Modified Geriatric Nutritional Risk Index in Patients with Pancreatic Cancer

Abstract

Background: The geriatric nutritional risk index (GNRI) was recently reported not as a nutritional assessment tool but as a useful index for predicting prognosis in various diseases including malignancies. The modified nutritional geriatric risk index (mGNRI), incorporating C-reactive protein instead of albumin, was developed as a novel index and provides a more appropriate prognostic index than the original GNRI. This study aimed to establish the prognostic significance of the mGNRI compared with the GNRI in patients with pancreatic cancer.Methods: This retrospective study included 137 patients who had undergone pancreatectomy for pancreatic cancer. The enrolled patients were grouped as high mGNRI (≥ 85.3) or low mGNRI (< 85.3), and high GNRI (≥ 92) or low GNRI (< 92) for prognostic analysis based on cutoff values.Results: The 5-year overall survival and recurrence-free survival of patients in the high mGNRI group were significantly longer than those in the low mGNRI group. Similarly, the 5-year overall survival and recurrence-free survival of patients in the high GNRI group were significantly longer than those in the low GNRI group. The concordance index of the mGNRI to predict the 5-year overall survival was greater than that of the GNRI. Multivariate analysis revealed that the mGNRI was an independent prognostic factor for patients with pancreatic cancer (P = 0.004).Conclusions: The mGNRI might be a useful prognostic factor for patients with pancreatic cancer and might predict prognostic outcomes more accurately than the GNRI.