Tang Xue, Yang Mei
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Front Nutr. 2025 Jun 25;12:1613868. doi: 10.3389/fnut.2025.1613868. eCollection 2025.
Early studies reported that the nutritional risk index (NRI) is a prognostic factor in patients with various malignant tumors. Our study aims to demonstrate the prognostic role of the NRI by assessing the longitudinal clinical data of patients with esophageal squamous cell carcinoma (ESCC) who had undergone neoadjuvant therapy followed by esophagectomy.
Our study retrospectively investigated 319 ESCC patients who had been treated with neoadjuvant therapy before esophagectomy at West China Hospital, Sichuan University, between August 2016 and August 2021. The NRI was calculated based on the height, weight, and albumin levels of ESCC patients at three time points during the entire treatment course: before treatment, before esophagectomy, and post-esophagectomy.
A total of 319 patients with ESCC were included in the study. Logistic regression showed that ESCC patients with a low preoperative NRI had a higher postoperative complication rate than those with a high preoperative NRI (odds ratio [OR] = 2.324, 1.318-4.095, = 0.004). The timing of malnutrition that affected survival was the preoperative NRI score. According to the multivariate analysis results, the preoperative NRI, rather than the pretreatment NRI or postoperative NRI, was an independent prognostic factor for overall survival (OS) (hazard ratio [HR] = 2.005, 1.070-3.760, = 0.030) and disease-free survival (DFS) (HR = 1.736, 1.086-2.775, = 0.021) in patients with ESCC.
In patients with ESCC who underwent neoadjuvant therapy followed by esophagectomy, preoperative NRI might predict postoperative complications and survival outcomes of patients. Further clinical investigations are needed to determine the prognostic value of the NRI.
早期研究报告称，营养风险指数（NRI）是各种恶性肿瘤患者的一个预后因素。我们的研究旨在通过评估接受新辅助治疗后行食管切除术的食管鳞状细胞癌（ESCC）患者的纵向临床数据，来证明NRI的预后作用。
我们的研究回顾性调查了2016年8月至2021年8月期间在四川大学华西医院接受新辅助治疗后行食管切除术的319例ESCC患者。根据ESCC患者在整个治疗过程中的三个时间点（治疗前、食管切除术前、食管切除术后）的身高、体重和白蛋白水平计算NRI。
本研究共纳入319例ESCC患者。逻辑回归分析显示，术前NRI低的ESCC患者术后并发症发生率高于术前NRI高的患者（比值比[OR]=2.324，1.318 - 4.095，P = 0.004）。影响生存的营养不良时间点是术前NRI评分。根据多因素分析结果，术前NRI而非治疗前NRI或术后NRI是ESCC患者总生存（OS）（风险比[HR]=2.005，1.070 - 3.760，P = 0.030）和无病生存（DFS）（HR = 1.736，1.086 - 2.775，P = 0.021）的独立预后因素。
在接受新辅助治疗后行食管切除术的ESCC患者中，术前NRI可能预测患者的术后并发症和生存结果。需要进一步的临床研究来确定NRI的预后价值。
