Cohort Studies

<p>The Value of Geriatric Nutritional Risk Index in Evaluating Postoperative Complication Risk and Long-Term Prognosis in Elderly Colorectal Cancer Patients</p>

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