Abstract
The world is becoming longer-lived, and the number of elderly colorectal cancer patients is increasing. It is very important to identify simple and inexpensive postoperative predictors in elderly colorectal cancer patients. The geriatric nutritional risk index (GNRI) is a marker of systemic nutrition and is associated with poor survival in various kinds of cancers. A few reports have investigated recurrence factors using preoperative GNRI with CRC (colorectal cancer) patients. This study aimed to investigate whether preoperative GNRI is associated with recurrence-free survival (RFS) and overall survival (OS) in elderly patients with CRC. This study retrospectively enrolled 259 patients with Stage I–III CRC who were more than 65 years old and underwent curative surgery at a single institution in 2012–2017. We classified them into low GNRI (RFS: ≤ 90.5, OS ≤ 101.1) group and high GNRI (RFS: > 90.5, OS > 101.1) group. Multivariable analyses showed low GNRI group was an independent risk factor for 3-year RFS (P = 0.006) and OS (P = 0.001) in the patients with CRC. Kaplan–Meier analysis showed 3-year RFS and 3-year OS were significantly worse in the low GNRI group than in high GNRI group (p = 0.001, 0.0037). A low-preoperative GNRI was significantly associated with a poor prognosis in elderly CRC patients.
Highlights
It has been widely accepted that geriatric nutritional risk index (GNRI) (Geriatric Nutritional Risk Index) is strongly associated with mortality in elderly patients with various cancers[4–6]
This study investigated whether GNRI is a useful predictor of recurrence and long-term survival in elderly patients with colorectal cancer who have undergone curative resection
A survival analysis of stage I–III CRC patients who underwent curative surgery revealed that patients with low GNRI had significantly worse 3-year recurrence-free survival (RFS) than those with high GNRI
Summary
Expansion of the worldwide population and elevation of life expectancy have increased the number of elderly individuals[1]. We know that increasing age increases the risk for complications during and after colorectal surgery. Aging itself can reduce physiological recuperative power, aging is an independent risk factor for both in-hospital morbidity and mortality after colorectal s urgery[2,3]. It has been widely accepted that GNRI (Geriatric Nutritional Risk Index) is strongly associated with mortality in elderly patients with various cancers[4–6]. As far as we know, there are few reports on the prognostic significance of GNRI in patients with colorectal cancer. This study investigated whether GNRI is a useful predictor of recurrence and long-term survival in elderly patients with colorectal cancer who have undergone curative resection
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