Xu Xue-Lian, Cheng Hao
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453100, Henan, China.
Department of Radiotherapy Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China.
Sci Rep. 2025 Jul 1;15(1):22309. doi: 10.1038/s41598-025-08609-8.
The impact of the Geriatric Nutritional Risk Index (GNRI) on the prognosis of postoperative parotid gland carcinoma (PGC) remains unclear. This study investigates the role of GNRI in predicting disease-free survival (DFS) and overall survival (OS) in postoperative PGC patients and develops a predictive model. We conducted a retrospective analysis of 389 postoperative PGC patients treated from May 2008 to June 2019 at two regional medical centers in China. The independent prognostic factors were identified by univariate and multivariate Cox regression analyses. Then, two nomograms were established based on these independent prognostic factors and verified by a series of methods. The GNRI was identified as an independent prognostic factor in postoperative patients with PGC. A higher GNRI value indicated a worse prognosis for the patient. Based on the recognized independent prognostic factors-such as surgical margin, perineural invasion, extranodal extension (ENE), age-adjusted Charlson comorbidity index (ACCI), American Joint Committee on Cancer (AJCC) stage, and GNRI-two nomograms for overall survival (OS) and disease-free survival (DFS) were developed. The concordance index (C-index) for DFS was 0.712 and 0.730, while for OS it was 0.697 and 0.722 in the training and validation groups, respectively. These results demonstrate a significant improvement over the traditional AJCC staging system. Additionally, the area under the curve (AUC) values in both the training and validation sets were impressive, with all AUC scores exceeding 0.7. Decision curve analysis (DCA) also indicated substantial clinical benefits. The GNRI is an important predictive index in postoperative patients with PGC, which is not limited to the elderly. The newly developed nomograms provide a new tool of prognostic evaluations for postoperative patients with PGC.
老年营养风险指数（GNRI）对腮腺癌（PGC）术后预后的影响尚不清楚。本研究探讨GNRI在预测PGC术后患者无病生存期（DFS）和总生存期（OS）中的作用，并建立一个预测模型。我们对2008年5月至2019年6月在中国两家地区医疗中心接受治疗的389例PGC术后患者进行了回顾性分析。通过单因素和多因素Cox回归分析确定独立预后因素。然后，基于这些独立预后因素建立了两个列线图，并通过一系列方法进行验证。GNRI被确定为PGC术后患者的独立预后因素。较高的GNRI值表明患者预后较差。基于公认的独立预后因素，如手术切缘、神经侵犯、结外扩展（ENE）、年龄校正的Charlson合并症指数（ACCI）、美国癌症联合委员会（AJCC）分期和GNRI，开发了两个总生存期（OS）和无病生存期（DFS）的列线图。训练组和验证组中DFS的一致性指数（C指数）分别为0.712和0.730，而OS的C指数分别为0.697和0.722。这些结果表明与传统的AJCC分期系统相比有显著改善。此外，训练集和验证集中的曲线下面积（AUC）值令人印象深刻，所有AUC分数均超过0.7。决策曲线分析（DCA）也表明有显著的临床益处。GNRI是PGC术后患者的重要预测指标，并不局限于老年人。新开发的列线图为PGC术后患者提供了一种新的预后评估工具。
