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The preoperative geriatric nutritional risk index predicts long-term prognosis in elderly locally advanced rectal cancer patients: a two-center retrospective cohort study.
- Source :
- Aging Clinical & Experimental Research; Feb2023, Vol. 35 Issue 2, p311-321, 11p
- Publication Year :
- 2023
-
Abstract
- Background: The objective is to explore the value of preoperative geriatric nutritional risk index (GNRI) in evaluating long-term prognosis in elderly locally advanced rectal cancer (LARC) patients who accepted neoadjuvant chemoradiotherapy (NCRT) and to compare GNRI with established nutritional markers, including prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score. Methods: Preoperative GNRI was retrospectively assessed in 172 LARC patients aged ≥ 60 years who underwent radical resection after NCRT at two centers. Optimal cutoff value of GNRI was determined by X-tile program. The association of GNRI with clinicopathological parameters and nutritional markers was analyzed. The survival ability of markers was evaluated using time-dependent receiver-operating characteristic (ROC) curve analysis. Finally, survival analysis was performed using Kaplan–Meier and Cox regression analysis. Results: GNRI was highly correlated with nutritional markers. An optimal cutoff value for the GNRI was 96. In the time-dependent ROC curve, GNRI demonstrated a stable predictive ability for both disease-free survival (DFS) and overall survival (OS). Multivariate analysis showed that GNRI was the only nutritional marker that independently predicted DFS (HR 2.457, 95% CI 1.066–5.665, P = 0.035) and OS (HR 9.002, 95% CI 3.100–26.146, P < 0.001). As an additional benefit, GNRI was able to stratify survival in subgroups of ypTNM and tumor response. Conclusion: Preoperative GNRI is a promising predictor of long-term survival for elderly LARC patients undergoing NCRT, superior to the established nutritional markers. [ABSTRACT FROM AUTHOR]
- Subjects :
- PREOPERATIVE care
BIOMARKERS
RESEARCH
CONFIDENCE intervals
NUTRITION disorders
RECTUM tumors
RESEARCH methodology evaluation
RESEARCH methodology
MULTIVARIATE analysis
GERIATRIC nutrition
GERIATRIC assessment
ACQUISITION of data
RETROSPECTIVE studies
ADJUVANT treatment of cancer
CHEMORADIOTHERAPY
RISK assessment
CANCER patients
COMPARATIVE studies
MEDICAL records
KAPLAN-Meier estimator
DESCRIPTIVE statistics
RESEARCH funding
COMBINED modality therapy
RECEIVER operating characteristic curves
PROGRESSION-free survival
LONGITUDINAL method
PROPORTIONAL hazards models
OVERALL survival
DISEASE risk factors
OLD age
Subjects
Details
- Language :
- English
- ISSN :
- 15940667
- Volume :
- 35
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Aging Clinical & Experimental Research
- Publication Type :
- Academic Journal
- Accession number :
- 161655175
- Full Text :
- https://doi.org/10.1007/s40520-022-02297-4