Hirahara Noriyuki, Matsubara Takeshi, Fujii Yusuke, Kaji Shunsuke, Hyakudomi Ryoji, Yamamoto Tetsu, Uchida Yuki, Miyazaki Yoshiko, Ishitobi Kazunari, Kawabata Yasunari, Tajima Yoshitsugu
Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
Oncotarget. 2020 Jun 16;11(24):2345-2356. doi: 10.18632/oncotarget.27635.
The geriatric nutritional risk index (GNRI) was developed to evaluate the prognosis in elderly hospitalized patients at risk of malnutrition and related morbidity and mortality. This study aimed to evaluate the relationship between preoperative GNRI and long-term outcomes in elderly gastric cancer patients.
We retrospectively reviewed 297 consecutive patients aged ≥ 65 years who underwent laparoscopic gastrectomy with R0 resection and evaluated their overall survival (OS) and cancer-specific survival (CSS).
In the univariate analyses, OS was significantly associated with the American Society of Anesthesiologists Physical Status (ASA-PS), tumor size, tumor differentiation, pathological stage, carcinoembryonic antigen (CEA), C-reactive protein, postoperative complications, and GNRI, whereas in the univariate analyses of CSS, ASA-PS, tumor size, tumor differentiation, pathological stage, CEA, postoperative adjuvant chemotherapy, and GNRI were significantly associated with poor prognosis. In the multivariate analysis, ASA-PS, tumor differentiation, pathological stage, and GNRI were significant independent prognostic factors of OS, whereas ASA-PS, pathological stage, and CEA were significant independent prognostic factors of CSS.
GNRI is significantly associated with OS and CSS in elderly gastric cancer patients and is an independent predictor of OS. It is a simple, cost-effective, and promising nutritional index for predicting OS in elderly patients.
老年营养风险指数(GNRI)旨在评估有营养不良风险以及相关发病率和死亡率的老年住院患者的预后情况。本研究旨在评估老年胃癌患者术前GNRI与长期预后之间的关系。
我们回顾性分析了297例年龄≥65岁、接受R0切除的腹腔镜胃切除术的连续患者,并评估了他们的总生存期(OS)和癌症特异性生存期(CSS)。
在单因素分析中,OS与美国麻醉医师协会身体状况分级(ASA-PS)、肿瘤大小、肿瘤分化程度、病理分期、癌胚抗原(CEA)、C反应蛋白、术后并发症以及GNRI显著相关;而在CSS的单因素分析中,ASA-PS、肿瘤大小、肿瘤分化程度、病理分期、CEA、术后辅助化疗以及GNRI与不良预后显著相关。在多因素分析中,ASA-PS、肿瘤分化程度、病理分期以及GNRI是OS的显著独立预后因素,而ASA-PS、病理分期以及CEA是CSS的显著独立预后因素。
GNRI与老年胃癌患者的OS和CSS显著相关,并且是OS的独立预测指标。它是一种用于预测老年患者OS的简单、经济高效且有前景的营养指标。