Tang Shuangyi, Xie Hailun, Kuang Jiaan, Gao Feng, Gan Jialiang, Ou Hesheng
Department of Pharmacy, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Cancer Manag Res. 2020 Jan 9;12:165-175. doi: 10.2147/CMAR.S234688. eCollection 2020.
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.
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.
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).
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.
老年营养风险指数（GNRI）已被报道为预测多种疾病预后的有用工具；然而，目前关于GNRI与老年结直肠癌（CRC）患者预后之间关系的研究较少。本研究旨在探讨GNRI在评估老年CRC患者术后并发症风险和长期预后中的价值。
回顾性分析2012年1月至2014年12月期间接受手术的230例年龄≥65岁的CRC患者的病历。通过改良二元分类将患者分为GNRI异常组和正常组。采用逻辑回归分析评估GNRI与并发症风险之间的相关性。采用Kaplan-Meier法和对数秩检验构建生存曲线。采用Cox比例风险模型进行单因素、多因素和亚组生存分析，以评估GNRI与长期预后之间的关系。
多因素逻辑回归分析显示，GNRI（p = 0.009，HR 2.280，95%CI：1.224 - 4.247）是老年CRC患者术后并发症的独立危险因素。Kaplan-Meier生存曲线显示，GNRI异常组的无病生存期（DFS；p = 0.005）和总生存期（OS；p = 0.007）显著低于GNRI正常组，尤其是在TNM I期。在多因素生存分析中，GNRI是DFS（p = 0.003，HR 1.842，95%CI：1.229 - 2.760）和OS（p = 0.003，HR 1.852，95%CI：1.231 - 2.787）的独立预后因素。
GNRI是预测老年CRC患者术后并发症风险和术后长期预后的简单有效工具，可为老年CRC患者的早期营养干预提供科学依据。
