Pre- and post-operative low prognostic nutritional index influences survival in older patients with gastric carcinoma

Sugawara, Katsuhiko; Aikou, Susumu; Yajima, Satoshi; Uemura, Yukari; Okumura, Yasuhiro; Nishida, Masato; Yagi, Koichi; Yamashita, Hiroharu; Seto, Yasuyuki

doi:10.1016/j.jgo.2020.02.007

Cited by 21 publications

(15 citation statements)

References 45 publications

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“…Because of advances in screening programs and diagnostic modalities for GC, the number of patients diagnosed with early‐stage GC has recently been increasing in Japan 4 . Although non–GC related deaths mainly determine the survival outcomes of patients with early GC, only a few studies have focused on noncancer mortality in GC patients 6,34,35 . GNRI evaluation appears to be useful for identifying GC patients at high risk of general mortality.…”

Section: Discussionmentioning

confidence: 99%

“…4 Although non-GC related deaths mainly determine the survival outcomes of patients with early GC, only a few studies have focused on noncancer mortality in GC patients. 6,34,35 GNRI evaluation appears to be useful for identifying GC patients at high risk of general mortality. These findings might help clinicians optimize postoperative surveillance strategy and patient education.…”

Section: Discussionmentioning

confidence: 99%

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Geriatric Nutrition Index Influences Survival Outcomes in Gastric Carcinoma Patients Undergoing Radical Surgery

Sugawara

Yamashita

Urabe

et al. 2020

J Parenter Enteral Nutr

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Background The survival impact of the geriatric nutrition risk index (GNRI) has yet to be investigated in patients undergoing gastric carcinoma (GC) surgery. Methods In total, 1166 GC patients who underwent radical gastrectomy were retrospectively reviewed. The predictive and discrimination abilities for overall survival (OS) were compared among GNRI, nutrition indices, and systemic inflammatory markers. Patients were dichotomized by GNRI (GNRI <98, low; GNRI ≥98, high), and the impacts of GNRI on OS and cancer‐specific survival (CSS) were evaluated using Cox hazards analysis. Results GNRI showed superior discrimination and predictive ability for OS as compared with other indices. There were 447 (38.3%) and 719 (61.7%) patients in the low‐ and high‐GNRI groups, respectively. Patients with low GNRI were older and had a higher pStage III disease rate than those with high GNRI (P < .001). OS curves were significantly stratified by GNRI in all patients (P < .001) and those with pStage I (P < .001), II (P < .001), and III (P = .02) disease. Multivariate analysis showed low GNRI to be independently associated with poor OS (hazard ratio [HR], 2.15; 95% CI, 1.612.87; P < .001). Furthermore, low GNRI was an independent predictor of poor CSS (HR, 1.61; 95% CI, 1.072.44; P = .02), as were total gastrectomy (P < .001) and pStage III disease (P < .001). Patients who had low GNRI and underwent total gastrectomy showed quite poor 5‐year OS (54.8%). Conclusion GNRI is useful for predicting survival and oncological outcomes in GC patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Geriatric Nutrition Index Influences Survival Outcomes in Gastric Carcinoma Patients Undergoing Radical Surgery

Sugawara

Yamashita

Urabe

et al. 2020

J Parenter Enteral Nutr

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“…Malignancy may be described as a state formed in the setting of specific tumor-host relationships at the molecular and cellular microenvironment levels 1 . The tumor microenvironment has many differences in physical and chemical properties from the normal internal environment of the human body.…”

Section: The Purpose Of This Article Is To Evaluate the Relationship mentioning

confidence: 99%

The role of prognostic nutritional index for clinical outcomes of gastric cancer after total gastrectomy

Zhao

Feiyan

Liang

et al. 2020

Sci Rep

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The purpose of this article is to evaluate the relationship between the nutrition-based microenvironment and clinicopathological information for gastric cancer patients and to investigate the prognostic value of nutrition index for gastric cancer patients undergoing total gastrectomy. We retrospectively collected clinical information of 245 gastric cancer patients who underwent total gastrectomy in our hospital between January 1st 2005 and December 30th 2015. According to the prognostic nutritional index (PNI) level, they were divided into low PNI (< 43) group and high PNI (≥ 43) group. The relationship between PNI and the disease-free survival (DFS) and overall survival (OS) were analyzed by statistical analysis. Univariate analyses demonstrated that TNM stage (p = 0.025), patients age (p = 0.042), lymph node metastasis (p = 0.028), tumor differentiation (p = 0.037) and a low PNI (p = 0.033) were closely correlated with a poor prognosis. In multivariate analysis, TNM stage (p = 0.027) and a low PNI (p = 0.041) were found to be independently associated with poor survival. Additionally, when age was considered as a stratified factor, univariate analyses demonstrated that low PNI correlated with shorter DFS in non-elderly (< 65) patients (p = 0.022) and shorter DFS (p = 0.036) and OS (p = 0.047) in elderly (≥ 65) patients. The low prognostic nutritional index is an independent risk factor associated with poor gastric cancer survival which represents the nutritional microenvironment. Patients with low pre-operative prognostic nutritional index levels should be observed more closely after surgery to prevent the occurrence of post-operative complications in the near future.

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“…In cancer patients, malnutrition is common [3] because of the following factors: (1) anorexia due to nausea, cancer pain, anxiety, or depression; (2) decreased absorption, especially in digestive tract cancer; (3) increased energy consumption; (4) increased insulin resistance; and (5) other mechanisms. The prevalence of malnutrition varies depending on sampling tools, cut-off value, and the type and stage of cancer: GNRI < 92, 19% in hormone-naïve prostate cancer [26] ; GNRI < 96.8, 54% in diffuse large B cell lymphoma [27] ; GNRI ≤98, 15% in lung cancer patients undergoing surgery [28]; PNI < 45, 39% in postoperative gastric cancer [29] ; and CONUT ≥2, 45% in preoperative esophageal cancer patients [30] , 51% in advanced urothelial cancer [31] , and 64% in gastric cancer patients before curative resection [32] . As in the case of HF, a lower GNRI [ 26 -28 ], lower PNI [29] , or higher CONUT [ 30 -32 ] can predict overall mortality in various types of cancer.…”

Section: Malnutrition In Hf Patients With and Without Cancermentioning

confidence: 99%

Cancer and malnutrition were independently associated with a poor prognosis in patients with heart failure

Miyanaga

Komukai

Kubota

et al. 2022

Journal of Cardiology

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Pre- and post-operative low prognostic nutritional index influences survival in older patients with gastric carcinoma

Cited by 21 publications

References 45 publications

Geriatric Nutrition Index Influences Survival Outcomes in Gastric Carcinoma Patients Undergoing Radical Surgery

Geriatric Nutrition Index Influences Survival Outcomes in Gastric Carcinoma Patients Undergoing Radical Surgery

The role of prognostic nutritional index for clinical outcomes of gastric cancer after total gastrectomy

Cancer and malnutrition were independently associated with a poor prognosis in patients with heart failure

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