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Geriatric Nutrition Index Influences Survival Outcomes in Gastric Carcinoma Patients Undergoing Radical Surgery
Author(s) -
Sugawara Kotaro,
Yamashita Hiroharu,
Urabe Masayuki,
Okumura Yasuhiro,
Yagi Koichi,
Aikou Susumu,
Seto Yasuyuki
Publication year - 2021
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1978
Subject(s) - medicine , gastroenterology , hazard ratio , gastrectomy , proportional hazards model , cancer , gastric carcinoma , multivariate analysis , surgery , confidence interval
Abstract Background The survival impact of the geriatric nutrition risk index (GNRI) has yet to be investigated in patients undergoing gastric carcinoma (GC) surgery. Methods In total, 1166 GC patients who underwent radical gastrectomy were retrospectively reviewed. The predictive and discrimination abilities for overall survival (OS) were compared among GNRI, nutrition indices, and systemic inflammatory markers. Patients were dichotomized by GNRI (GNRI <98, low; GNRI ≥98, high), and the impacts of GNRI on OS and cancer‐specific survival (CSS) were evaluated using Cox hazards analysis. Results GNRI showed superior discrimination and predictive ability for OS as compared with other indices. There were 447 (38.3%) and 719 (61.7%) patients in the low‐ and high‐GNRI groups, respectively. Patients with low GNRI were older and had a higher pStage III disease rate than those with high GNRI ( P < .001). OS curves were significantly stratified by GNRI in all patients ( P < .001) and those with pStage I ( P < .001), II ( P < .001), and III ( P = .02) disease. Multivariate analysis showed low GNRI to be independently associated with poor OS (hazard ratio [HR], 2.15; 95% CI, 1.612.87; P < .001). Furthermore, low GNRI was an independent predictor of poor CSS (HR, 1.61; 95% CI, 1.072.44; P = .02), as were total gastrectomy ( P < .001) and pStage III disease ( P < .001). Patients who had low GNRI and underwent total gastrectomy showed quite poor 5‐year OS (54.8%). Conclusion GNRI is useful for predicting survival and oncological outcomes in GC patients.