Liao Chun-Kai, Chern Yih-Jong, Hsu Yu-Jen, Lin Yueh-Chen, Yu Yen-Lin, Chiang Jy-Ming, Yeh Chien-Yuh, You Jeng-Fu
Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan 333423, Taiwan.
Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung City 204201, Taiwan.
Cancers (Basel). 2021 Nov 22;13(22):5852. doi: 10.3390/cancers13225852.
Research on the relationship between the geriatric nutritional risk index (GNRI) and postoperative complications/oncological outcomes in elderly colorectal cancer (CRC) patients is limited. This study investigated the prognostic value of the GNRI in aged CRC patients. We retrospectively analyzed 1206 consecutive CRC patients aged over 75 years who underwent curative-intent surgery from January 2008 to December 2015 and categorized them into high GNRI (≥98) and low GNRI (<98) groups according to a receiver operating characteristic (ROC) curve analysis. Uni- and multivariate logistic regression analysis were used to explore the association of the GNRI with postoperative complications. Kaplan-Meier survival analyses and the Cox proportional hazard model were used to explore the association between GNRI and survival. We discovered that GNRI is an independent risk factor for postoperative complications (HR: 1.774, = 0.037). Surgical site infection, wound dehiscence and pneumonia were more common in patients with GNRI < 98. Survival analysis showed significantly worse overall survival and disease-free survival in the low GNRI group (both < 0.001). In the multivariate analysis, GNRI < 98 was an independent risk factor for OS (HR: 1.329, = 0.031) and DFS (HR: 1.312, = 0.034). Thus, preoperative GNRI can be effectively used to predict postoperative complications and long-term survival in elderly CRC patients after curative surgery.
关于老年结直肠癌(CRC)患者的老年营养风险指数(GNRI)与术后并发症/肿瘤学结局之间关系的研究有限。本研究调查了GNRI在老年CRC患者中的预后价值。我们回顾性分析了2008年1月至2015年12月期间接受根治性手术的1206例年龄超过75岁的连续CRC患者,并根据受试者工作特征(ROC)曲线分析将他们分为高GNRI(≥98)和低GNRI(<98)组。采用单因素和多因素逻辑回归分析来探讨GNRI与术后并发症的关联。采用Kaplan-Meier生存分析和Cox比例风险模型来探讨GNRI与生存之间的关联。我们发现GNRI是术后并发症的独立危险因素(HR:1.774, = 0.037)。GNRI<98的患者手术部位感染、伤口裂开和肺炎更为常见。生存分析显示低GNRI组的总生存和无病生存均显著更差(均<0.001)。在多因素分析中,GNRI<98是总生存(HR:1.329, = 0.031)和无病生存(HR:1.312, = 0.034)的独立危险因素。因此,术前GNRI可有效用于预测老年CRC患者根治性手术后的术后并发症和长期生存。