Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Innovative Oncology Research and Regenerative Medicine, Osaka International Cancer Institute, Osaka, Japan.
Sci Rep. 2020 Jul 1;10(1):10744. doi: 10.1038/s41598-020-67285-y.
Malnutrition has been considered to be associated with the prognosis of cancer. The Geriatric Nutritional Risk Index (GNRI), based on serum albumin levels, present body weight, and ideal body weight, is a simple screening tool to predict the risk of nutrition-related morbidity and mortality in elderly patients. We aimed to evaluate whether preoperative GNRI was associated with postoperative complications and prognosis in elderly patients with colorectal cancer (CRC). We retrospectively enrolled 313 CRC patients aged ≥65 years after curative surgery and classified them into an all-risk GNRI (≤98) group and a no-risk GNRI (>98) group. Kaplan-Meier analysis showed overall survival was significantly worse in the all-risk GNRI group than in the no-risk GNRI group (P = 0.009). Multivariable analyses showed low GNRI (≤98) was an independent risk factor for postoperative complications (P = 0.048) and overall survival (P = 0.001) in the patients. Among the complications, the incidence of surgical site infection, in particular, was significantly higher in the all-risk GNRI group (P = 0.008). In conclusion, low preoperative GNRI (≤98) was associated with increased postoperative complications and poor prognosis. Preoperative GNRI can be used as an identifier for potential high-risk group of morbidity and mortality in elderly CRC patients.
营养不良被认为与癌症的预后有关。基于血清白蛋白水平、现有体重和理想体重的老年营养风险指数(GNRI)是一种简单的筛选工具,可预测老年患者与营养相关的发病率和死亡率的风险。我们旨在评估术前 GNRI 是否与老年结直肠癌(CRC)患者的术后并发症和预后相关。我们回顾性纳入了 313 名接受根治性手术后年龄≥65 岁的 CRC 患者,并将他们分为全风险 GNRI(≤98)组和无风险 GNRI(>98)组。Kaplan-Meier 分析显示,全风险 GNRI 组的总生存率明显低于无风险 GNRI 组(P=0.009)。多变量分析显示,低 GNRI(≤98)是术后并发症(P=0.048)和总生存率(P=0.001)的独立危险因素。在并发症中,全风险 GNRI 组的手术部位感染发生率明显更高(P=0.008)。总之,术前 GNRI 较低(≤98)与术后并发症增加和预后不良相关。术前 GNRI 可作为老年 CRC 患者发病率和死亡率潜在高危人群的识别指标。