Impact of geriatric nutritional risk index on outcomes after gastrectomy in elderly patients with gastric cancer: a retrospective multicenter study in Japan
Abstract Background Several studies investigated the utility of inflammation and nutritional markers in predicting the prognosis in patients with gastric cancer; however, the markers with the best predictive ability remain unclear. This retrospective study aimed to determine inflammation and nutriti...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-022-09638-6 |
| _version_ | 1818202446888960000 |
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| author | Tomoyuki Matsunaga Hiroaki Saito Tomohiro Osaki Sadamu Takahashi Akemi Iwamoto Kenji Fukuda Kenjiro Taniguchi Hirohiko Kuroda Tsutomu Takeuchi Kenji Sugamura Kenichi Sumi Kuniyuki Katano Yuji Shishido Kozo Miyatani Yoshiyuki Fujiwara |
| author_facet | Tomoyuki Matsunaga Hiroaki Saito Tomohiro Osaki Sadamu Takahashi Akemi Iwamoto Kenji Fukuda Kenjiro Taniguchi Hirohiko Kuroda Tsutomu Takeuchi Kenji Sugamura Kenichi Sumi Kuniyuki Katano Yuji Shishido Kozo Miyatani Yoshiyuki Fujiwara |
| author_sort | Tomoyuki Matsunaga |
| collection | DOAJ |
| description | Abstract Background Several studies investigated the utility of inflammation and nutritional markers in predicting the prognosis in patients with gastric cancer; however, the markers with the best predictive ability remain unclear. This retrospective study aimed to determine inflammation and nutritional markers that predicted prognosis in elderly patients over 75 years of age undergoing curative gastrectomy for gastric cancer. Methods Between January 2005 and December 2015, 497 consecutive elderly gastric cancer patients aged over 75 years underwent curative gastrectomy in 12 institutions. The geriatric nutritional risk index (GNRI), prognostic nutritional index, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and C-reactive protein/albumin ratio were examined as prognostic markers for overall survival (OS) and disease-specific survival (DSS) using area under the curve (AUC) using receiver operating characteristic (ROC) curve analysis. Results The GNRI had the highest AUC and predictive value for both OS (0.637, p < 0.001) and DSS (AUC 0.645, p < 0.001). The study cohort was categorized into the high and low GNRI groups based on the optimal GNRI cut-off values for OS (97.0) and DSS (95.8) determined with the ROC analysis. For both OS and DSS, there was a significant correlation between the GNRI and several clinicopathological factors including age, body mass index, albumin, American Society of Anesthesiologists physical status score, depth of tumor invasion, lymph node metastasis, lymphatic invasion, pathological stage, operation duration, bleeding, procedure, approach, death due to primary disease, and death due to other disease. The GNRI remained a crucial independent prognostic factor for both OS (Hazard ratio [HR] = 1.905, p < 0.001) and DSS in multivariate analysis (HR = 1.780, p = 0.043). Conclusions Among a panel of inflammation and nutritional markers, the GNRI exhibited the best performance as a prognostic factor after curative gastrectomy in elderly patients with gastric cancer, indicating its utility as a simple and promising index for predicting OS and DSS in these patients. |
| first_indexed | 2024-12-12T03:09:35Z |
| format | Article |
| id | doaj.art-609ebda25dec4693a4fc69e60bce6c11 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-12T03:09:35Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-609ebda25dec4693a4fc69e60bce6c112022-12-22T00:40:26ZengBMCBMC Cancer1471-24072022-05-0122111010.1186/s12885-022-09638-6Impact of geriatric nutritional risk index on outcomes after gastrectomy in elderly patients with gastric cancer: a retrospective multicenter study in JapanTomoyuki Matsunaga0Hiroaki Saito1Tomohiro Osaki2Sadamu Takahashi3Akemi Iwamoto4Kenji Fukuda5Kenjiro Taniguchi6Hirohiko Kuroda7Tsutomu Takeuchi8Kenji Sugamura9Kenichi Sumi10Kuniyuki Katano11Yuji Shishido12Kozo Miyatani13Yoshiyuki Fujiwara14Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of MedicineDepartment of Surgery, Japanese Red Cross Tottori HospitalDepartment of Surgery, Tottori Prefectural Central HospitalNational Hospital Organization, Hamada Medical CenterDivisions of Digestive Surgery, Tottori Prefectural Kousei HospitalDepartment of Surgery, Sanin Rosai HospitalDepartment of Surgery, Yonago Medical Center of National