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

Abstract

BackgroundThe Geriatric Nutritional Index (GNRI) has been indicated as a nutritional index which is highly associated with complications and mortality in older hospitalized patients. Moreover, early studies had suggested that GNRI is a potential prognostic indicator for some malignances. However, the prognostic value of GNRI in esophageal squamous cell carcinoma (ESCC) patients underwent neoadjuvant therapy followed by esophagectomy remains elusive.Materials and methodsThis retrospective study incorporated 373 patients with ESCC who had underwent neoadjuvant therapy followed by radical esophagectomy at West China Hospital of Sichuan University between April 2011 and September 2021. The GNRI formula was: 1.489 × albumin (g/dl) + 41.7 × current weight/ideal weight. Patients were classified as GNRI-low (GNRI < 98.7) or GNRI high (GNRI ≥ 98.7). The association between GNRI and clinical survival status were assessed utilizing Kaplan-Meier methods and Cox regression analysis.ResultsThree hundred and seventy three patients were retrospectively included in this study. 80 (21.5%) and 293 (78.5%) patients had been divided into the GNRI-low and GNRI-high groups respectively. Pathological T stage and the rate of nodal metastasis were significantly higher in the GNRI low group than in the GNRI high group (P = 0.003 and P = 0.001, respectively) among the examined demographic parameters. Furthermore, GNRI was significantly correlated with postoperative complications, patients with lower GNRI had a higher postoperative complication rate as compared with GNRI high group [Odds ratio: 2.023; 95% confidence interval (CI): 1.208–3.389; P = 0.007]. Univariate analysis of 5-year overall survival (OS) and disease-free survival (DFS) found that the rate of survival was considerably lower in the GNRI-low group than in the GNRI-high group (P < 0.001). However, multivariate analysis demonstrated that GNRI was not an independent risk factor.ConclusionIn patients with ESCC, low GNRI exhibited a poor nutritional indicator and related to postoperative complications after neoadjuvant therapy. Intensive follow-up after surgery should be performed for ESCC patients with low GNRI.

Geriatric Nutritional Risk Index has a Prognostic value for Recovery Outcomes in Elderly Patients with Brain Abscess

“…A positive correlation emerged between GNRI scores and GOS scores(P < 0.001), indicating a nutritional status may be signi cantly associated with recovery and long-term outcomes in brain abscess patients. Several studies also have demonstrated a correlation between elevated malnutrition risks and adverse clinical outcomes in geriatric patients [27,31]. It can be seen that in the process of diagnosis and treatment of geriatric diseases, the assessment of nutritional status cannot be ignored.…”

Geriatric nutritional risk index predicts postoperative prognosis in older patients with hip fracture: A meta-analysis

“…The GNRI is a valuable tool for assessing sarcopenia incidence, mortality in hospitalized older patients, and various postoperative outcomes. [11][12][13] Additionally, this index has shown high prognostic value in various geriatric conditions, such as cancer, heart failure, and diabetes mellitus. [13][14][15] However, whether the GNRI could serve as a valuable prognostic indicator in older patients with hip fractures who underwent surgery has not been determined.…”

Nutritional care is the first-line therapy for many conditions

“…These complications further lead to poor prognosis, including poor wound healing, increased infection rates, impaired tolerance to therapy, increased complications related to disease progression and therapy, delayed recovery with increased length of stay during hospitalization, reduced QoL, and, eventually, increased mortality. [14,15] During the coronavirus disease 2019 (COVID-19) pandemic, the important role of malnutrition in worsening risk of infection and disease outcomes has been unfortunately confirmed to be also a major component of disease burden in acute, infectious conditions, also in the presence of obesity. [16,17] Hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19) are at nutritional risk, [18] and nutritional management can significantly improve patient outcomes.…”