Abstract
Background Geriatric Nutritional Risk Index (GNRI) has been widely used to assess the nutritional status in a variety of human pathological conditions, but the prognostic value of the GNRI in malignancies has not been evinced. Methods Relevant studies updated on Jul 27, 2019, were retrieved in available databases, including PubMed, Web of Science, Cochrane library, Chinese CNKI, and Chinese Wan-fang. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted and pooled by using STATA 14. Results A total of 15 studies involving 8,046 subjects were included in this meta-analysis. Meta-analysis results evinced that low GNRI was associated with poor OS (HR = 1.95, 95% CI: 1.49-2.56, p ≤ 0.001), poor CSS (HR = 1.81, 95% CI: 1.49-2.19, p ≤ 0.001), poor DFS (HR = 1.67, 95% CI: 1.28-2.17, p ≤ 0.001), and poor PFS (HR = 1.68, 95% CI: 1.28-2.21, p ≤ 0.001), and the correlation of GNRI with OS was not changed when stratified by possible confounding factors, suggesting that malignancy patients with low GNRI would suffer from reduced survival rate and increased recurrence rate. Moreover, low GNRI was also associated with postoperative complications in malignancies. Conclusions In summary, GNRI is associated poor prognosis in human malignancies, and GNRI should be used as a predictive indicator of adverse outcomes during malignancy treatment.
Highlights
In 2005, Bouillanne et al created a new index of malnutrition, called the Geriatric Nutritional Risk Index (GNRI), which is based on three parameters: height, body weight, and serum albumin level
Five studies were based on patients with hematological malignant tumors [15,16,17,18,19], 4 studies were based on esophageal cancers [20,21,22,23], 2 studies were based on renal cell carcinoma [24, 25], and 4 studies were based on hepatocellular carcinoma, prostate cancer, pancreatic cancer, and lung cancer respectively [26,27,28,29]
When compared with Mini Nutritional Assessment (MNA) validated for grading nutritional status in the elderly, the GNRI has been reported to show poor agreement in nutritional assessment but appeared to better predict outcome [31]. This present meta-analysis firstly evinced that lower GNRI is associated with poor prognosis in human malignancies
Summary
In 2005, Bouillanne et al created a new index of malnutrition, called the Geriatric Nutritional Risk Index (GNRI), which is based on three parameters: height, body weight, and serum albumin level. Thereafter, the GNRI has been widely used to assess the nutritional status and reported to be associated with adverse outcomes in a variety of human pathological conditions. Geriatric Nutritional Risk Index (GNRI) has been widely used to assess the nutritional status in a variety of human pathological conditions, but the prognostic value of the GNRI in malignancies has not been evinced. Meta-analysis results evinced that low GNRI was associated with poor OS (HR = 1:95, 95% CI: 1.49-2.56, p ≤ 0:001), poor CSS (HR = 1:81, 95% CI: 1.49-2.19, p ≤ 0:001), poor DFS (HR = 1:67, 95% CI: 1.28-2.17, p ≤ 0:001), and poor PFS (HR = 1:68, 95% CI: 1.28-2.21, p ≤ 0:001), and the correlation of GNRI with OS was not changed when stratified by possible confounding factors, suggesting that malignancy patients with low GNRI would suffer from reduced survival rate and increased recurrence rate. GNRI is associated poor prognosis in human malignancies, and GNRI should be used as a predictive indicator of adverse outcomes during malignancy treatment
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