Lu Wei, Shen Jian, Zou Dehong, Li Peng, Liu Xiaocong, Jian Yi
Department of Gastroenterology, Chengdu Second People's Hospital, Chengdu, China.
Department of General Surgery, Chengdu Second People's Hospital, Chengdu, China.
Front Surg. 2022 Nov 2;9:1020482. doi: 10.3389/fsurg.2022.1020482. eCollection 2022.
The association between the preoperative Geriatric Nutritional Risk Index (GNRI) and postoperative short-term and long-term clinical outcomes remains unclear. The aim of this meta-analysis was to identify the predictive role of the preoperative GNRI for postoperative clinical outcomes of gastric cancer patients based on current evidence.
Several databases were searched up to July 28, 2022. The primary and secondary outcomes were long-term survival, including overall survival (OS), cancer-specific survival (CSS) and postoperative complications. Meanwhile, the hazard ratios (HRs) and relative risks (RRs) with 95% confidence intervals (CIs) were combined to assess the association of preoperative GNRI with postoperative survival and complications separately. The results Eight studies involving 4,189 patients were included, and they were all from Japan. The pooled results demonstrated that a lower preoperative GNRI was significantly related to worse OS (HR = 1.72, 95% CI: 1.18-2.53, = 0.005) and CSS (HR = 1.67, 95% CI: 1.20-2.32, = 0.002). Meanwhile, a lower preoperative GNRI was significantly associated with postoperative complications (RR = 1.97, 95% CI: 1.51-2.58, < 0.001). Further analysis focusing on elderly patients showed similar results.
Preoperative GNRI is related to postoperative short-term and long-term clinical outcomes of Japanese gastric cancer patients, and a lower GNRI predicts poorer prognosis.
术前老年营养风险指数（GNRI）与术后短期和长期临床结局之间的关联尚不清楚。本荟萃分析的目的是根据现有证据确定术前GNRI对胃癌患者术后临床结局的预测作用。
检索截至2022年7月28日的多个数据库。主要和次要结局为长期生存，包括总生存（OS）、癌症特异性生存（CSS）和术后并发症。同时，合并95%置信区间（CI）的风险比（HR）和相对风险（RR），分别评估术前GNRI与术后生存和并发症的关联。结果纳入8项研究，共4189例患者，均来自日本。汇总结果显示，术前GNRI较低与较差的OS（HR = 1.72，95%CI：1.18 - 2.53，P = 0.005）和CSS（HR = 1.67，95%CI：1.20 - 2.32，P = 0.002）显著相关。同时，术前GNRI较低与术后并发症显著相关（RR = 1.97，95%CI：1.51 - 2.58，P < 0.001）。针对老年患者的进一步分析显示了相似的结果。
术前GNRI与日本胃癌患者术后短期和长期临床结局相关，较低的GNRI预示着较差的预后。