Hospital OrganizationDepartment of Surgery, Japanese Red Cross Masuda HospitalDepartment of Surgery, Tottori Seikyo HospitalDepartment of Surgery, Yasugi Municipal HospitalDepartment of Surgery, Hakuai HospitalDepartment of Surgery, The Nanbu Town National Health Insurance Saihaku HospitalDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of MedicineDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of MedicineDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of MedicineAbstract Background Several studies investigated the utility of inflammation and nutritional markers in predicting the prognosis in patients with gastric cancer; however, the markers with the best predictive ability remain unclear. This retrospective study aimed to determine inflammation and nutritional markers that predicted prognosis in elderly patients over 75 years of age undergoing curative gastrectomy for gastric cancer. Methods Between January 2005 and December 2015, 497 consecutive elderly gastric cancer patients aged over 75 years underwent curative gastrectomy in 12 institutions. The geriatric nutritional risk index (GNRI), prognostic nutritional index, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and C-reactive protein/albumin ratio were examined as prognostic markers for overall survival (OS) and disease-specific survival (DSS) using area under the curve (AUC) using receiver operating characteristic (ROC) curve analysis. Results The GNRI had the highest AUC and predictive value for both OS (0.637, p < 0.001) and DSS (AUC 0.645, p < 0.001). The study cohort was categorized into the high and low GNRI groups based on the optimal GNRI cut-off values for OS (97.0) and DSS (95.8) determined with the ROC analysis. For both OS and DSS, there was a significant correlation between the GNRI and several clinicopathological factors including age, body mass index, albumin, American Society of Anesthesiologists physical status score, depth of tumor invasion, lymph node metastasis, lymphatic invasion, pathological stage, operation duration, bleeding, procedure, approach, death due to primary disease, and death due to other disease. The GNRI remained a crucial independent prognostic factor for both OS (Hazard ratio [HR] = 1.905, p < 0.001) and DSS in multivariate analysis (HR = 1.780, p = 0.043). Conclusions Among a panel of inflammation and nutritional markers, the GNRI exhibited the best performance as a prognostic factor after curative gastrectomy in elderly patients with gastric cancer, indicating its utility as a simple and promising index for predicting OS and DSS in these patients.https://doi.org/10.1186/s12885-022-09638-6Elderly patientGastric cancerPrognosisGeriatric nutritional risk index |
| spellingShingle | Tomoyuki Matsunaga Hiroaki Saito Tomohiro Osaki Sadamu Takahashi Akemi Iwamoto Kenji Fukuda Kenjiro Taniguchi Hirohiko Kuroda Tsutomu Takeuchi Kenji Sugamura Kenichi Sumi Kuniyuki Katano Yuji Shishido Kozo Miyatani Yoshiyuki Fujiwara Impact of geriatric nutritional risk index on outcomes after gastrectomy in elderly patients with gastric cancer: a retrospective multicenter study in Japan BMC Cancer Elderly patient Gastric cancer Prognosis Geriatric nutritional risk index |
| title | Impact of geriatric nutritional risk index on outcomes after gastrectomy in elderly patients with gastric cancer: a retrospective multicenter study in Japan |
| title_full | Impact of geriatric nutritional risk index on outcomes after gastrectomy in elderly patients with gastric cancer: a retrospective multicenter study in Japan |
| title_fullStr | Impact of geriatric nutritional risk index on outcomes after gastrectomy in elderly patients with gastric cancer: a retrospective multicenter study in Japan |
| title_full_unstemmed | Impact of geriatric nutritional risk index on outcomes after gastrectomy in elderly patients with gastric cancer: a retrospective multicenter study in Japan |
| title_short | Impact of geriatric nutritional risk index on outcomes after gastrectomy in elderly patients with gastric cancer: a retrospective multicenter study in Japan |
| title_sort | impact of geriatric nutritional risk index on outcomes after gastrectomy in elderly patients with gastric cancer a retrospective multicenter study in japan |
| topic | Elderly patient Gastric cancer Prognosis Geriatric nutritional risk index |
| url | https://doi.org/10.1186/s12885-022-09638-6 |
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