Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive‐stage disease small cell lung cancer: Results from a randomized controlled trial
Background Clinical impact of the Geriatric Nutritional Risk Index (GNRI) in patients with extensive‐stage disease small cell lung cancer (ED‐SCLC) have not previously been reported. Methods This study analyzed 352 patients enrolled in a previous randomized phase III trial comparing the efficacy of...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.13229 |
| _version_ | 1811310015461457920 |
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| author | Gyeong‐Won Lee Se‐Il Go Dong‐Wan Kim Hoon‐Gu Kim Joo‐Hang Kim Ho Jung An Joung Soon Jang Bong‐Seog Kim Seokyung Hahn Dae Seog Heo |
| author_facet | Gyeong‐Won Lee Se‐Il Go Dong‐Wan Kim Hoon‐Gu Kim Joo‐Hang Kim Ho Jung An Joung Soon Jang Bong‐Seog Kim Seokyung Hahn Dae Seog Heo |
| author_sort | Gyeong‐Won Lee |
| collection | DOAJ |
| description | Background Clinical impact of the Geriatric Nutritional Risk Index (GNRI) in patients with extensive‐stage disease small cell lung cancer (ED‐SCLC) have not previously been reported. Methods This study analyzed 352 patients enrolled in a previous randomized phase III trial comparing the efficacy of irinotecan plus cisplatin with that of etoposide plus cisplatin as the first‐line therapy for ED‐SCLC. GNRI values were calculated using serum albumin levels and actual and ideal bodyweights. Patients with a GNRI > 98, 92–98, and <92 were grouped into no, low, and moderate/major risk groups, respectively. Results The objective response rates were 63.2%, 52.6%, and 49.2% in the no, low, and moderate/major risk groups, respectively (P = 0.024). The median progression‐free survival (PFS) was shorter in patients with a lower GNRI than in those with a higher GNRI (no vs. low vs. moderate/major risk group; 6.5 vs. 5.8 vs. 5.9 months, respectively; P = 0.028). There were significant differences in median overall survival (OS) according to GNRI (no vs. low vs. moderate/major risk group; 13.2 vs. 10.3 vs. 8.4 months, respectively; P < 0.001). Multivariate analysis revealed that being in the moderate/major risk group was an independent poor prognostic factor for PFS (hazard ratio [HR]: 1.300, 95% confidence interval [CI]: 1.012–1.670; P = 0.040) and OS (HR: 1.539; 95% CI: 1.069–2.216; P = 0.020). Conclusions This prospective study shows that a low GNRI value was associated with a poor prognosis, and it supports the relationship between systemic inflammation, nutritional status, and clinical outcomes in patients with ED‐SCLC.Key points Significant findings of the study The lower GNRI group had a low response rate to chemotherapy for ED‐SCLC. The HRs for PFS and OS were 1.300 and 1.539 in the patients with GNRI < 92. What this study adds Low GNRI is associated with poor prognosis in ED‐SCLC. |
| first_indexed | 2024-04-13T09:52:22Z |
| format | Article |
| id | doaj.art-ca7394c18f2a454aad37585d966601d6 |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-04-13T09:52:22Z |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-ca7394c18f2a454aad37585d966601d62022-12-22T02:51:34ZengWileyThoracic Cancer1759-77061759-77142020-01-01111627110.1111/1759-7714.13229Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive‐stage disease small cell lung cancer: Results from a randomized controlled trialGyeong‐Won Lee0Se‐Il Go1Dong‐Wan Kim2Hoon‐Gu Kim3Joo‐Hang Kim4Ho Jung An5Joung Soon Jang6Bong‐Seog Kim7Seokyung Hahn8Dae Seog Heo9Department of Internal Medicine Gyeongsang National University Hospital, Gyeongsang National University School of Medicine Jinju KoreaDepartment of Internal Medicine Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine Changwon KoreaDepartment of Internal Medicine Seoul National University Hospital Seoul KoreaDepartment of Internal Medicine Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine Changwon KoreaDepartment of Internal Medicine, Division of Medical Oncology CHA Bundang Medical Center, CHA University Seongnam KoreaDivision of Medical