Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
Int J Surg. 2018 Aug;56:44-48. doi: 10.1016/j.ijsu.2018.03.052. Epub 2018 Mar 27.
The Geriatric Nutritional Risk Index (GNRI) is a new index recently introduced to predict the risk of nutrition-related complications and mortality. Our aim is to examine the association between the GNRI and long-term prognosis in patients with esophageal squamous cell carcinoma (ESCC) who underwent esophagectomy.
The present study enrolled consecutive 216 patients with ESCC who underwent esophagectomy. The GNRI at admission to the hospital was calculated as follows: (1.489 × albumin, g/l) + (41.7 × present/ideal body weight). The characteristics and long-term prognosis were compared between four groups: the severe risk (GNRI: <82), moderate risk (GNRI: 82 to <92), low risk (GNRI: 92 to <98) and no risk (GNRI: >98) groups. The 5-year overall survival and independent prognostic factors were investigated, respectively.
A decreased GNRI significantly correlated with unfavorable overall survival (p < 0.001). In all patients, a multivariate analysis demonstrated that the severe and moderate risk groups (GNRI: <92) (hazard ratio 0.50; p = 0.002), T factor (≥T2) (hazard ratio 0.52; p = 0.026), and N positive factor (hazard ratio 0.47; p = 0.004) were independent prognostic factors. In the subgroup analysis, which excluded patients with preoperative chemoradiotherapy, the severe and moderate risk groups (GNRI: <92) (hazard ratio 0.48; p = 0.0057), and T factor (≥T2) (hazard ratio; p = 0.021) were independent prognostic factors.
GNRI is considered to be a useful prognostic factor in patients with ESCC undergoing esophagectomy.
老年营养风险指数（GNRI）是一种新的指数，最近被引入以预测与营养相关的并发症和死亡率的风险。我们的目的是研究 GNRI 与接受食管切除术的食管鳞状细胞癌（ESCC）患者的长期预后之间的关系。
本研究纳入了 216 例接受食管切除术的 ESCC 连续患者。入院时的 GNRI 计算如下：（1.489×白蛋白，g/L）+（41.7×当前/理想体重）。比较了四个组之间的特征和长期预后：严重风险（GNRI：<82）、中度风险（GNRI：82 至<92）、低风险（GNRI：92 至<98）和无风险（GNRI：>98）组。分别研究了 5 年总生存率和独立预后因素。
GNRI 降低与总生存率降低显著相关（p<0.001）。在所有患者中，多变量分析表明，严重和中度风险组（GNRI：<92）（风险比 0.50；p=0.002）、T 因子（≥T2）（风险比 0.52；p=0.026）和 N 阳性因子（风险比 0.47；p=0.004）是独立的预后因素。在排除术前放化疗患者的亚组分析中，严重和中度风险组（GNRI：<92）（风险比 0.48；p=0.0057）和 T 因子（≥T2）（风险比；p=0.021）是独立的预后因素。
GNRI 被认为是接受食管切除术的 ESCC 患者的有用预后因素。
