Geriatric nutritional risk index predicts cancer prognosis in patients with local advanced rectal cancer undergoing chemoradiotherapy followed by curative surgery
Abstract Aim The clinical significance of the geriatric nutritional risk index (GNRI) in locally advanced rectal cancer (LARC) patients undergoing preoperative chemoradiotherapy (CRT) followed by curative surgery has not been comprehensively evaluated. Methods This retrospective study enrolled 93 LA...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-021-02139-z |
| _version_ | 1818615890082529280 |
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| author | Shozo Ide Yoshinaga Okugawa Yusuke Omura Akira Yamamoto Takashi Ichikawa Takahito Kitajima Tadanobu Shimura Hiroki Imaoka Hiroyuki Fujikawa Hiromi Yasuda Takeshi Yokoe Yoshiki Okita Masaki Ohi Yuji Toiyama |
| author_facet | Shozo Ide Yoshinaga Okugawa Yusuke Omura Akira Yamamoto Takashi Ichikawa Takahito Kitajima Tadanobu Shimura Hiroki Imaoka Hiroyuki Fujikawa Hiromi Yasuda Takeshi Yokoe Yoshiki Okita Masaki Ohi Yuji Toiyama |
| author_sort | Shozo Ide |
| collection | DOAJ |
| description | Abstract Aim The clinical significance of the geriatric nutritional risk index (GNRI) in locally advanced rectal cancer (LARC) patients undergoing preoperative chemoradiotherapy (CRT) followed by curative surgery has not been comprehensively evaluated. Methods This retrospective study enrolled 93 LARC patients diagnosed with clinical lymph node metastasis. The GNRI formula was as follows: 1.489 × albumin (g/l) + 41.7 × current weight/ideal weight. Patients were categorized as GNRI low (GNRI < 104.25) or high (GNRI > 104.25) according to the receiver operating characteristic (ROC) curve for survival analysis. The impact of GNRI status on the prognostic outcomes of curative surgery for LARC was examined. Results There were 55 (59.14%) and 38 (40.86%) patients in the GNRI high and low groups, respectively. Of the investigated demographic factors, age, pathological tumor invasion, and presence of recurrence were significantly associated with the GNRI value. In Kaplan–Meier analysis, overall survival (OS) and disease-free survival (DFS) were significantly shorter in the GNRI low group (OS: p = 0.00020, DFS: p = 0.0044, log-rank test). Multivariate analysis using a Cox proportional hazards model showed that a low GNRI was an independent risk factor for poor OS (hazard ratio (HR) = 3.22; 95% confidence interval (CI), 1.37–8.23; p = 0.0068) and DFS (HR = 2.32; 95%CI = 1.15–4.79; p = 0.018). Although use of adjuvant therapy has no impact on prognosis (OS: p = 0.26, DFS: p = 0.29), low GNRI showed shorter OS and DFS in patients with pathological lymph node metastasis [ypN(+)] (OS: p = 0.033, DFS: p = 0.032, log-rank test). Conclusions GNRI is a useful marker for LARC patients diagnosed with clinical lymph node metastasis and treated by preoperative CRT followed by curative surgery. GNRI is a useful tool to identify high risk of recurrence for improving the survival in LARC patients. |
| first_indexed | 2024-12-16T16:41:05Z |
| format | Article |
| id | doaj.art-ad39f9696fe64308babe5cd4270c392e |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-16T16:41:05Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
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| series | World Journal of Surgical Oncology |
