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Abstract
BackgroundThe geriatric nutritional risk index (GNRI), originally developed as a nutritional assessment tool to evaluate mortality and morbidity in older hospitalized patients (i.e., those aged ≥65 years), is regarded as a prognostic factor in several cancers. Body composition is also an important consideration when predicting the prognosis of patients with cancer. This study aimed to investigate the relationship between the GNRI and psoas muscle volume (PMV) for survival outcomes in patients with pancreatic cancer.MethodsThis retrospective study evaluated the prognostic significance of the GNRI and PMV in 105 consecutive patients aged ≥65 years who underwent pancreatectomy for histologically confirmed pancreatic cancer. The patients were divided into high (GNRI > 98) and low GNRI groups (GNRI ≤98), and into high (PMV > 61.5 mm3/m3 for men and 44.1 mm3/m3 for women) and low PMV (PMV ≤ 61.5 mm3/m3 for men and 44.1 mm3/m3 for women) groups.ResultsBoth the 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly greater among patients in the high GNRI group than among patients in the low GNRI group. Similarly, both the 5-year OS and RFS rates were significantly greater among patients in the high PMV group than among patients in the low PMV group. Patients were stratified into three groups: those with both high GNRI and high PMV; those with either high GNRI or high PMV (but not both); and those with both low GNRI and low PMV. Patients with both low GNRI and low PMV had a worse 5-year OS rate, compared with patients in other groups (P < 0.001). The C-index of the combination of the GNRI and PMV for predicting 5-year OS was greater than the C-indices of either the GNRI or PMV alone. Multivariate analysis revealed that the combination of the GNRI and PMV was an independent prognostic factor in patients aged ≥65 years with pancreatic cancer (P = 0.003).ConclusionsThe combination of the GNRI and PMV might be useful to predict prognosis in patients aged ≥65 years with pancreatic cancer.
Highlights
The geriatric nutritional risk index (GNRI), originally developed as a nutritional assessment tool to evaluate mortality and morbidity in older hospitalized patients, is regarded as a prognostic factor in several cancers
Based on the GNRI and psoas muscle volume (PMV) cutoff values, the patients were grouped as high GNRI (GNRI > 98, n = 55) or low GNRI (GNRI ≤98, n = 50), and as high PMV (PMV > 61.5 mm3/m3 for men and 44.1 mm3/m3 for women; n = 60) or low PMV (PMV ≤ 61.5 mm3/m3 for men and 44.1 mm3/m3 for women; n = 45)
This study demonstrated that both GNRI and PMV were associated with the prognosis of older patients with pancreatic cancer
Summary
The geriatric nutritional risk index (GNRI), originally developed as a nutritional assessment tool to evaluate mortality and morbidity in older hospitalized patients (i.e., those aged ≥65 years), is regarded as a prognostic factor in several cancers. The evaluation of nutritional status and body composition in patients with cancer have received attention in the context of survival outcomes; their potential prognostic values have been reported in various malignant diseases. The geriatric nutritional risk index (GNRI), first reported by Bouillanne et al, is a novel and wellestablished objective nutritional assessment tool for the prediction of malnutrition-related risks of mortality and morbidity, including infection and bedsores, in hospitalized older patients (i.e., those aged ≥65 years) [1]. Malnutrition causes secondary sarcopenia, which suggests that the close relationship between nutrition status and body composition may affect survival outcomes in patients with cancer
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