Oncology, Department of Internal Medicine St. Vincent's Hospital, College of Medicine, The Catholic University of Korea Seoul KoreaDivision of Hematology/Oncology, Department of Internal Medicine Chung‐Ang University College of Medicine Seoul KoreaDivision of Hemato‐Oncology, Department of Internal Medicine Veterans Health Service Medical Center Seoul KoreaMedical Research Collaborating Center Seoul National University College of Medicine Seoul KoreaDepartment of Internal Medicine Seoul National University Hospital Seoul KoreaBackground Clinical impact of the Geriatric Nutritional Risk Index (GNRI) in patients with extensive‐stage disease small cell lung cancer (ED‐SCLC) have not previously been reported. Methods This study analyzed 352 patients enrolled in a previous randomized phase III trial comparing the efficacy of irinotecan plus cisplatin with that of etoposide plus cisplatin as the first‐line therapy for ED‐SCLC. GNRI values were calculated using serum albumin levels and actual and ideal bodyweights. Patients with a GNRI > 98, 92–98, and <92 were grouped into no, low, and moderate/major risk groups, respectively. Results The objective response rates were 63.2%, 52.6%, and 49.2% in the no, low, and moderate/major risk groups, respectively (P = 0.024). The median progression‐free survival (PFS) was shorter in patients with a lower GNRI than in those with a higher GNRI (no vs. low vs. moderate/major risk group; 6.5 vs. 5.8 vs. 5.9 months, respectively; P = 0.028). There were significant differences in median overall survival (OS) according to GNRI (no vs. low vs. moderate/major risk group; 13.2 vs. 10.3 vs. 8.4 months, respectively; P < 0.001). Multivariate analysis revealed that being in the moderate/major risk group was an independent poor prognostic factor for PFS (hazard ratio [HR]: 1.300, 95% confidence interval [CI]: 1.012–1.670; P = 0.040) and OS (HR: 1.539; 95% CI: 1.069–2.216; P = 0.020). Conclusions This prospective study shows that a low GNRI value was associated with a poor prognosis, and it supports the relationship between systemic inflammation, nutritional status, and clinical outcomes in patients with ED‐SCLC.Key points Significant findings of the study The lower GNRI group had a low response rate to chemotherapy for ED‐SCLC. The HRs for PFS and OS were 1.300 and 1.539 in the patients with GNRI < 92. What this study adds Low GNRI is associated with poor prognosis in ED‐SCLC.https://doi.org/10.1111/1759-7714.13229Cachexiainflammationnutrition assessmentsmall cell lung carcinoma |
| spellingShingle | Gyeong‐Won Lee Se‐Il Go Dong‐Wan Kim Hoon‐Gu Kim Joo‐Hang Kim Ho Jung An Joung Soon Jang Bong‐Seog Kim Seokyung Hahn Dae Seog Heo Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive‐stage disease small cell lung cancer: Results from a randomized controlled trial Thoracic Cancer Cachexia inflammation nutrition assessment small cell lung carcinoma |
| title | Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive‐stage disease small cell lung cancer: Results from a randomized controlled trial |
| title_full | Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive‐stage disease small cell lung cancer: Results from a randomized controlled trial |
| title_fullStr | Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive‐stage disease small cell lung cancer: Results from a randomized controlled trial |
| title_full_unstemmed | Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive‐stage disease small cell lung cancer: Results from a randomized controlled trial |
| title_short | Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive‐stage disease small cell lung cancer: Results from a randomized controlled trial |
| title_sort | geriatric nutritional risk index as a prognostic marker in patients with extensive stage disease small cell lung cancer results from a randomized controlled trial |
| topic | Cachexia inflammation nutrition assessment small cell lung carcinoma |
| url | https://doi.org/10.1111/1759-7714.13229 |
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