| spelling | doaj.art-ad39f9696fe64308babe5cd4270c392e2022-12-21T22:24:19ZengBMCWorld Journal of Surgical Oncology1477-78192021-01-0119111010.1186/s12957-021-02139-zGeriatric nutritional risk index predicts cancer prognosis in patients with local advanced rectal cancer undergoing chemoradiotherapy followed by curative surgeryShozo Ide0Yoshinaga Okugawa1Yusuke Omura2Akira Yamamoto3Takashi Ichikawa4Takahito Kitajima5Tadanobu Shimura6Hiroki Imaoka7Hiroyuki Fujikawa8Hiromi Yasuda9Takeshi Yokoe10Yoshiki Okita11Masaki Ohi12Yuji Toiyama13Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of MedicineAbstract Aim The clinical significance of the geriatric nutritional risk index (GNRI) in locally advanced rectal cancer (LARC) patients undergoing preoperative chemoradiotherapy (CRT) followed by curative surgery has not been comprehensively evaluated. Methods This retrospective study enrolled 93 LARC patients diagnosed with clinical lymph node metastasis. The GNRI formula was as follows: 1.489 × albumin (g/l) + 41.7 × current weight/ideal weight. Patients were categorized as GNRI low (GNRI < 104.25) or high (GNRI > 104.25) according to the receiver operating characteristic (ROC) curve for survival analysis. The impact of GNRI status on the prognostic outcomes of curative surgery for LARC was examined. Results There were 55 (59.14%) and 38 (40.86%) patients in the GNRI high and low groups, respectively. Of the investigated demographic factors, age, pathological tumor invasion, and presence of recurrence were significantly associated with the GNRI value. In Kaplan–Meier analysis, overall survival (OS) and disease-free survival (DFS) were significantly shorter in the GNRI low group (OS: p = 0.00020, DFS: p = 0.0044, log-rank test). Multivariate analysis using a Cox proportional hazards model showed that a low GNRI was an independent risk factor for poor OS (hazard ratio (HR) = 3.22; 95% confidence interval (CI), 1.37–8.23; p = 0.0068) and DFS (HR = 2.32; 95%CI = 1.15–4.79; p = 0.018). Although use of adjuvant therapy has no impact on prognosis (OS: p = 0.26, DFS: p = 0.29), low GNRI showed shorter OS and DFS in patients with pathological lymph node metastasis [ypN(+)] (OS: p = 0.033, DFS: p = 0.032, log-rank test). Conclusions GNRI is a useful marker for LARC patients diagnosed with clinical lymph node metastasis and treated by preoperative CRT followed by curative surgery. GNRI is a useful tool to identify high risk of recurrence for improving the survival in LARC patients.https://doi.org/10.1186/s12957-021-02139-zRectal cancerGeriatric nutritional indexChemoradiotherapyPrognosis |
| spellingShingle | Shozo Ide Yoshinaga Okugawa Yusuke Omura Akira Yamamoto Takashi Ichikawa Takahito Kitajima Tadanobu Shimura Hiroki Imaoka Hiroyuki Fujikawa Hiromi Yasuda Takeshi Yokoe Yoshiki Okita Masaki Ohi Yuji Toiyama Geriatric nutritional risk index predicts cancer prognosis in patients with local advanced rectal cancer undergoing chemoradiotherapy followed by curative surgery World Journal of Surgical Oncology Rectal cancer Geriatric nutritional index Chemoradiotherapy Prognosis |
| title | Geriatric nutritional risk index predicts cancer prognosis in patients with local advanced rectal cancer undergoing chemoradiotherapy followed by curative surgery |
| title_full | Geriatric nutritional risk index predicts cancer prognosis in patients with local advanced rectal cancer undergoing chemoradiotherapy followed by curative surgery |
| title_fullStr | Geriatric nutritional risk index predicts cancer prognosis in patients with local advanced rectal cancer undergoing chemoradiotherapy followed by curative surgery |
| title_full_unstemmed | Geriatric nutritional risk index predicts cancer prognosis in patients with local advanced rectal cancer undergoing chemoradiotherapy followed by curative surgery |
| title_short | Geriatric nutritional risk index predicts cancer prognosis in patients with local advanced rectal cancer undergoing chemoradiotherapy followed by curative surgery |
| title_sort | geriatric nutritional risk index predicts cancer prognosis in patients with local advanced rectal cancer undergoing chemoradiotherapy followed by curative surgery |
| topic | Rectal cancer Geriatric nutritional index Chemoradiotherapy Prognosis |
| url | https://doi.org/10.1186/s12957-021-02139-z |
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